SDH

[Bakht Nishan]

I had a 53 years old patient with PMH of HIV who came for routine health check up. He was skeptical of whole Wayne state and the care it provides. He was complaining about all the different physicians he had so far and how he was made to wait for 10 minutes in the waiting area. It took me some time to gain his confidence and found out that he had a poor social support system.He opened up how he felt unwanted because of his HIV status. He said he does not care about his health anymore and kept missing doctor’s appointment. I realized that its not enough to just medically treat a patient by providing pills. Its also important to address the behavioral and psychosocial factors affecting the patient, and ultimately avoid poor health outcomes. This patient had poor social support and was depressed. Acknowledging and addressing psychosocial factors not only helped in gaining patient’s confidence but also motivated patient to take the needed steps for better health.

[Dr. Nnodim]

Thank you Bakht, for a nice reflection. I was touched by your patient’s feeling of being “unwanted”. I am curious as to how that made you feel when you heard him say that. This is a common feeling among HIV patients and there are multiple factors possibly at play: their sexuality, drug use, homelessness, and societal stigma of the disease itself. Sometimes, we don’t feel empowered to change the whole “Wayne State” culture or the entire US health system. But, by taking the time to acknowledge and address his psychosocial issues, you have done a lot of good for this patient – good for you! Any thoughts as to next steps for him?

[Author]

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