SSO ramble, really.

Part of the professionalism module we're doing this year involves a Special Study Option (SSO) in which we're able to take special interest topics from a range of really interesting subject matters like sign language, psychiatric imaging, pre-emergency care, basic surgery skills, complementary medicine, and adolescent medicine.

Adolescent is generally a vague term, if I were to ask 20 people what they thought the age range for an adolescent was I'd probably get 20 different answers. Age is subjective, although the average answer would be around 10-20 years for Europeans. Slightly different for people in different parts of the world (surely). A better way of defining adolescence is probably by way of grading biological and psychosocial elements. There must be certain criteria that must be met biologically. Psychological assessment would involve grading their level of maturity, among other things.

In the hospital, there's the paediatric ward and the adult ward, and nothing to cater for young adults. If a 14 year-old girl was admitted into the hospital, its more likely that she'll end up in the ward that has the clown-themed wallpapers and animal-style bedsheets than the other one. It presents potential embarrassment (and trauma?) for the patient. I'm not sure how the hospital decides who gets into which ward, I'm sure its entirely age-based. And even if it didn't involve hospital admissions, patients in that age group, say 12-17, who goes to their GP and is then referred to a specialist, would they end up seeing a paediatrician? I think there's a stark difference in the way certain groups of patients should be managed, the three main ones being infants, young adults and adults. Trying to place adolescents in any one of the two other groups is an unreasonable solution where no one wins, the patient receives ineffective counselling and the GP would have only wasted their time.

Paediatrics as it is now probably covers a wide scope, I used to think it was just infants and small children but they probably extend that to adolescents seeing as how there's not a specific field of study for that particular age group. I'm not sure why that is despite the fact that adolescents represent a substantial percentage of the patients that come in every year. It doesn't seem like there's much emphasis on the issue.

I like the idea of personal GPs. It makes sense, the doctor is able to gauge a lot more from a patient if she (or he, in rare cases) is able to keep a track record of the patient and more importantly understand them that much better which means they're better equipped to sense changes in behaviour. 1 in 3 people suffer from depression. Its a shocking figure and the reason the prevalence of the illness is not known is probably because 1) people don't readily admit depression and if even they do the doctor would probably be the last person they'd tell, especially if the doctor is not their personal GP 2) It goes unnoticed and thus rarely diagnosed, which is the most depressing thing. Better diagnosis is such a huge area for improvement in this case, but the importance is (probably) greatly understated.

If a doctor sees a patient regularly then they'll know HOW and WHEN to make that gradual transition in communication since they already know the patient's level of maturity and comprehension whereas if a young patient simply comes in into any clinic the normal approach would probably be either like that of an adult, if the patient comes in alone, or a child of they come in with a parent.

But how different can it be really? If they have flu, then they have flu, its not going to make a difference if it was a 15 year-old or a 50 year-old. But what if it was a sexually transmitted infection. For the 50 year-old you'd probably go 'Right, (not again!) here: medication' but if it was the 15 year-old..I mean underage sex and the legal implications, telling the parents, finding out the details and explaining things to her. The level of maturity can be so different in some people, I don't know how doctors go around that. You probably get a sense of what to do when you've been in the profession for a long time but at the same time I don't think its reasonable to think new doctors are 'allowed' to make more mistakes just because they're lacking in experience.

That's it, I won't ramble on. Sorry, I've realized I've used the word 'probably' in almost every sentence, and thats because most of it is conjecture, I assume certain things and stick 'probably' in the sentence as opposed to doing proper scholarly research on the subject.