The human-shaped obstacle to medical improvement

Medicine is a field where extraordinary innovation is the norm.

Whether through advances in cutting-edge technology, pharmaceutical breakthroughs or new insights into conditions which previously confounded us – every year seems to narrow the gap between what we know and the myriad ways a human body can go wrong.

But there’s one crucial component of healthcare which remains unchanging despite the dizzying progress taking place around it: the patient.

Human beings are prone to irrational belief and occasional stubbornness – especially when they’re in pain or fearful – meaning they can easily derail the best efforts of medical professionals by going against advice, refusing treatment or merely not attending appointments.

For Tangiers International medical case manager Natasha Petarska, this poses a problem.

Natasha is responsible for ensuring a patient’s assessment and treatment goes without a hitch – getting them on the path to recovery as efficiently as possible – while simultaneously satisfying the requirements of their insurance company.

When patients stand in the way of their own medical improvement, she must present to them the best options available and be ready to put arrangements into place at the drop of a hat.

As is often the case when dealing with real people, building a relationship of trust can make all the difference.

She said: “They have to trust you, but in order for that to happen, you have to be providing the best service for their needs.

“You try to give them the best medical options, offer them the best specialists to treat them, but, in the end, the patient will be the one to make the decision.”

Natasha has worked for Tangiers since 2009 handling cases in her native Macedonia as well as Europe more generally and South Africa.

In that time, the majority of medical cases have gone smoothly, with patients taking on board the best advice of medical professionals. But that’s not always the case.

A recent case involving a South African national, injured while working as a civilian contractor, highlights some of the difficulties case managers can encounter.

The patient was flown back home after sustaining a head injury and immediately booked in for a series of consultations in Pretoria in order to rule out common complications.

Despite the best advice of doctors, the patient opted not to continue treatment with the orthopaedic surgeon – meaning their maximum medical improvement was jeopardised.

Patients can delay or obstruct their best medical options for a variety of reasons: they may be fearful of invasive procedures; they may be clinging to poor medical advice they had received previously; or they may have personal circumstances which are not conducive to treatment being carried out in a particular location.

Even travel arrangements between a patient’s home and a clinic or hospital can prove a sticking point, with some patients opting to take much more arduous transport options.

Natasha said: “You have some patients who might live in quite remote regions – perhaps 500-1,000km away from the hospital where they will be treated. We’ll always offer to organise transportation, but if they do not accept that – we may have to work around it.”