Laura Jonikaitė: people want to engage in self-medication less and less

"In my practice, for the past few years, people have mostly been willing to get vaccinated. Of course, there are occasional patients who are anti-vaccination or anti-vaccine. But against tick-borne encephalitis, flu, and pneumococcal infection, people willingly get vaccinated," says Laura Jonikaitė, a family doctor at the Rezus.lt clinic in the capital and a practitioner of cognitive behavioral psychotherapy. The doctor and I talk about the current affairs of the family doctor's practice, seasonal diseases and the synthesis of psychotherapy with family medicine.

- What do you notice in your practice after several waves of the COVID-19 virus and previous quarantines?

- I notice that people take more care of their health, check themselves preventively. When suffering from an acute illness, patients want to undergo the necessary tests to make the diagnosis as accurate as possible.

I think that lack of communication or strange expectations of patients is caused by insufficient amount of knowledge, fears, different view of the situation. It often happens that patients come in after Googleing all kinds of articles, suspecting their own diagnoses and really worried.

I do not recommend doing this, better protect your nervous system and discuss these questions in the doctor's office, who will prescribe the necessary tests.

And if we talk about the wishes or whims of patients or their relatives, they cannot bypass the treatment algorithms and the most important thing is that the wishes do not harm health.

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For example, a classic everyday case: to differentiate a bacterial disease from a viral one in order to prescribe the necessary treatment. In my practice, I see that people are less and less willing to engage in self-medication, even when it comes to such simple diseases as a cold.

Our quality of life and habits during the quarantine were also significantly affected by the fact that most of us were isolated, socialized less, there were more fears, withdrawal, stress to do things that seemed normal before.

Of course, after the previous waves of COVID-19 and quarantines, I also observe cases of neglected diseases, when patients did not go to medical facilities. Especially those with chronic diseases avoided going to the polyclinic for fear of getting infected. Therefore, there was no monitoring of the condition, no tests or access to specialists.

We want to be happy that people are paying more and more attention to mental health. The stigma of talking about it, going to a psychiatrist or psychotherapist is decreasing, people are interested and seek help.

After the pandemic, patients have become more cautious about their health and are willing to undergo research. However, there are patients who are overworked, work a lot and don't spend enough time on self-care, sports, and nutrition - this is often revealed by research.

Many neurological complaints. Fatigue, insomnia and low mood are also caused by a lack of various vitamins (e.g. vitamins B3, B5, B12, vitamin D, vitamin C) and bad habits such as smoking and alcohol consumption. Various diseases lead to poorer absorption of vitamins from food. Nowadays, working and active people want to be energetic and productive, so they pay more attention to their health and want to recover it as soon as possible. Intravenous vitamin therapy is effective for this.

- Autumn, like every year, gives us a bouquet of ailments - it's a runny nose, a cough, and a sore throat. What cold prevention measures and tips would you recommend?

- The deeper I learn about human health, the more I understand that all of us currently lack the satisfaction of the simplest basic needs. It is a quality sleep that adheres to sleep hygiene. Work and rest mode, balanced diet, quality communication - satisfaction of the need for closeness, sports, meditation, free time.

I would say that this is the base that we often push to the background in our busy lives and think that it will be enough to take a magic pill and we will be fine. Good emotional health significantly affects our immunity and helps prevent diseases.

Adequate levels of vitamin D are important for colds and other illnesses. It is recommended to test the level of vitamin D in the blood in order to prescribe the necessary dose. As well as the use of vitamin C, sufficient fluid intake, and the replenishment and restoration of other vitamin and electrolyte reserves.

- You integrate the models and practices of cognitive behavioral therapy in the field of work of a general practitioner. How do these fit together?

- Knowledge of cognitive behavioral therapy helps me a lot when working as a family doctor. Helps to better understand patients, their fears, causes of anxiety, defense mechanisms, avoidance. It helps to recognize depression, panic disorder, burnout and other disorders, which we can assess in the office in a few minutes with the help of various tests, and if necessary, I can send patients to the necessary specialists. I also share recommendations on how to prevent the problem from getting worse. Psychotherapeutic knowledge allows us to see a person as a whole organism, and not just to treat a sore spot or a damaged organ. It is important for me to give each person quality attention and enough time during the consultation.

- Share how you strive for a harmonious and clinical professional relationship with the patient? To what extent are the sometimes hyperbolized expectations and wishes of the patients influencing the consultation?

- Probably every doctor has his own rules or beliefs about how to work with patients. In my opinion, the patient and I are like a team where both are important. As a doctor, I have to provide understandable information, options, explain options and possible consequences. And the patient - to make choices in health matters, to follow the given recommendations.