An unexpected clinical downside to the pharmaceutical "pill culture" in this country:

[Aristus]

As a practitioner of clinical medicine, I'm a firm believer in conservative treatment of certain acute conditions, and conservative management of chronic conditions, with no prescribed medications whenever possible. Often, for acute problems, it can mean things as simple as ice, rest, wet compresses, diet, exercise, or increased fluid intake.

Most of the time, my patients accept my treatment plan and leave the clinic satisfied. (And almost always get better).

This last week, no fewer than six patients got upset with me because I evaluated and treated their conditions without prescribed medications. I wonder whether they felt "cheated" for lack of a better word, because they left the clinic without a bottle of pills, or a tube of topical medication, or something.

Granted, every single case was a new patient not used to my style of practice, which has received compliments from the doctor auditing my charts. My regulars trust me and my methods.

I have half a mind to invest in some sugar pills, and mark the bottles "amphohydroteracetezine", or something, that I can give out for an ailment that otherwise requires no pharmaceutical treatment. Just to avoid incidents like those above.

That's all. Just wanted to vent...

I love you all...

Note to anyone currently taking prescription medications: Notice I wrote 'whenever possible'; I always prescribe pharmaceuticals when they are indicated, or conform to the standard of care. There are many prescription medications that I trust, and are the bedrock of my practice. I just don't prescribe medications during every single visit. This note is to prevent recriminations, or misplaced charges of being a witch doctor, or something.

[applegrove]

1. My mother was a GP and friends used to joke that we had to be 'dead' before she would let us stay

home from school sick.

[Kali]

2. a lot of it has to do with our culture of instant gratification and silver bullet "solutions"

we want everything RIGHT FUCKING NOW, and diets, nutrition, WORK - all take too long. people also don't have TIME to be sick or to heal, they are under so much pressure to produce and serve there is no way to rest. think what two weeks in the country or in a spa would prevent in terms of stress-related illness. but our economic system seems more like it just wants to use workers up and let them die as quickly as possible when they aren making anybody any money any more.

on the other hand so much of medicine has become like a production line - get em in and out without any human connection. the old "healing arts" that were more about listening and caring

I think that is the main draw of alternative woo type stuff - the desire for connection

even the word clinical has become somewhat of a negative term - cold and clinical as opposed to warm and caring...

um, sorry this turned into my own rant... oops

[fizzgig]

7. you make very good points

i know both my husband and i would both feel a lot better if we even got to take a four-day weekend every couple of months. i have the paid time off, but he doesn't and we can't always justify him losing those hours.

[Odin2005]

8. I think you make a good point about the woo.

Most of the benefit from the woo-meisters comes from the stress-relief (lowered cortisol) because the personal attention the "Holistic Practitioners" give to their clients. high cortisol levels over long periods of time are very damaging to the body, it's equivalent to being on emergency alert all the time.

[kcass1954]

3. Years ago, a friend took her kids to the same pediatric group I used for my kids.

She stopped going there, because they quit calling in antibiotic prescriptions without seeing children, and she said it was a horrible imposition on her to find time to take her kids to the doctor's office. Besides, "I know when my kids are sick!"

So do I. But what I don't know is when antibiotics are the correct treatment. And as a person who is allergic to most antibiotics (and a handful of other medications), I'm very concerned about their overuse.

[Aristus]

6. She doesn't sound terribly bright.

I'll bet anything her doctor didn't deny that her children were sick. It's just that they had viral illnesses, which antibiotics won't cure. Not to mention, prescribing antibiotics when not indicated can promote antibiotic-resistant microbes.

One of my patients mentioned in the OP above explained one of her symptoms as 'fever'. Her temperature, taken only 10 minutes before, was 98.2 - not a fever by any stretch (fever is 101F or higher). I explained that she may have felt feverish, but did not have a fever. I diagnosed her with a viral illness, and prescribed symptomatic treatment, with no antibiotics, and she became enraged and stormed out of the clinic.

[Tobin S.]

4. You know what will probably work

Jen had a problem a while back that sent us to the emergency room. I won't say what it was, but it appeared to be a very scary thing. She walked out of there after treatment with nothing prescribed but some words and she was fine.

I walked into an urgent care facility a while back because Jen wanted me to see a doctor thinking that a raspy cough might be a sign of a bigger problem. I didn't think it was a big deal. They ended up sending me to the emergency room thinking that I had pneumonia. It wasn't that serious, but it was serious enough that I walked out of there after an examination and an x-ray with a steroid, antibiotic, and an inhaler.

You have to have a little faith in the staff when you seek medical treatment. It's a scary place to be sometimes, but I just find my happy place and let them do their thing.

[dana_b]

5. I appreciate this

as both a nurse and a patient I appreciate that you are concerned with this. I think that for some it may be easier just to give the patient 'something' rather than deal with them however it's obvious that you put real care into your caregiving and look beyond something easy. My physiatrist is much like you. I have been under his care for 7 and a half years for a serious back injury (for which I just had surgery) and in all the time I have known him he has never suggested or prescribed narcotics. We have always gone the more conservative route with my pain issues and that has allowed me to be able to work and function. No, there are times that it would have been easier and quicker just to give me narcotics (and more than likely less painful!) but we talked about these issues together and kind of took the tougher yet more beneficial path.

I also think what one poster above me said about people needing something, anything, to make them better quickly because of our face paced lives is true too. People just don't have time to be sick! I understand them but I know that it is our jobs as clinicians to educate them and I really appreciate that you do that. As I said before, many don't.

[Odin2005]

9. People think there is a pill for everything.

They are probably the same idiots that think antibiotics work on viruses.