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CHAPTER 6 — The First Script
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Sometimes at the end of the Call-Me-First Invitation, I’ll utilize an
interviewing technique called “Feel Free to Discontinue.” I learned about
the technique during a workshop I was giving on the MIM in Waterloo,
Iowa from a nurse practitioner, Cyd Q. Grafft. I add it to the Call-Me-First
Invitation with a patient who, in my gut, I sense is particularly frightened
or hesitant about a medication but genuinely wants to try it. The following
tip can help to relieve some of this fear:
“By the way, I really do mean that I want to hear about
any side effects you may be having. For different reasons,
people sometimes are hesitant to let their physicians and
nurses (insert whatever professions seem appropriate)
know about side effects, but I really want to know. Some-
times we can reduce them or even get rid of them, and
sometimes we may need to stop the medication. And if
for some reason you start getting a side effect, please call
our office before you do anything. I’ll let you know what
I think is happening and you can decide what to do. Even
if I’m not available, one of our staff will talk with you and
provide advice. But try not to stop any medication without
talking with me or one of my staff first. Sometimes it isn’t
a side effect. And some types of side effects even go away
shortly after appearing as your body adjusts. In any case, I
really am your consultant. In the end, you’ve got to call the
shots, but be sure to use me.”
TIP
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The Call-Me-First Invitation
“We have really covered the side effects carefully, and
hopefully you won’t get many or any. But if for some rea-
son, before our next appointment, you feel concerned about
a side effect and you can’t reach me or one of my staff by
phone or e-mail, feel free to stop the medication immedi-
ately. You can give me a call afterward and we can see if we
can come up with a better fit at our next appointment.”
TIP
12
Feel Free to Discontinue
My only caveat here is that one can only use this technique if, indeed, it is
safe for the patient to discontinue the newly prescribed medication abruptly.