I chose the picture up top today because of what the character he plays lacks: bedside manner. Today’s story is not so much about a patient as much as it is about a physician treating a patient.
So, my story starts with a prescription that was brought to us by the caretaker of a bed bound man. He had been in the emergency room the night prior and had received a prescription for an antibiotic. This antibiotic is very expensive and not many insurances cover it. The caretaker for the patient said they couldn’t afford to pay for it out of pocket. I tell her I’d call over to the hospital and see about switching it to something else.
After a few transfers to the correct station and some waiting on hold, I am talking to the physician covering the emergency department for the day. I explain the situation to him and tell him the patient will not be able to purchase the medication. His response was blunt and rude: “I know the price of medications is expensive, but so is the cost of medical care.” I asked what he suggested the patient do, and he told me to have the patient come back to the hospital for further evaluation. Without any more speaking, he hung the phone.
This kind of situation always leaves me frustrated and feeling bad for the patient. Trust me, I understand that you need to select the correct antibiotic to treat the infection. I am not trying to undermine any prescriber’s authority when I call for substitutions. I am trying to make things as smooth and easy for the patient as it can be. If you refuse to prescribe something more affordable and the patient absolutely cannot afford the medication, guess what? They won’t be taking it. Period. Then, the infection will continue to manifest, and the patient will get worse. So, prescribing something the patient can’t afford is worse than prescribing something with slightly less coverage. If you’re going to give the patient a prescription, you should always be prepared for the insurance not to cover it just in case they do not because, truthfully, when a person has to choose between getting a medication and being able to provide food for tonight’s dinner, they will almost always go with the necessity. No one chooses medication over food unless not having the medication causes immediate devastation. The only exception is with pain medications.
This situation also makes me realize why some patients do not seem to care for or trust their physicians as much as they should. When prescribers do not have good bedside manner and prescribe in this fashion, the patients begin to feel like a number instead of a person. They feel like they are being used for reimbursement from insurance companies and not getting the care they deserve. They feel like the prescriber is not taking their individual needs into account.
Also, acting pompous and arrogant over the phone to the pharmacy in this situation makes patients trust prescribers even less. Many times, this is their thought process: “The pharmacy is trying to save me money and the doctor isn’t letting them. They must be getting financial benefits from drug companies for using this.” That’s when we tend to hear people complaining about the kind of care they receive at the prescriber’s office.
To sum this whole entry up, bedside manner is critical to forming and maintaining a good patient-healthcare professional relationship, as is interdisciplinary teamwork.