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CHAPTER 6 — The First Script
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Exploring the Patient’s Medication Passport after she finishes forging the
medication alliance:
Clin.:
Juan, this is your first appointment here, and before we talk a little
about our possibly working together long term, I’d like to talk a little
bit about how I approach using medications. First let me just reas-
sure you that unless there is an important reason to do so, or unless
you really want me to, I generally don’t make any suggestions about
changing medications in a first appointment when picking up a pa-
tient transferred from another doctor. Before doing so, I would like
to get to know you better and what you thought about your work
with your previous treatment team before I make any suggestions for
changes, if indeed I have any. I also know it can be a little unnerv-
ing to switch doctors. Especially if you’ve . . . I see that you’ve been
seeing Dr. Travis for almost 15 years. That’s a . . .
Pt.:
Long time?
Clin.:
Right.
Pt.:
Yea, I really liked her.
Clin.:
I can see why. From her notes, it looks like she took great care of you.
What did you like about her?
(Exploring the Patient’s Passport on
Previous Prescribers)
Pt.:
I don’t know exactly, hmmm, she was just, I don’t know, low key, sort
of an average kind of person, but really bright. I just liked her. I felt
comfortable with her. I don’t know.
Clin.:
Well, I’m hoping you’ll like me too. In fact, it’s very important to me
that you feel comfortable with me and how I use medications, so
that’s why I thought I should share with you a little bit about how I
approach medications in general, because each doctor may be a little
different. Is that okay?
Pt.:
Yea, sure.
Clin.:
My goal is to always give you my best advice, whether that advice is
to start a medication, stay on it, or get off it. Together, if we decide
to try another medication, we want to find a medication that you are
genuinely interested in taking because it makes you feel better and
is doing what you want it to do, like lowering your blood pressure.
You’re the one who is putting the medication in your body, so it’s
your opinion that is most important, not mine. Obviously, as a physi-
cian (use appropriate discipline), I have tremendous respect for med-
ications and I have found them to be very helpful in many patients.
I also have a healthy respect for the fact that medications can cause
problems too. In my own life, I only take medications when I feel