Brilliant! Masterly!
Am already opening the BNF to the right page. Looking forward to the next
hapless creature to walk INTO THE TRAP!!!!
I feel like Jel C (new Spice Girl?) in letter writing mode.
Graham Balin, (Essex Man)
----------
> From: Andrew Herd <[log in to unmask]>
> To: GP-UK <[log in to unmask]>
> Subject: Re: Lost the Battle
> Date: 09 February 1998 08:44
>
> In a rather high risk (but successful) manouever, I once turned the same
> situation to my advantage.
>
> I offered the parent the BNF, and said, "you choose."
>
> The effect was quite startling. He said, "but you're the doctor."
>
> I replied, "quite, and my opinion is that antibiotics won't work here,
and
> might even be harmful. *You* take the risk."
>
> After much blathering, my opponent retreated.
>
> I then spent 48 hours fervently hoping that I was right!
>
> The alternative (and safer) method, is to ask the patient if they are
> threatening you. Curiously, this is usually quite effective. You win
either
> way. Most people will say no, because they don't want it made explicit
(and
> also because they can work out that you are up to something) - in this
case,
> you can then exploit into the gap and ask why on earth they were behaving
> the way they did (I usually give them a let out of "of course, any parent
> would be worried under the circumstances, but remember, you can bring the
> child back any time etc). If they say yes, then you can occupy what moral
> high ground is left , and say "fine, I am prescribing under duress here,
and
> I am going to make a statement to that effect in the notes before taking
the
> matter up with the CHC/HA/God etc."
>
> Andrew
> -----Original Message-----
> From: C-P <[log in to unmask]>
> To: [log in to unmask] <[log in to unmask]>
> Date: 08 February 1998 21:25
> Subject: Lost the Battle
>
>
> >Saturday morning surgery, first patient - apparently a pleasant enough
dad
> >with his 12 year old daughter. The daughter, a known asthmatic on MDI
> >beclomethasone and salbutamol, has gone a bit wheezy; parents have,
> >reasonably enough, increased steroids, and come for advice. Examination
of
> >the girl reveals no specific focus of infection, temp is normal, ENT -
NAD,
> >and chest has a few wheezes, but nothing spectacular. I explain all this
to
> >dad, agree the next step up the BTS guidelines, about to say cheerio,
> when.....
> >
> >*BAM* - "So you're not going to give her antibiotics then?"
> >
> >Careful explanation of why I felt this was entirely inappropriate
resulted
> >in a verbal haranguing along the lines of "I KNOW that if she doesn't
have
> >antibiotics, she'll end up in hospital within the next few hours. You
did
> >this last time and look what happened; if she'd seen any other doctor,
> she'd
> >have been given antibiotics without any problem. If my daughter gets any
> >worse, I'll take this a lot further, believe me."
> >
> >Attempts at any kind of logical explanation of best practice, my 15
years
> >experience in general Practice, etc, merely served to inflame the
> situation,
> >and to avoid a potentially nasty confrontation, I gave in and gave him a
> >scrip for antibiotics.
> >
> >I lost the battle with him, and I'm sure I've also lost the war - I
can't
> >see me getting anywhere with any attempts at patient education. So what
do
> I
> >do? Give in each time, suggest they find another doctor, remove them
from
> >the list, or simply stand my ground and tough it out next time?
> >
> >Offers please,
> >
> >C-P
> >***************************************************
> >
> > Dr Adrian Canale-Parola
> >
> >"If you want a doctor I'll examine
> >Every inch of you....."
> >
> >***************************************************
> >
> >
>
>
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