Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Outside Observations

Understanding, predicting and controlling human behavior is both an art and a science. Most people can learn the science. It is merely data. There is nothing magic about astrophysics or neurosurgery. It is merely the acquisition of data, usually in a classroom which ultimately leads to the granting of a degree in the field.

However, there are unquestionably people with such keen sensitivity (the “art”) that even though they lack that degree, they can pinpoint precisely what is happening and what the patient will do next.

While paraprofessional observations may not be permitted as part of the formal medical records, that does not, in any way, mean that the observations and concerns have no validity. Such input is invaluable since some may have far more opportunity to observe the patient and even have more access to relevant data than someone who has, or is about to, examine the patient.

One of the most concerning problems in patient care arises when someone is examining or treating a patient yet does not have the benefit of the data that you have gathered. A clinician may see the patient arrive with numerous pain behaviors and seemingly obtunded by pain. He may not be aware that these behaviors were not exhibited consistently in other settings.

It is a rare clinician who would not wish to have doubts, suspicions and concerns shared. On the other end of that extreme is that the clinician may receive very negative (and invalid) impressions from his referral source who did not communicate well with the patient. Those negative observations may not have been valid.

Without all input, the clinician may erroneously believe that the patient’s complaints have no merit when, in fact, the only problem was the relationship the patient had with the previous doctor.

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