62. Primum Non Nocere | How 8 doctors practice 'first do no harm'
Oct 18, 2021
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Leading physician educators discuss the core principle of patient care: primum non nocere. They explore topics such as doing what's medically right, reducing opioid prescribing, and prioritizing patient interests in medical decision-making.
Minimizing harm in medical practice involves reducing opioid prescriptions, engaging patients in conversations about risks and benefits.
Striving to behave in a way that reduces harm requires self-awareness, reflection, and prioritizing patients' interests over personal convenience.
Deep dives
Recognizing the Importance of Do No Harm in Medical Decision-Making
In this podcast episode, the speakers discuss the concept of 'do no harm' in medical practice. They explore different perspectives and philosophies, highlighting the need to prioritize patient welfare above all else. One doctor shares his experience in minimizing harm by decreasing opiate prescriptions and engaging patients in conversations about risks and benefits. Another doctor emphasizes the importance of doing less and allowing the body's natural healing capacity to take effect. The podcast also delves into the necessity of reevaluating traditional practices, such as fluid resuscitation in sepsis, to reduce harm and improve outcomes. Overall, the episode stresses the significance of putting patients' interests first and making informed, compassionate decisions.
Striving to Behave in a Way that Reduces Harm
The speakers in this podcast episode discuss the idea of 'striving to behave in a way that reduces harm' as a practical approach to medical practice. They share examples of doctors who have adopted this mindset, such as a primary care physician who focuses on limiting unnecessary tests and interventions, and an emergency physician who pauses to reflect on what he would want as a patient. The episode emphasizes the need for self-awareness and honest reflection to avoid prioritizing personal interests or convenience over the best interests of patients. By considering the patient's perspective and striving to provide care that minimizes harm, healthcare providers can make more patient-centered and evidence-based decisions.
Addressing Limitations and Focusing on Patient Needs
This podcast episode explores how healthcare professionals can address limitations in their decision-making and focus on patients' needs. The speakers highlight examples where doctors may unintentionally cause harm, such as overprescribing antibiotics to satisfy patient expectations. They suggest practical strategies like seeking permission to practice good medicine and reframing discussions around the patient's family member. The episode also encourages doctors to embrace shared decision-making, acknowledge end-of-life situations, and prioritize the patient's comfort and dignity above all else. By reflecting on the central ethic of medicine, 'first, do no harm,' healthcare professionals can improve patient care and outcomes.
In this episode we hear from eight leading physician educators about a core principle of patient care: primum non nocere. We learn that limiting harm can translate into doing what’s medically right, putting the patient’s welfare first, judicious use of IV fluids, reducing opioid prescribing, making a habit of pausing when depleted, acknowledging the end of life, and allowing a natural death.
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