Ice cream and Free Fire: can you joke about a prescription? – 06/02/2023 – Balance and Health

What can happen in a medical consultation? The case of a doctor who was fired —and later rehired— after prescribing ice cream and the Free Fire video game to a child with a sore throat and flu-like symptoms, in Osasco (Greater São Paulo), raised questions.

Despite the controversy caused by the indications, the prescription was not the center of the problem. Before noticing what was in the document, the child’s mother, Priscila da Silva Ramos, 37, said she was dissatisfied with the service.

According to her, the consultation did not take even five minutes and the doctor did not examine the boy, who is 9 years old. For this reason, when she saw the prescription, which also listed medications, she understood that the doctor was making fun of her.

The report was unable to contact the doctor. When explaining why he rehired the doctor, Mayor Rogério Lins (Podemos) said that the doctor tried to humanize the service.

A Sheet heard experts talk about what an ideal consultation should look like, considering the doctor’s behavior and other procedures. See what they say:

What are the steps of a medical appointment?
The professional needs to establish a good doctor-patient relationship. Listening and listening to the complaint of the person or companion —if it is a child— and realizing their anguish. From there, questions are asked directed to the complaint, such as symptoms, time and medications already used.

The next step is the general physical exam. In the case of specialist appointments —gynecologist, for example— there are specific exams. After the physical evaluation, if necessary, the doctor may request additional tests. When closing the diagnostic hypothesis, the professional must express himself well in relation to what he concludes and the proposed treatment. Finally, it prescribes medications and gives other guidelines.

Is it always necessary to touch the patient?
Yes. It’s important to examine it.

Should the consultation take place in a reserved place?
Yes. It should not be performed in front of people unrelated to the patient.

Is there a recommended time for consultation?
It is difficult to quantify the time, according to experts. It depends on the complexity of the case, the type of consultation, the tests to be performed and the doctor’s experience.

Are games allowed in children’s appointments?
In pediatric care, it is interesting that the patient is captivated by the doctor. But it’s important to be aware of the receptiveness of pranks and to have common sense. “It’s natural to sit on the floor with the child, play, make little planes. The child’s language is play. You also need to make it clear that you are playing, but also serious. The doctor cannot say something during the game that leads the mother to doubt the conduct, as was the case with the ice cream in the prescription”, explains Fausto Flor Carvalho, president of the Department of School Health of the Society of Pediatrics of São Paulo.

Can this joke go to a doctor’s prescription?
It is not always suitable. The medical prescription is a document. In it, it is allowed to place guidelines, always objectively. “For children’s prescriptions, there are pediatricians who use stamps with Mickey, Monica, children’s characters. This is tolerable, but with common sense”, says Carvalho.

What is unacceptable in a consultation?
Treating the patient badly, not attending properly and being inconvenient. “When the patient seeks the doctor it is because he has a problem. You cannot be the cause of another problem”, says Angelo Vattimo, first secretary of Cremesp (Regional Council of Medicine of the State of São Paulo).

In the child consultation, it is sometimes necessary to contain the child for a safe procedure, but this must be done in a humane and never brutal way. It’s wrong not to give parents space to talk. It is essential for the adult to accompany the child to consultations and exams. “We cannot make room for episodes of abuse and violence”, comments Carvalho.

How should the prescription be?
The letter must be legible. It is recommended to explain the information point by point to the patient, who, preferably, should read the prescription in the presence of the doctor to show understanding. “It does no good to have clinical reasoning and a well-done diagnosis and then write a prescription with illegible handwriting or not explain to the patient the importance of following the treatment”, says Vattimo.

How does the person know if they received good care at the consultation?
Empathy and patient satisfaction often do not depend on time. The doctor can spend an hour with the person and not even look at him. Sometimes, in a shorter amount of time, she leaves satisfied, with the problem solved and the diagnosis clarified. The thermometer is the patient, according to Vattimo.

“The pillar of care is to establish a relationship of trust between the doctor and the patient. But there is the other side: the doctor is often assaulted, mistreated and unduely denounced by the patient”, says the doctor from Cremesp.

What are the channels for complaints?
In an institution, hospital and in the public network, the complaint can be registered in the channels of the ombudsman. If there was a major problem with the service, the complaint can be forwarded to Cremesp (go to Services and then Citizen).