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This is where we sort of disagree. Patients should be informed consumers of their health care and by listing the medications that you typically prescribe to treat a specific problem doesn't change the fact that they have to see their doctor to get it. There will always be patients out there that disregard your instructions, self medicate with OTC drugs, use old prescriptions to treat current ailments...This will never change! I wish patients were better informed of the medications they are receiving. There is not a day that goes by that I don't see another doctors patient that is taking the wrong medication for their problem or medications that are no longer indicated due to resistence and/or a multitude of other factors. I pride myself on my patient education and I stress the importance of taking the medications as prescribed. There is nothing out there that states the medications, their indications, their side effects, their interactions with other medications and so on are the sole ownership of the physicians that prescribe them or that they influence a patient's decision to self medicate. Patient's will always self diagnose, self medicate, and self treat regardless of what they are told or what they read. If this were the case we should do away with Web MD where individuals can attempt to self diagnose...We should also do away with most OTC medication as well. Not every case of dysuria, urgency, and frequency is a UTI! Why is there Azo and Uristat OTC for these people? Having these medications available can lead to more severe urinary tract infections and inaccurate diagnosis in a clinical setting. I can name off 30 plus conditions that are included in the differential diagnosis of dysuria/urgency/frequency....this is what distinguishes the patient from their MD.
"Most people don't need all the qualifiers - equipped facility"
I wish patients understood the qualifications possessed by the physician and the facility within which they practice. Every patient that uses my facility knows my qualifications, where I trained, and what types of services I am able to offer. I feel fortunate that I can stabilize an MI in my office prior to transport, treat pyelonephritis as an outpatient, surgically repair a tendon, definitively diagnose an acute appendicitis or ectopic pregnancy before sending them to the surgeon, and .......
Why? I'm trained to do it, but my facility is also equipped with a CT scanner, ultrasound, EKG, digital X-ray, full lab capable of obtaining stat troponins, CKMB, BNP, D dimer, CMP, CBC.......I employ registered nurses efficient at placing IV's and pushing medications, I have trained lab personnel, I have an employed Radiologist that rereads my films, and I have a very strong subspecialty support system in place.
I have also practiced in a clinic that is capable of only performing a strep screen and running a UA and that is about all. Patients that come to such a facility should know the limitations and risks associated with seeking treatment there. If you are coming in for a strep throat that is OK, a BP medication refill that is OK, a DVT? Nope!, Syncope? Nope!, Chest pain? Nope!
Why delay treatment when timing is of the essence when the physician and facility are not equipped to handle it. This would appear to be common sense to most but unfortunately it isn't. They know you are a physician and assume that you can diagnose and treat just about anything that walks through your front door. In my facility we have the technology to assist in doing this but in other places they do not. It has nothing to do with the diagnostic skill of the physician but more to do with what the physician has available at his disposal to aid in diagnosing and treating the patient.
Long story short, it is very important for patients to research their physicians, know what their specialty is in, know whether they are board certified, how long they have been in practice, what services does their practice offer, what hospitals are they affiliated with, what subspecialists do they utilize, can they perform minor surgery and take X-rays, what lab studies are offered and how long does it take to get the results....
Be an informed patient! Patients knowing the names of the antibiotics used to treat a UTI doesn't imply that they will self medicate and not seek the proper medical attention. I'm not telling someone that if you have symptom X/Y/Z take medication A/B/C. I thought I was straight forward in saying that there are many problems that can predispose one to getting a UTI but also many problems that mimick one as well. Information on the web regardless of the source should never be used in place of seeing your physician face to face and having the necessary examination and studies performed. That being said, people will do what they want regardless of what you you write on this forum. This is meant to be a stepping stone from which to gain additional insight and information.
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