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Explore the significance of Michael Balint in healthcare, focusing on the doctor's role as a therapeutic tool and the dynamics of Balint groups. Learn to prescribe yourself as a 'drug doctor' and navigate common challenges and benefits in patient care.
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Unlocking Balint & the ‘Drug Doctor’ Courtesy of Emma Hardwick GPR 2008
Why is he important? • The Doctor, his Patient and the Illness • Understanding the physical, psychological, social aspects of the consultation • Balint groups • A doctor’s apostolic function • An entry ticket • A hidden agenda • The collusion of anonymity • The “drug doctor” • The mutual investment fund
Work in pairs and discuss what you understand by these terms
A doctor’s apostolic function • An entry ticket • A hidden agenda • The collusion of anonymity • The “drug doctor” • Balint groups • The mutual investment fund
Mechanism of action You can help by being: • Supportive • Informative • Catalytic • Cathartic
Prescribing yourself as a drug Working in pairs consider the: • Indications • Dose • Side effects
Prescribing the Doctor – When? Potential indications – to help tackle/alleviate: • Multiple problems (often insoluble) • Multiple attendances • Multiple referrals to no avail • Multiple treatments (tried & failed) • Heart sinks • Persisting patient uncertainty or concern
Prescribing the Doctor – How? You have to utilise/explore: • Your advanced consultation skills • Active listening • Picking up and using cues • Building rapport • Empathy • Triangular thinking • Ideas Concerns and Expectations
Prescribing the doctor – common problems • If the doctor doesn’t realise they are the drug and therefore does not understand why the patient keeps re-attending • Time constraints (long and sometimes multiple consultations) • Differing agendas between patient & doctor
Prescribing the doctor – side effects • Encouraging doctor dependency • Transference – negative emotions engendered in the patient being transferred to the GP • Counter transference – negative emotions (expressed by the patient) are engendered in the GP and are reflected back by the GP to the patient
Summary • The doctor as a drug is a powerful tool • Be aware of when it can be effective • Utilise consultation skills to make the most of this therapy • Remember that there may be pitfalls for both patient and doctor
Balint Groups – The Bradford Way • A small group(6-12) • The material of the group is based on the presentation of current cases giving the clinician cause for thought • Not necessarily limited to problem cases but can include ones which have intrigued, interested, maybe disturbed • The purpose of the group is to increase understanding of the patient's problems, not to find solutions • The discussion focuses on the relationship between the presenting doctor and his patient
Balint Groups • Standard rules for small group working apply • The facilitator takes ultimate responsibility for trying to ensure that the group functions!
