Background (109-028-14-3) Vered and Anat
In an attempt to defend herself against accusations of mal-practice the doctor has just explained again that a condition [viral URI] can evolve in a short time into more serious conditions [pneumonia and otitis media].
The patient’s mother rejects the doctor’s explanation arguing that surely the signs of more serious disease were there at the time the doctor examined her. The doctor supports her own approach by reminding the mother that because she was aware of potential complications in the near future she had told her to return if necessary and even gave the mother her private telephone number.
- This clip is very appropriate for demonstrating one part of the general mnemonic device for organizing a response aimed at limiting a patient’s behavior: R3NO2 Ad2 . In particular, “Ad2” is a reference to Eric Berne’s system of transactional analysis where he warns against being maneuvered into responding to a patient as if in a child-parent interaction (or in parent-child one). Instead, he advises that the conversation should be conducted as between two rational and autonomous adults- hence Ad(ult)2. In this clip the mother refused to take responsibility for not following the doctor’s professional (and generous) advice about contacting her if the child’s condition worsened and instead acting impetuously out of frustration and anger. Although the doctor mentioned her advice as a defense against the charges against her, she missed a chance to explore with the mother, in a non-accusative fashion, the causes of the mother’s actions. By recognizing the role her lack of trust and general frustration in life in this incident, the mother could be helped to be more trusting and to act more responsibly next time.
- A challenging exercise would be to role play this scene with the doctor achieving an adult-to-adult conversation.