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Friday, January 7, 2011

Confrontation and Communication

I changed some one's life this week. Not to brag, but it's not always so easy to have an affect.

This is a mid 50 year old woman with multiple medical problems. She came in 11 months ago for needing refills. Did some labs at the time, but didn't really follow through on other parts of my recommendations. Not everyone has to do everything I say, but in this case she was not doing so well. Non-compliance is not an option when what your doing doesn't work.

She came in this week with a rash, needing her refills, labs, referrals, and other new, but embarrassing, symptoms. She specifies to me exactly how she wants her refills. She has her insurance formulary tier book and will only take the tier-one. She wants 90 days supplies with refills.... that's where I stopped in my tracks. I already thought she was asking for way too much in one visit. Now if I give her a years worth of medication, she has no motivation to come in again. In my mind I anticipated that I'd see her in a year when prescriptions ran out, needed referrals updated, and none of her real issues resolved. This is the kind of practice I am trying to stay away from. Being the refill doctor serves no purpose.

So I explained to her that I would give her, her refills, but she must do her labs and follow-up accordingly. She said she didn't come in because of the co-pay. She says it's only $10.00 but it still holds her back.

I was quite direct. "I am not here to prescribe medications only. I don't want to be your drug doctor. I do want to help you."

She replied, "She could respect that." I actually expected her to be argumentative and find another doctor. Instead she started tearing and further said that I made her feel like I care about her and she hasn't had anyone care before. She readily agreed that she would follow through with her labs and come back in when I need her to.

She remained very apologetic the rest of her visit which was not necessary. The rest of our appointment went well and I found her quite receptive and pleasant after my confrontation.

A few hours later I received a social networking friend request.

As my teens would say... Score.

Taking care of herself may have not been a priority when she walked in to my office, but I had no doubt that by the time she left her focus shifted.

1 comment:

Mama K said...

yay for you! I hope she is able to follow through. It can be so hard to change habits, even when part of you wants to. It sounds like she has a doc who listens and respects, and that will help. I am happy that you made such a difference for her.

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