Here’s a question for you to ponder – when the doctor tells you to take your medications two hours after food, will you take them TWO HOURS AFTER food? If the pharmacist advises you to stop smoking, will you do that immediately?
Throughout my internship stint at a Polyclinic, I have seen patients from all walks of life – patients who come in just for the MC, patients who think they can cut the queue because “I pay my taxes too”, and patients who will not admit to their mistakes etc. But what worries (or frustrates?) me are chronic patients who fail to follow their medication regime, and patients who fail to listen to their healthcare providers’ advice.
While working at the counter, patients will come with their leftover packets of medications, telling me to cut down on the prescription since they still have the medications. Some people might not think too much of this, but for us healthcare providers, it is a cause for medical intervention. Usually, medications prescribed for chronic diseases such as high blood pressure and diabetes mellitus are just enough until the next appointment. Having leftovers just mean that patients have not been taking their medication according to their doctors' orders. I would have to sit them down in the counseling room, and guide them through their medications (we call it medication reconciliation). Some patients would then recall what their doctors have told them before, while some have no idea what I am talking about.
There were a few days where I shadowed a clinical pharmacist who was consulting patients with diabetes mellitus. When she asked the patients whether they did what she advised them to do such as exercising, eating healthy food, stop smoking etc, they would tell her grandmother stories and beat around the bush before admitting to not following her advice.
All these lead me to more questions – is there active listening between the patient and the healthcare provider at all? If the doctor tells the patient the medication regime, why would there be leftovers? Or when the pharmacist advises the patient to eat healthily, what is stopping them from doing so?
What do you think?
Haha... This is quite a common problem actually and it is definitely not a trivial matter. I think people nowadays appear to have not practiced active listening when they consult their healthcare providers because their purpose for going to them was not to listen in the first place. Rather, some people visit the doctors or pharmacists for the sole aim of getting medicines that are not available over the counter.
ReplyDeleteIn this aspect, I can speak from experience too. For example, when I am down with a runny nose, sore throat and cough, I'd go to the doctor with a diagnosis of my condition already in my head and expect them to ask the same questions and give the same prescription. After which, I'd keep the leftovers of my medicine (with exception for antibiotics which I'd finish) and self-medicate until it's used up before visiting the clinic again.:) I think this mentality has developed in some of us because of our experience from the numerous visits to the doctor, where we would receive the same prescription when presented with similar symptoms. This has caused us to be slightly more informed on the drugs that we are consuming for our sicknesses.
However, this being the case for the common flu, I think it can have serious implications if people who have chronic illnesses try to self-medicate or ignore the advice of healthcare providers. I think some of them do that not because they do not actively listen but because they do not see immediate consequences of not following the advice of the healthcare providers. I have heard a story of an elderly patient with hypertension, who forgot to consume his regular dosage of medicine for a period of time and decided to make it up by consuming all the medicine he missed at one go. Symptoms didn't show but he scared the wits out of his attending doctor when he told him this. I think these patients and other chronically ill patients who think they are fine with missing one or two doses of medicine are putting their lives at risk.
I think the problem here might not be due to inactive listening to the dosage of medicine required for them, but the lack of awareness of the adverse consequences of not strictly following the regime. I think if healthcare providers could spend some time explaining to them, especially the elderly patients, the ill effects of not adhering strictly to their medication regime, people would generally be too scared to risk their lives by playing around with their medications, and would obediently follow their healthcare providers’ instructions.:)
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