Shea_Chapter 6

88

PART TWO — Interviewing Techniques and Strategies

prescribers.” Thus, patients come to our offices carrying a passport regard- ing their interactions with previous prescribers in the same sense that they have a passport regarding their experiences with previous medications. If a patient has a history of bad encounters with prescribers, it is very easy for the patient to anticipate that we will fit the same mold. Such a projec- tion can be devastating to the patient’s future interest in our medication recommendations. Our next interviewing principle mirrors our previous one, Before prescribing a first medication, try to review the patient’s passport regarding previous prescribers . The following interviewing technique, which can be worded with some degree of variations, puts the principle to use: “How have you felt about your previous doctors, nurse clinicians, physician assistants or anyone else who has prescribed medications for you? Did any of them seem particularly good at helping you to understand your medi- cations and any concerns you had about side effects or were any of them particularly bad at doing that?” or if the patient is a direct transfer “What are your feelings about your last doctor (use name of appropriate professional discipline as fits the situation)?” TIP 7 Exploring the Patient’s Passport on Previous Prescribers Note that if you are nurse or social worker functioning as a case man- ager following the patients use of medications and integrated care, the Patient’s Passport on Previous prescribers is easily modified as, “What are your feelings about your last case manager.” In the initial appointment, there exists no single correct way for a clini- cian to introduce his or her approach to prescribing medications. Each of us will vary what we say depending on our own beliefs and the differing needs of each of our patients. The following approach is not presented as the “right way” to do it, but it emphasizes that we must all give consider- able thought to how we do it. Even more important, if the student (as well as the more experi- enced prescriber) is to take one thing away from this section, it is the recognition that discussing one’s personal approach to medication use Introducing Your Personal Approach to Using Medications to the Patient