BLOOD-PRESSURE AND COMPETENCE IN MEDICINE

Hypertension diagnosis depends closely to the blood pressure measureme nt. The aim of this work is to show whether blood pressure measurement should be done by a beginner or a competent doctor. The blood pressur e of 180 patients. (150 females, 30 males) was taken by two physicians . The patients' average age was 51 +/- 11. One of the two physicians w as a cardiologist who took all the patients blood pressure. Others whe re six doctors in training, that is sixth' year students at the facult y of medicine. They took part in this study for a week. The procedure was that the cardiologist and one of the training doctors took the pat ient's blood pressure at the same time after 15 min rest. We have calc ulated the average systolic blood pressure and diastolic blood pressur e of 720 measures. Then the difference between the cardiologist's meas ures and those of all the training doctors. After that we have analyse d the difference between the average of 120 measures taken by one of t he training doctors and the corresponding measurement of the specialis t. We have then compared the difference of the 20 measures of every da y taken by the training doctor and the ones taken by the specialist. T he difference wasn't statistically significant either for the systolic blood pressure or the diastolic blood pressurement. We have studied t he evolution of the average of the 20 measurements of every day during the whole week. So, we have noticed that the difference lowers from t he first days to the sixth. In tine end, we were interested in the las t figure of each measurement of blood pressure. The training doctor of ten gave measurements up to 0 or 5 whereas the specialist gave precise measurements. We have concluded from this work that if experience is needed, the physician has to know the principals and the tricks of blo od pressurement. Moreover, the blood pressure variations by white coat ,, effect can't be explained by measurements techniques. This effect c an be considered as psychic, interactions between doctors and patients ...