NetNews Usenet Archive 1992 #26/NN_1992_26.iso/spool/sci/med/20738

Internet Message Format | 1992-11-09 | 3.3 KB

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Newsgroups: sci.med
Subject: Re: How Often Are Placebo's Prescribed?
Message-ID: <[e-mail]>
From: [e-mail] (Ruth Ginzberg)
Date: 9 Nov 92 22:00:49 EDT
References: <[e-mail]| <[e-mail]| <[e-mail]| <[e-mail]>
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Organization: Philosophy Dept., Wesleyan University
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In <[e-mail]> [e-mail] writes:

> Hmm. This describes the behavior of hundreds of patients that I know.
> To come back from the doctor empty-handed is a sign to these people
> that they didn't need to go in the first place. If these people have
> colds, they demand PRESCRIPTION MEDICINE for them, and oftentimes,
> specific antibiotics ("My previous doctor always gave me [insert name
> of expensive, hard to spell and pronounce oral cephalosporin here] -


Hmmmm.  For another perspective on this phenomenon, consider:  most patients
try NOT to go to the doctor in instances where self-treatment or
over-the-counter treatment (or no treatment) is likely to be appropriate.  In
other words, we try to do triage on our own selves & families.  After all, who
wants to take off 1/2 a day from work & pay the bill for an office visit if the
doc isn't going to do (or tell you) anything you couldn't have done for
yourself?  So by the time we show up in your office, its because we've already
been through self-triage, & for you to tell us to rest in bed & drink lots of
fluids & take Tylenol, &c, is tantamount to you telling us that we guessed
wrong in our triage attempt.  So when a patient says, "My previous doctor
always gave me ... (etc., etc., etc)" maybe it is because he or she is trying to
learn to do a better job of self-triage.  I.e., the patient may be trying to
educate him- or herself on how to distinguish between the kinds of symptoms
which indicate a bacterial illness & the kinds of symptoms which indicate a
viral illness.  Or, the new patient may just be trying to adjust to your
prescribing practices, which may be a change from the old doc's prescribing
practices.  In otherwords, just as you need to learn to communicate w a new
patient, the patient needs to learn to communicate efficiently w a new doctor,
too.  So maybe when a new patient says, "my old doc used to (blah, blah, blah)"
he or she is just trying to understand the finer points of the differences in
approach or prescribing practices between you & the previous doc.

OR -- sometimes the new patient may have a reason for wanting an antibiotic;
e.g., (for example) if I am traveling, especially out of the country, & I have
a stuffy nose that I KNOW is viral, or allergic, or whatever, I may well ask my
doc for a prophylactic antibiotic just so as NOT to risk winding up in
Timbuktu (or wherever) with one of my all-too-common sinus infections & having
to *FLY* home (owwwch!) before being able to get it treated.

--just another perspective on the situation --- :-)


------------------------
Ruth Ginzberg <[e-mail]>
Philosophy Department;Wesleyan University;USA