November 13, 2007

How do you handle stepping on someone else's toes?

Filed under: Money

Two recent posts of mine have dealt with bad information, and both times I've wondered what the accepted protocol is for addressing it. Obviously "Hey dumbass, go read some medical literature," doesn't cut it. I addressed one instance — the cholesterol one — quietly, after it happened. It wasn't life-threatening misinformation, so immediate intervention didn't seem necessary.

I didn't bother to say anything about the antibiotic shenanigans.

The trouble with this is addressing something someone does without stepping on their toes. If I do something stupid, I'd like someone to smack me upside the head and tell me I'm wrong. Pussyfooting around the issue is for people with no self-confidence. I don't have that problem — after all, I write on the Intarweb, and think people actually care about what I have to say, don't I? — so just come right out and tell me I'm wrong.*

Not everyone is that resilient, however, and I'm sensitive to this.

Recently I've heard a pharmacist say she was going to take lots of Vitamin C and echinacea to get over a cold. I've seen pharmacists recommend Airborne for cold on more than one occasion. I've heard a pharmacist recommend a homeopathic remedy for migraine. I said nothing — these suggestions aren't harmful, but they certainly aren't helpful, either. In these cases, it's just not worth the effort. Besides, Father Time and the body's own defenses will clear these problems up on their own. (And in the case of the migraine, I suspect it was psychosomatic anyway.)

When someone says something boneheaded to a patient, how do you handle it? Especially if it's a pharmacist colleague? I would imagine doctors and nurses run into this problem from time to time as well, even if they practice alone now.

* I'm happy to say that this hasn't happened in a very long time, which can be viewed as either a good thing (I'm SMRT!) or a bad thing (I work with a bunch of idiots). Which one I lean towards is dependent on where and who I am working with, naturally.

View Comments | 6:20 am |

Maggie

I suffered a cold last winter, my first in ten years. That's how long I'd been retired and no longer so much in contact with the public. Last winter I was visiting with my daughter's family which includes an early-teenage daughter with MANY visiting friends! While I was raising my family and working (child protective services) and would get a cold, I'd be frantic for anything suggested to relieve the symptoms and also to not pass it on. Last winter, I just kept kleenex handy and a little bag for stuffing used ones in and alcohol handwash, and relaxed as it ran its course. Family agreed I was not 'kissable' for a while. It was miserable, of course, but on the tenth day was about gone. As always. Symptoms and duration were just the same, no worse and no better, than when I fought colds via the pharmacy in days of old.

By the way, I never had a pharmacist recommend stuff like echinechia (sp?) (or anything else, for colds). The pharmacists I met were always the most down-to-earth, blunt and responsive people, and I trusted them often before I did the doctor's office!
Kirsten

As you say, if the advice is harmless, I'd just let it stand. Sometimes people feel that they have to do something, and the "placebo effect" is never to be underestimated.

On another note, "medical literature" should never be overestimated.
RJS

Well in that particular case, he recommended it probably a dozen times over the course of two months. Usually in response to "I think I'm coming down with a cold. What should I do?" To which the correct response is "There's nothing you can do, except continue to eat a balanced diet, and get plenty of sleep."

It wasn't so much that he was recommending Airborne as much as the fact that he was a believer.

I think emphasis on reducing workload and increasing sleep so the body can fight off an infection on its own would be far more beneficial than taking a multivitamin. It's difficult to come up with a advertising budget for that sort of thing, though. People want to feel more active, even if it's just smoke in mirrors.
The Ole' Apothecary

How likely was it that the pharmacist was giving the Airborne recipient the brush-off because (s)he was busy and didn't have time to go through that familiar ritual of the individual rejecting recommendation after recommendation? These patients want a rubber stamp, not information.

Very few of my customers in my retail days received my studied recommendations, but only because it never traveled, as radio-emdee Dr. Dean Edell says, "from my larynx to his tympanic membrane."
greensunflower

As a migraine suffer, who has been told by many including doctors that they are "psychosematic," please come and tell me that when I am in a cold sweat hugging the toilet with my eyes closed.

On another note, we had a parent treat a child with laryngeal papillomas with airborne. She showed up at the ER in resp distress.

On another note, I am a newbie, so I almost never tell anyone they are wrong.

OnThePharm

How do you handle stepping on someone else's toes?

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