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    Can patient satisfaction and quality care coexist?


    He finds this approach useful when discussing options for the testing and treatment of prostate cancer, among other issues. They may have “lots of discussion about whether or not screening is necessary, based on the physiology of prostate cancer and the pretty nasty outcomes” that can occur with treatment of the disease, he says. Duda strives to help his patients stay focused upon concrete outcomes. He guides patients to consider key issues about whether or not a certain approach will lengthen their life or increase its quality, and about how it might be problematic.  Usually, he says, once he has built rapport with a patient, that person will defer to his judgment, but patients are not always predictable.  

    Countering the magic pill mindset

    Roxana Lascu, MD, ran a solo primary care practice in Lake Mary, Florida, for three years until recently, when she closed it and became a hospitalist with Orlando Health. In her practice, she found problematic patient requests falling into two main categories: request for unneeded antibiotics and for unnecessary tests. 


    Further reading: 5 tips for tactfully combatting negative patient reviews


    She attributes the patients’ frequent requests for antibiotics, even for viral conditions, to their wanting an easy fix. Often, patients, she says, are simply intolerant of being sick, and will press strongly to obtain prescriptions.

    “With so many medicines today to counteract this or that or the other, there is a tremendous feeling that a pill is going to fix it,” she says.

    She reports that about 70% of the time, she makes her point that antibiotics are unneeded, but that the rest of the time, patients dig in. They may tell her that they plan to go to a walk-in center for the drugs. In those cases, she will agree to call in a prescription but asks that they wait 24 or 48 hours before picking it up to see if they improve without it, as they often will.

    Requests for tests were also a problem during her years in private practice, she says. She mentions women wanting Pap smears and mammograms yearly despite current recommendations for less frequent screening. In such instances, Lascu would strive to help them understand the disadvantages of too much testing. 

    Next: Sticking with Hippocrates


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