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PART TWO — Interviewing Techniques and Strategies

and e-mails requiring responses, as well as frequently necessitating an increased number of appointments (some squeezed – because of their ur- gent nature – into an already tight schedule). It is exactly the type of time consumption that can lead to burn-out in your administrative staff, clinical staff, and yourself. Moreover, patients, who have discontinued their meds, may require hospitalization requiring large amounts of time on the part of the treating clinician whether it be a hospitalist or yourself. The interviewing principle at hand is a simple one: Before recommending your first new medication, take the time to introduce your personal approach to prescribing medications in general . The following three interviewing techniques provide prototypes for putting this principle into practice. Clinicians tend to use them near the end of the first appointment usually directly before discussing their recommendations. The bridging statement might sound like this: “You know, before I discuss any of my thoughts on a particular medication, I thought it might be of value, since we have never worked together before, to share with you how I like to approach the use of medi- cations just in general. Does that sound okay with you?” “My goal as a physician (substitute appropriate prescriber discipline) is to always give you my best advice, whether that advice is to start a medication, stay on it, or get off it. Together we want to find a medication that you’re genuinely interested in taking because it makes you feel better and/or is doing what you want it to do. You’re the one who is put- ting the medication in your body, so it’s your opinion that is most important, not mine. Obviously, as a physician (sub- stitute appropriate prescriber discipline), I have tremendous respect for medications 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 that I really need them and I feel that the benefits will outweigh the costs. I take the same approach with my patients. So, I don’t suggest a medication unless I really have a feeling it will help you. I would never recommend a medication that I myself would not take or give to one of my family. And I always try to fill my patients in on possible side effects and the pros and cons of using the medication. How’s that sound to you?” TIP 8 The Medication Interest Opening