At what point, if ever, do you "discharge" a patient for noncompliance? There has to come a time where you can't help a patient who won't help themselves?
One of my MD's told me he has had to do it a few times over the last 18 or so years. He said that he sends the patient a certified letter (under legal guidance)explaining why they are being discharged from the practice, etc.
So, I was just wondering your "take" or "approach" in situations like that!
Any MD's out there I would be interested on your take on this as well!
"But then, after I picked up the medicine, I was driving home from the pharmacy, and I really had to take a leak, so I grabbed what I thought was my usual piss bottle..."
@ Haven--I will tell you what I tell patients: If 100% of people got the side effects, the drug company wouldn't be able to sell it!! Most side effects of most drugs affect less than 5% of people. They almost always are NOT permanent if you are the unlucky 5%. Please rethink this. If you really need the medication, it should be worth trying it!
Sometimes there's a reason for non-compliance. I'm compliant with most of my prescriptions, but I was recently prescribed one that came in tablets almost an inch across. I just can't swallow them, and they taste increadibly bitter, so I can't chew them.
WTF? You would think they would make them smaller.
I want to know why they come in for the frigging bloodwork that tells me if the medication is working. Let me give you a clue. The medicine does not work just because you got a paper (and possibly a bottle) with the name of the drug on it.
And, yes I have discharged people for noncompliance. But only after feeling like they were putting their lives in danger. And after they drove me up the wall for months.
Me - what meds are you on? Pt - none Me - what are you supposed to be on? Pt - not sure. Something for my high blood. A little yellow tablet. Me - Are you taking it? Pt - of course! Me - no, are you opening the bottle, taking one, putting it in your mouth and swallowing? Pt - sometimes. Me - today? Pt - no. Me - well, that's why your BP is 187/95. Pt - but the person at the pharmacy said it's an emergency! I could have a stroke! Me - how about you take one of your pills and see what happens? Pt - why? Will that work?
So homework for the coming week:
ReplyDelete1. Open bottle
2. Take dose
3. Close bottle
4. Put down
????
Hold pill bottle against area of body affected by pain.
ReplyDeleteClick heels together 3 times.
Repeat "There's no cure for this" 3 times.
Whine to Doctor.
Another case of possible side effects. I am not going to take the medication because of possible side effects.
ReplyDeleteNo gonna lie. I've done this. I always read about the medication I'm about to take and sometimes the side effects are just too scary.
ReplyDeleteAny explanation as to why he didn't take it?
ReplyDeleteWhen I asked him that question, he said "I don't know. I just didn't."
ReplyDeleteBetter to have someone honestly say they didn't take it than lie and say they did.
ReplyDeleteOf course, that's like saying, "It's better to be stabbed than shot."
"If any of the pills were missing, I wouldn't be able to re-gift it."
ReplyDeleteJust having it sit around the house should help, right?
ReplyDeleteIt probably speaks volumes about the regularity of this that you actually ASKED "Did you take it?"
ReplyDeleteAt what point, if ever, do you "discharge" a patient for noncompliance? There has to come a time where you can't help a patient who won't help themselves?
ReplyDeleteOne of my MD's told me he has had to do it a few times over the last 18 or so years. He said that he sends the patient a certified letter (under legal guidance)explaining why they are being discharged from the practice, etc.
So, I was just wondering your "take" or "approach" in situations like that!
Any MD's out there I would be interested on your take on this as well!
It's a lot closer to working than some of my patients who never even bother to pick up the prescription.
ReplyDeleteMr. Metal:It wasn't artisnal.
ReplyDelete"But then, after I picked up the medicine, I was driving home from the pharmacy, and I really had to take a leak, so I grabbed what I thought was my usual piss bottle..."
ReplyDeleteA close family member has stopped complaining to me about her dizziness because my first question is always "Have you taken your antivert?"
ReplyDeleteI have an inkling why it didn't work.
ReplyDelete@ Haven--I will tell you what I tell patients: If 100% of people got the side effects, the drug company wouldn't be able to sell it!! Most side effects of most drugs affect less than 5% of people. They almost always are NOT permanent if you are the unlucky 5%. Please rethink this. If you really need the medication, it should be worth trying it!
ReplyDeleteSometimes there's a reason for non-compliance. I'm compliant with most of my prescriptions, but I was recently prescribed one that came in tablets almost an inch across. I just can't swallow them, and they taste increadibly bitter, so I can't chew them.
ReplyDeleteWTF? You would think they would make them smaller.
Baaaaaaaaah. People will make my eyes roll out of their sockets one of these days.
ReplyDeleteI want to know why they come in for the frigging bloodwork that tells me if the medication is working. Let me give you a clue. The medicine does not work just because you got a paper (and possibly a bottle) with the name of the drug on it.
ReplyDeleteAnd, yes I have discharged people for noncompliance. But only after feeling like they were putting their lives in danger. And after they drove me up the wall for months.
This is why my usual pt encounter goes:
ReplyDeleteMe - what meds are you on?
Pt - none
Me - what are you supposed to be on?
Pt - not sure. Something for my high blood. A little yellow tablet.
Me - Are you taking it?
Pt - of course!
Me - no, are you opening the bottle, taking one, putting it in your mouth and swallowing?
Pt - sometimes.
Me - today?
Pt - no.
Me - well, that's why your BP is 187/95.
Pt - but the person at the pharmacy said it's an emergency! I could have a stroke!
Me - how about you take one of your pills and see what happens?
Pt - why? Will that work?