RxISK Map: Relationship Based Medicine

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November 14, 2017 | 13 Comments

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  1. It would be great to see the Rxisk map with a growing number of doctors who offer relationship based medicine in the way we see the map for Rxisk Prize donations.

    In my attempts to get a doctor onto the map, which I guess I’ve often confused with trying to influence someone prone to not hearing, I have found myself having distressing emotional reactions to doctors who are staunchly committed to the status quo. Out of a desire to never feel that powerless again, I somewhat abandoned the idea, at least until I could get my bearings. (Very similar to the feelings expressed by Uma Thurman when she speaks about Harvey Weinstein https://www.youtube.com/watch?v=RkraTK7-Rew ).

    I guess a good point can be made for simply stepping over the mess to find the professionals who care enough to put themselves on the line. I may know one (in functional medicine) who considers it a miracle that she’s even allowed to practice where she is within the current system. I don’t know if this means her higher ups would negatively influence a decision to back up her patient but we’re about to find out.

  2. If you want to follow my Run Against Castration updates in support of the Rxisk Prize

    you can here: Twitter https://twitter.com/alan_johnson555 Facebook https://www.facebook.com/runagainstcastration Website http://runagainstcastration.wordpress.com

    You can help raise awareness by sharing, I am posting my runs. This is probably a good one to share

    https://twitter.com/alan_johnson555/status/930494460701675520

    https://www.facebook.com/runagainstcastration/photos/a.161270201141392.1073741827.159763301292082/161270094474736/?type=3&theater

    I haven’t added the campaign photo and landing video yet, it’s coming…

  3. A few comments from Tom Poole via Twitter:

    Based on my experience of 26 years: The best approach is giving a patient support and skills so that in time they can better manage their own minds. Depending on diagnosis, drugs often have limited value. Sometimes important. Not always. More of a problem for me. Better without.

    Re: “You are the expert on what is happening to you when it comes to the effects of a drug …”

    For some conditions. You may not be the best judge of the efficacy of powerful drugs which may or may not be helping. Close supervision by trusted support staff does have value – IF they know their game and aren’t just using you as a guinea pig in their clinical trial.

    • I like your reference to ‘close supervision by trusted support staff’ being of value. I couldn’t agree more but, unfortunately, I think the experience of the majority of us brings us to the opposite conclusion – that being, that ‘the lack of supervision by trusted support staff is detrimental to a patient’s mental health’. Lack of staff = lack of support; lack of time = poor support; support staff lack of access to their superiors = lack of patient confidence in the system and doctors’ lack of taking problems seriously = unnecessary death. In this vicious circle, can we see any way out? I suggest that we can. We – the family, carers and friends of patients can, if viewed wisely, be a great asset to tackling this problem. We KNOW the patient almost as well as the patient knows him/herself. We SEE what is happening on a daily basis. We ASSESS the needs according to what we see. We can, independently, record the progress or further lack of such without the emotional burden that the patient may feel. Surely, when support staff are short of time, doctors are dependent on their support staff’s view of matters and only available to their staff in crisis, the availability of information from a third party should be welcomed?
      The only ‘doctor’ that I have come across in the last 15 years who seems to enjoy his work and to have a real interest in his patient is David. Appointments are given (not often – but in a regular pattern which the patient understands) and kept, however the patient is coping at that time. There is no pressure of doctor over patient – it is a friendly chat about how things are going and where THE PATIENT, not the doctor, sees the next hurdle may be, which is then discussed and carried out ACCORDING TO PATIENT’S timetable. Relevant, additional comments from family/ carer/ friend are accepted as part of the whole picture.This is truly ‘Relationship Based Medicine’ in my view. It is so simple in its execution, so refreshingly different and such a relaxing experience that I feel it would be beneficial for many other doctors to take this path in order for their own health to be taken care of. You’ve given us your recent ‘You tube’ videos David – maybe it’s time for a tutorial for other doctors along the same lines. I’m sure I know of a very willing participating patient! If only it were that simple to get doctors to listen and accept that there is an easier way for all to prosper.

  4. A doctor onto the map ..

    Mashhood Syed
    @mashhood

    Husband|Father|Ahmadi Muslim|GP ST3|Budding #FunctionalMedicine Doctor|Graduate AFMCP 2017 #Nutrition #LCHF #JERF #Peace #Languages #Religion. RT ≠ Endorsement

    Mashhood Syed Retweeted
    Data Based Medicine‏ @RxISK Oct 9

    People w/other disabilities can get counseling on sex & relationships. What can we tell folks with drug-induced sexual dysfunction? https://rxisk.org/rxisk-prize-relationships/ … #PSSD

    Mashhood Syed Retweeted
    Data Based Medicine‏ @RxISK Oct 5

    We’re trying to reach huge Pharma cos about RxISK Prize for #PSSD cure. Funny thing: they can be awful hard to reach https://rxisk.org/rxisk-prize-no-nos/ …

    Critical Psychiatry Blogspot
    http://criticalpsychiatry.blogspot.co.uk/2017/09/is-it-better-to-manage-without.html

    cobweb said…
    For those who have not come across it yet David Healy academic and clinical professor of psychiatry and pharmacology runs an open access web site where he raises serious concerns about the prescribing of SSRs. It is open to responses, many have highlighted the serious adverse effects of taking SSRs. See under David Healy blogs.

    cobweb said
    Many users and survivors have realised that anti depressants and ant psychotic drugs were a cause of loss of sexual feeling and infertility. And suspected that that was a welcomed effect by those prescribing them – it would lead of course to fewer children being born to people with mental health problems/illnesses. It can hardly be disputed that the side effects of the ‘newer’ SSRs are causing massive distress because of the long term loss of sexual feelings and therefore an important part of loving relationships. Rxisk (see website on David Healy Blogs) is setting up a novel approach to investigate what is happening to cause these serious sometimes irreversible debilitating effects .As there is no conventional research funding the project needs funds – there is a prize for anybody who comes up with a workable solution. Donations from anybody and of any amount are desperately needed as a few dedicated individuals just cannot afford to fund the project. Even if no donation is made it is vital that people do access the warnings about SSRs and make their decisions.

    cobweb said
    Just to add I have no self interests – am only interested in the ethical and humane treatment of individuals

    Spenden für Preisgeld einer PSSD-Heilung!

    Beitragvon synthiefreak » Samstag, 30.09.17, 2:11

    Hallo!

    Wie vielleicht einige Leute von euch wissen ist PSSD eines der schlimmsten Absetzsymptome der Welt und es gibt immernoch keine Klarheit.

    Nun hat Dr. David Healy (Betreiber von “rxisk”) einen Spendentopf auf seiner Homepage gestartet, welcher 100.000 $ erreichen soll, für denjenigen der eine eindeutig Behandlung bzw. Heilung von PSSD findet.

    Nur wenn jeder von uns PSSD-Patienten oder anderen Menschen die uns helfen wollen sich beteiligt können wir das Ziel erreichen.

    Hier der Link:

    https://rxisk.org/prize/

    Bitte seht das als eine Chance!

    Liebe Grüße, synthiefreak

    http://adfd.org/austausch/viewtopic.php?t=13727#p209941

    • Thanks for passing on the critical psychiatry blog Annie Hadn’t got round to passing it on myself (I am ‘cobweb’ it was an old pseudo-name I haven’t bothered to change). Critical psychiatry blog has been nominated in the best 50 psychiatric blogs so any mention of Rxisk on the site gets a lot of readers .Duncan Double psychiatrist runs the open blog.
      There is an article well worth reading in thebmj this week ‘campaigners vow to fight on after losing fight to prove hormone treatments caused birth defects for children damaged by hormone treatments in 60/70’s’. Have written to their ‘Association for Children Damaged by Hormone Pregnancy Test ‘as there are so many similarities in what they have come up against – maybe some tips can be shared betee Rxisk and the Assoc. e mail marielyon@virginmedia,com

    • Kelly, our thoughts are with you and your family. Nothing that we say can heal your hurt – all that we can offer is that, should you wish to share your worries with us, you will find us a very welcoming, understanding and supportive group.
      Most of us have suffered a ‘loss’ – for some, like you, it is the loss of a life. For others, like me, it is the loss of part of a son – a part that is now slowly returning after 15 years on psychiatric medications which hindered, rather than supported, his journey back to life as it used to be. Yet another group here let us know how things have been first hand – they comment on their own suffering and that’s tough for sure.
      Since my ‘loss’ is nowhere as great as your loss, it is hard for me to imagine what you are going through right now, but there are others here who know EXACTLY how you are suffering. Please keep your comments coming.

  5. This comment sits uncomfortably here, after Kelly’s sad sad comment – it’s helpful to be reminded of the dreadful human cost of medication misuse and I’m so sorry. Really sorry.

    Seems like a return to a ‘harm v harm’ model in medicine can only be good? It’s more honest – acknowledges the fact that medics use a harm to treat a harm; medication or surgery. It would need a mega shift in how we think about prescription drugs. I wonder how many people think of antibiotics or blood thinners as damaging – despite the fact that both can make you feel crap. And you can’t see the harm that’s going on in your liver or glucose levels. So, it’s very easy for a prescribing medic to simply ignore the topic. Anyone who’s had a major operation is all too aware that they face being sliced open and probably spent the night before in a state of mortal alarm about whether they’ll come through. Then the process of recovery reminds you how much the body does not like being mutilated. With medication the ‘harm’ never figures. Not in any discussion I’ve ever had with a medic – or nurse. It’s as though an adverse event (‘unwanted effect’ seems to be the current term) either doesn’t exist or cannot ever be mentioned. I was told when I queried whether metformin had any side effects that no, it didn’t. In fact it was positively life-enhancing, anti aging, weight reducing and all sorts. Moreover, a recent study had showed that people who looked up the harms of a particular medication were more likely to get them. Evidence based hypochondria was the message, for people who like to know what a drug might do before swallowing it – and then weigh up their own minds about taking it. I was perfectly prepared (then) to take metformin – what I actually wanted to know was whether it might make me feel crap, and for how long.

    Ask a pharmacist the same question, which I did, and you’ll get a decent answer: 30% of people on metformin get bad diarrhoea. Pharmacists appear to have no problem sharing their technical knowledge. Ditto physiotherapists. They work with what they see – a wonky knee or deranged balance. Is it something to do with the ‘I’m at the very top of the expert tree’ that makes medics so disinclined to work equally with patients?

    Relationship-based medicine. It’s a huge shift. I’m wondering how one – me – goes about it in real life. After the discussion and diagnosis and drug offer -do we just say ‘tell me about the harms’. That’s likely to produce a bemused face and a ‘what do you mean?’ but I suppose could open up a discussion. (Providing you ignore the fact that there are 15 other patients waiting outside). I tried it once, with a nurse practitioner but she got so red in the face and started waving her pencil round. I thought she might be about to have a heart attack and resorted to ‘no, I’m not going to take the stuff’.

    Strikes me too that mostly in medicine these days we’re being asked to take a pill to prevent a risk. A risk may never happen (the basis of the whole insurance industry). So it then becomes a possibly remote risk v a certain harm – given that all drugs/poisons cause a degree of damage.

    If an honest doc said ‘I want you to take a pill which stands a good chance of damaging your liver or muscles, but has a slight chance of preventing a heart attack at some unknown future point – how many people would actually sign up to that?’ It would certainly sharpen up the discussion.

    Maybe we need to call in some experts in relationships management to give us a few tips.

  6. Dear Kelly,
    Very, very sorry to hear about the loss of your beautiful daughter.
    I hope a few words of comfort will help you like it helped me.
    Please hang in there.
    My sincerest condolences to you and your family.
    Love Carla

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