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Anybody ever give a patient a specific drug just because he asked for it? I do it all the time.
Granted, this doesn’t extend to situations where a drug is unnecessary or contraindicated, but – for example – if a migraine patient comes in and wants to try another preventive or triptan, what do you do? As with any other drug, I discuss it with the patient, and if she still wants it, and it’s not unreasonable, I’ll do it.
Some out there will say that this makes me a pushover for direct-to-consumer advertising, since that’s where most patients hear about these things. (For the rest, the information usually comes from a friend or their own research.)
But realistically, resistance is futile. If you deny patients a reasonable request because it was their idea instead of yours, they’ll likely move on to another doctor, complain to their internist or friends about you, or both.
The argument of "your insurance doesn’t cover this" won’t hold water at first. Samples or your handwritten script are free. All it takes for them to realize they’d rather stay with their old medicine is the pharmacist’s telling them how much it will cost. So, in the end, economics will be the decider.
Generics work the same way. In most cases – the exception being epilepsy drugs – I won’t fight for brand names. Some patients think I can write magic notes to get them brand-name drugs at generic prices. It’s easier than arguing, so I write them. The cost will always make them change their mind.
After years of experience, I find that it’s a lot easier to let the patients’ pocketbooks make them realize this than to waste time trying to convince them myself.
Dr. Block has a solo neurology private practice in Scottsdale, Ariz. He has been a practicing neurologist since 1998 and in private practice since 2000.
Anybody ever give a patient a specific drug just because he asked for it? I do it all the time.
Granted, this doesn’t extend to situations where a drug is unnecessary or contraindicated, but – for example – if a migraine patient comes in and wants to try another preventive or triptan, what do you do? As with any other drug, I discuss it with the patient, and if she still wants it, and it’s not unreasonable, I’ll do it.
Some out there will say that this makes me a pushover for direct-to-consumer advertising, since that’s where most patients hear about these things. (For the rest, the information usually comes from a friend or their own research.)
But realistically, resistance is futile. If you deny patients a reasonable request because it was their idea instead of yours, they’ll likely move on to another doctor, complain to their internist or friends about you, or both.
The argument of "your insurance doesn’t cover this" won’t hold water at first. Samples or your handwritten script are free. All it takes for them to realize they’d rather stay with their old medicine is the pharmacist’s telling them how much it will cost. So, in the end, economics will be the decider.
Generics work the same way. In most cases – the exception being epilepsy drugs – I won’t fight for brand names. Some patients think I can write magic notes to get them brand-name drugs at generic prices. It’s easier than arguing, so I write them. The cost will always make them change their mind.
After years of experience, I find that it’s a lot easier to let the patients’ pocketbooks make them realize this than to waste time trying to convince them myself.
Dr. Block has a solo neurology private practice in Scottsdale, Ariz. He has been a practicing neurologist since 1998 and in private practice since 2000.
Anybody ever give a patient a specific drug just because he asked for it? I do it all the time.
Granted, this doesn’t extend to situations where a drug is unnecessary or contraindicated, but – for example – if a migraine patient comes in and wants to try another preventive or triptan, what do you do? As with any other drug, I discuss it with the patient, and if she still wants it, and it’s not unreasonable, I’ll do it.
Some out there will say that this makes me a pushover for direct-to-consumer advertising, since that’s where most patients hear about these things. (For the rest, the information usually comes from a friend or their own research.)
But realistically, resistance is futile. If you deny patients a reasonable request because it was their idea instead of yours, they’ll likely move on to another doctor, complain to their internist or friends about you, or both.
The argument of "your insurance doesn’t cover this" won’t hold water at first. Samples or your handwritten script are free. All it takes for them to realize they’d rather stay with their old medicine is the pharmacist’s telling them how much it will cost. So, in the end, economics will be the decider.
Generics work the same way. In most cases – the exception being epilepsy drugs – I won’t fight for brand names. Some patients think I can write magic notes to get them brand-name drugs at generic prices. It’s easier than arguing, so I write them. The cost will always make them change their mind.
After years of experience, I find that it’s a lot easier to let the patients’ pocketbooks make them realize this than to waste time trying to convince them myself.
Dr. Block has a solo neurology private practice in Scottsdale, Ariz. He has been a practicing neurologist since 1998 and in private practice since 2000.