synergy

Pills, Prescriptions, and Doctors

Dr. Zuger wrote a good essay for the NY Times today discussing a doctor's tendencies to rely on particular medications and not always listen to the patient. She discusses her biases and struggle to balance statistically proven outcomes versus the needs of individual patients.

Given the importance of medications in the treatment of bipolar disorder, the dilemma between percentage outcomes and individual needs remains a constant tension. The additional challenge is finding a doctor, who is willing to work with a patient to work through that tension to develop a medication regime, which is tolerable and effective.

I believe strongly in having an advocate at the doctor's visits to make sure that the patient explains his/her concerns to the doctor clearly and to take notes of the doctor's response. Also, the advocate may speak to elucidate individual points or to query the doctor more closely.

Every since K's heart attack and subsequent depression (prior to the bipolar diagnoses), I've attend the psychiatric visits with her. I was able to listen more clearly and not get hung up on a single statement. K found it valuable to have me there to offer Dr. X feedback as to her moods, ask questions, and to rehash the visit afterwards. If we were to ask him, I believe that he finds my presence valuable in treating K.

An advocate becomes particularly important in discussions of medications to support the patient if the doctor has trouble hearing, listening, or believing the patient. The last role an advocate can play is aiding a patient, who may not want to challenge the doctor. A doctor isn't infallible, and the patient needs to question and challenge, as appropriate.

posted by synergy @ 8:37 AM