Jeudi, 13 novembre 2014

« LES MÉDECINS NE SONT PAS FORMÉS POUR SOIGNER » - MARC ZAFFRAN

Une rencontre avec le Dr Marc Zaffran ne peut faire autrement que de vous remuer lorsqu’il lève le voile sur ce qui se passe dans les cabinets de médecins. La crédibilité du corps médical en prend pour son… rhume.

 
Le médecin vient de publier un ouvrage, Le patient et le médecin aux Presses de l’Université de Montréal, et a préfacé Le grand mythe du cholestérol chez Édito. Il vient un peu beaucoup brasser la cage, en rappelant à ses collègues médecins qu’il faut être à l’écoute du patient. Et que tout ce qui s’appelle soigner passe par l’attention qu’on va accorder à l’autre. « Actuellement les médecins ne sont pas formés pour soigner. Dans les facultés de médecine, on passe l’essentiel du temps à traiter des maladies graves, pas à soigner. »



Mais est-ce que traiter et soigner ne sont pas au fond la même chose? « Pas du tout. Par exemple, si je vous prescris un placebo pour un mal imaginaire et que vous dites après coup être guéri, je vous ai soigné, mais je ne vous ai pas traité. Le problème en ce moment est qu’il y a un conflit entre les attentes d’un patient et la formation du médecin. Le meilleur exemple que je peux vous donner est qu’il y a des gens qui passent un temps fou à des visites chez leur médecin et ne sont jamais soignés. »

Et d’ajouter que pour qu’un médecin soigne, il doit accompagner le patient, et ça ne peut pas se faire sur une seule consultation de dix minutes. Il déplore que les médecins ne posent plus de questions détaillées sur les habitudes de vie de ceux qui se trouvent en face d’eux.

UN MÉDECIN NE DEVRAIT JAMAIS RECEVOIR DE VISITES DE REPRÉSENTANTS PHARMACEUTIQUES

Si les gens retournent voir leur médecin, c’est pour recevoir leurs doses de médicaments. Un peu comme une personne qui va chez son revendeur de drogues. Et ne venez pas lui parler des sombres desseins de l’industrie pharmaceutique. « Déjà à l’université commence le maraudage, qui peut prendre la forme de simples crayons offerts aux étudiants en médecine avec dessus le logo de la compagnie pharmaceutique. Et des études ont montré que les bénéficiaires de ces cadeaux retiendront le nom de cette entreprise lorsque viendra le temps de prescrire. Et pour ma part je suis catégorique, jamais un médecin, comme ça se fait trop souvent, ne devrait recevoir de représentants pharmaceutiques à son bureau. Ces derniers ne leur offrent que de l’information biaisée. Savez-vous que sur les 20 ou 30 000 médicaments commercialisés, seulement 250 ont une réelle utilité? Et les mêmes représentants font peur aux médecins en leur disant « Si vous prenez le risque de ne pas le prescrire vous pouvez aggraver la situation de votre patient ».



Le Dr Zaffran s’en prend du coup aux campagnes de peur. Ainsi, en ce moment au Québec, on est en programme de sensibilisation pour le dépistage de la prostate. Pour lui c’est de la foutaise et dangereux. « Du côté de la médecine américaine on en est venu à déconseiller les tests sur la prostate. C’est qu’une fois dépisté (car les cancers de ce type sont « silencieux » à 80 %) vous risquez, s’il y a chirurgie, ou bien l’incontinence, ou l’impuissance, quand ce ne sont pas les deux en même temps. »

COMBIEN DE MÉDECINS CORROMPUS?

À vue d’œil, quel pourcentage pourrait-il attribuer quant au nombre de médecins en collusion avec l’industrie pharmaceutique? « Il faut faire attention. Une collusion, c’est recevoir un montant d’argent en échange de services. Il y a bien des cadeaux indirects, mais ce n’est pas la norme. Les médecins sont les produits de leur milieu. Ils sont comme les gens, avec des craintes aussi. Il ne faut pas non plus porter de jugement de valeur sur les patients et les accuser parce qu’ils sont en surpoids. Car étrangement ils peuvent être en bonne santé. Je suis optimiste pour une chose, j’enseigne à la Faculté de médecine d’Ottawa, et je peux vous dire que la jeune génération de futurs médecins est plus conscientisée qu’avant et le public mieux informé. »



Justement, beaucoup vont chercher de l’information sur Internet. Est-ce recommandé? « Ce n’est jamais mauvais de s’informer, mais vous avez des descriptions de symptômes qui peuvent donner l’illusion que c’est ce dont vous souffrez. Ainsi vous pouvez avoir une sorte de sensation de « déchirure » au thorax, vous pourriez croire à un malaise cardiaque, alors que ça peut-être tout simplement la conséquence d’un problème de dos. Le Web ne fait pas d’analyse. Je reviens à ce que je disais tantôt, il faut aller voir le médecin, qui va prendre du temps avec vous. »

L’ART PERDU DU DIAGNOSTIC

Une répercussion épouvantable de l’absence d’écoute des médecins est le nombre incalculable de tests à subir. On ne sait plus diagnostiquer. « Et sur le plan économique, les coûts en santé explosent. Si quelqu’un a un malaise et que je ne sais pas faire cette démarche d’explorer avec lui, qu’est-ce que je fais? Pour me rassurer, je l’enverrai passer des batteries de radiographies, des tests de sang et quoi encore? Tout ça représente des pertes de productivité et surtout d’argent. » On écoute parler ce médecin fidèle à son serment d’Hippocrate et on se prend à regretter qu’il n’y en ait pas plus comme lui, pour être vraiment au service du malade. A-t-il l’impression que ses alertes font bouger les choses? Il ne se fait pas d’illusions. « Je suis un moustique à côté d’un éléphant. »



MARC ZAFFRAN (MARTIN WINCKLER)

Cet article est classé sous :Dr Marc Zaffran LaMetropole.com
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