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URL:  http://boards.fool.com/rsh-this-was-a-brilliant-post-260-that-18081459.aspx

Subject:  Re: Poll: Patient Information Date:  10/31/2002  3:20 PM
Author:  rshunter2 Number:  263 of 892


RSH--- this was a brilliant post (#260) that deserves wider readership. Taking your permission for granted, I am going to try to forward this to someone at the Fool discussion boards in hopes that it might get picked as a post of the day.
You expressed very well the predicament I have found myself in more and more often over the 20 years I have been in medical practice.


Dr. Jerry, I cannot remember the last time I have been so flattered by a compliment, on TMF or anywhere. I hope they do post it, if only because it was heartfelt and based on my own knowlege and personal experiences.

I saved my grandfather from almost certain death from his first home IPPB treatment, when I noticed he was reacting poorly, complaining of tachycardia; I stopped the treatment, and found that the dosage of Isuprel (isoproterenol) was a quadruple overdose. I was 12.

There are all kinds of doctors out there, as you well know. There are doctors who have a collegial approach, and doctors who sit on a high, unapproachable throne.

Advising a patient is always walking on a wire, especially with the elderly, or those with mental defecits, or a tendency toward hypochondria, or just plain not very bright. The prescriber has to balance all that out, and give counselling that is appropriate, without scaring the patient to death, and making sure they understand as best they can what they are taking, why, and what it does.

But even that rule needs to be broken sometimes, if a patient desparately needs a drug, say for severe depression, and they're the type that "won't take pills like that".

And then there are the drugs that you absolutely, positively MUST put the fear of God into the patient, such as Flagyl and NO ALCOHOL, or MAOI's and {huge list of things you mustn't eat, drink, or take} or protease inhibitors and grapefruit juice.

Anyone able to make all their patients finish their 7,10,14 whatever day course of oral antibiotics should be automatically eligible for the Nobel Prize for Medicine. (My pet peeve, even my own mother the RN; "Mom, " take this medicine until finished ", is there another language you'd prefer they print the label in?" That mean's when the bottle's empty, not when you feel like not taking it anymore."

Nurses are THE worst patients in the world, Physicians are second worst.

RSH.
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