AETCOM Module 1.2 – What Does It Mean to Be a Patient?

Learning Purpose

This module helps first-year MBBS students understand the meaning of being a patient. Before learning how to diagnose and treat diseases, it is essential to understand how illness affects people’s bodies, emotions, families, and lives. This forms the foundation of empathy, professionalism, and patient-centered care.

Pre-Session MCQs (Baseline Understanding)

1. A patient is best described as:

A person with abnormal investigations
A person experiencing illness, vulnerability, and uncertainty
A hospital admission number
Someone receiving treatment

2. Which emotional state is commonly experienced by patients?

Authority
Confidence
Anxiety and uncertainty
Control

3. Illness primarily refers to:

Lab findings
Physical signs
The patient’s lived experience
Diagnosis

Who Is a Patient? Beyond Illness and Diagnosis

A patient is not just someone with symptoms or a diagnosis. A patient is a person whose life is disrupted by illness, discomfort, fear, or limitation. Illness often affects how people think, feel, and function in daily life.

Patients may have concerns not only about their body, but also about their future, family responsibilities, education, employment, and finances. Becoming a patient often means depending on others for information, reassurance, decisions, and care.

Common feelings experienced by patients include:

Vulnerability
Anxiety
Dependence
Uncertainty

Examples:
• A student with dengue worrying about missing examinations
• A daily wage worker with back pain worried about loss of income
• A mother anxious about her child’s fever

Reflect:
What changes in a person’s life when they become a patient?

Illness vs Disease: Understanding the Patient’s Lived Experience

Disease and illness are related but not the same.

Disease: What the doctor identifies
- Diagnosis
- Laboratory reports
- Physical signs
Illness: What the patient experiences
- Pain
- Fear
- Fatigue
- Worry

Illustrative Scenario:
Two patients have the same diagnosis of asthma. One fears breathlessness at night. The other fears social embarrassment during attacks.

Doctors treat diseases. Patients live with illnesses. Good doctors understand both.

Reflect:
List three ways illness can affect daily life beyond physical symptoms.

Suffering: Physical, Emotional, Social, and Psychological Dimensions

Suffering is multidimensional and often invisible on examination or investigations.

Physical suffering: pain, breathlessness, fatigue, disability
Emotional suffering: fear of diagnosis, anxiety about treatment, sadness, frustration
Social suffering: role changes in family, financial stress, dependence on others
Psychological suffering: loss of control, uncertainty about the future, feeling like a burden

Hospital Example:
A patient admitted for surgery experiences physical pain, anxiety about the operation, worry about expenses, and fear of outcomes.

Suffering is not always visible in test results.

Coping Mechanisms Adopted by Patients

Coping refers to how patients deal with illness and suffering.

Seeking information
Trusting doctors
Family and social support
Religious or spiritual beliefs
Denial or avoidance
Humor or optimism

Coping styles differ between individuals. What appears as non-cooperation may reflect fear or misunderstanding.

Reflect:
How would you cope if you were admitted to a hospital today?

Patient Experience of Healthcare Encounters

Positive experiences include:

Being listened to
Clear explanations
Respectful behavior
Feeling involved in decisions

Negative experiences include:

Being ignored
Complex medical language
Rushed consultations
Lack of privacy

Example:
A patient may forget medical advice because they are anxious, do not understand explanations, or feel intimidated.

Patient experience often matters as much as clinical outcome.

Professional Qualities and Roles of a Physician from the Patient’s Viewpoint

From a patient’s perspective, a good doctor is:

Competent
Approachable
Respectful
Honest
Calm
Willing to listen

Roles of a physician beyond treatment:

Listener
Reassurer
Guide
Supporter

Professionalism is not only technical skill but also how a doctor makes a patient feel.

Empathy in Clinical Encounters

Empathy is the ability to understand what a patient is going through and communicate that understanding.

Empathy is not:

Sympathy alone
Feeling sorry without action

Why empathy matters early:

Shapes communication habits
Builds trust
Improves patient cooperation
Prevents mechanical, detached practice

Reflect:
What would you want from a doctor if you were scared or in pain?

Post-Session MCQs

4. Disease is:

Identified by the doctor
The patient’s fear
Emotional distress
Social disruption

5. Which is NOT a dimension of suffering?

Physical
Emotional
Social
Administrative

6. Coping mechanisms:

Differ between individuals
Are always healthy
Mean non-cooperation
Are same for all patients

7. A positive patient experience includes:

Rushed consultation
Being listened to
Medical jargon
Ignoring concerns

8. Professionalism includes:

Only knowledge
Only skills
Attitude and behavior
Seniority

9. Empathy means:

Feeling sorry
Emotional involvement
Understanding and communicating understanding
Avoiding emotions

10. Empathy should begin:

After graduation
During internship
From the first year of MBBS
Only in clinical years

Key Take-Home Messages

Patients are people, not diagnoses
Illness affects life beyond the body
Suffering has multiple dimensions
Empathy begins with listening
Professionalism starts from the first year

Follow-Up Reflection

Read and reflect on the question: “What does it mean to be a patient?” Observe patients during hospital visits with attention to emotions, concerns, and coping.