I have patients decline meds all the time; I’ve had to learn this same lesson. I tell my patients the last thing I want to do is be a burden to their consciences. Some decline meds and do just as well as if they would on it…maybe even better. Some decline meds and join my personal M/M list. But I’m thankful my patients will never be able to say, “He never offered me this therapy” or “He pushed this medication on me”.
Thanks for sharing. Patient concerns are not always on the tip of their tongues , they often need help in discovering them. Asking what are your concerns , making suggestions - tabling various concerns etc eventually helps to identify concerns and then collaboratively problem solving. My DW refused to take a statin , one way discussion and a note in her file - refusing the statin.. My doctor knows that there are soe things that I know more about than him , besides knowing who I am and what are my concerns
When I started my residency 25 years ago, I took part in student classes in medical conversation at the departement for family medicine at the Charité, Berlin. Our Professor there at that time: Ulrich ( please, dear US Americans, try to pronounce this name:-)) Schwantes distiguished three groups of patients: the sufferer, the changer, and the visitor. These are prototypes, but it helps me alot till today. If there is a visitor I do not have to try to change anythibg. He is sent by an extertal force( the police, his wife, his company ,...). The only thing I can do, us to show him, that I'm no asshole and that he can come again. If there is a sufferer/complainor, he might do, what I suggest as long as it does not take long and he has not to change his life( if there is a complainor I would rather give azitromycin for 1-3 days , even so Penicillin would be better, but he would "forget it" after the second day). If there is a changer, you can work happyly with him, but you ruin your financial source, as he takes LOT'S of time.
As nurse of over 40 years ,yes! I have had several conversations with friends who were given a new Rx and not much information . I have suggested calling their.doctor and talk about the issue. People have a lot of real reasons for not taking medications
That's a really nice piece Lucy. I have an ongoing crusade against the word 'defaulter', this is in the context that the vast majority of patients I see in hospital have previously taken anti-retrovirals for HIV, but stopped and are now sick. I insist that everyone says 'has interrupted therapy' because there are 1,000 reasons that this happens and most of them are completely understandable if you just ask the patient what happened.
I have patients decline meds all the time; I’ve had to learn this same lesson. I tell my patients the last thing I want to do is be a burden to their consciences. Some decline meds and do just as well as if they would on it…maybe even better. Some decline meds and join my personal M/M list. But I’m thankful my patients will never be able to say, “He never offered me this therapy” or “He pushed this medication on me”.
Thanks for sharing. Patient concerns are not always on the tip of their tongues , they often need help in discovering them. Asking what are your concerns , making suggestions - tabling various concerns etc eventually helps to identify concerns and then collaboratively problem solving. My DW refused to take a statin , one way discussion and a note in her file - refusing the statin.. My doctor knows that there are soe things that I know more about than him , besides knowing who I am and what are my concerns
When I started my residency 25 years ago, I took part in student classes in medical conversation at the departement for family medicine at the Charité, Berlin. Our Professor there at that time: Ulrich ( please, dear US Americans, try to pronounce this name:-)) Schwantes distiguished three groups of patients: the sufferer, the changer, and the visitor. These are prototypes, but it helps me alot till today. If there is a visitor I do not have to try to change anythibg. He is sent by an extertal force( the police, his wife, his company ,...). The only thing I can do, us to show him, that I'm no asshole and that he can come again. If there is a sufferer/complainor, he might do, what I suggest as long as it does not take long and he has not to change his life( if there is a complainor I would rather give azitromycin for 1-3 days , even so Penicillin would be better, but he would "forget it" after the second day). If there is a changer, you can work happyly with him, but you ruin your financial source, as he takes LOT'S of time.
The real lesson is in slowing down and listening to our patients. Good job Lucy.
As nurse of over 40 years ,yes! I have had several conversations with friends who were given a new Rx and not much information . I have suggested calling their.doctor and talk about the issue. People have a lot of real reasons for not taking medications
That's a really nice piece Lucy. I have an ongoing crusade against the word 'defaulter', this is in the context that the vast majority of patients I see in hospital have previously taken anti-retrovirals for HIV, but stopped and are now sick. I insist that everyone says 'has interrupted therapy' because there are 1,000 reasons that this happens and most of them are completely understandable if you just ask the patient what happened.
Fascinating; lovely story. A cascade of improvement (SSRI, dog, gardening), probably working in synergy.