Sudbury.com – More and more doctors are being faced with patients who are requesting medical tests or treatments that physicians might deem inappropriate.
The issue, outlined in a recent edition of the Journal of the American Medical Association (JAMA) examines how patients bring issues and concerns to their physicians and how those physicians respond, said the report.
The article said clinicians discuss tests, referrals, and treatments with patients and caregivers every day. The study looked at 1319 outpatient visits to 56 family physicians at a single US academic health centre.
It showed 68 per cent included at least one patient request for a test, referral or medication that the physician might consider unnecessary.
Conversations around these requests may require clinical negotiation to find common ground if the patient requests a test or treatment that a clinician deems inappropriate, unnecessary, or low-value, said the article.
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It also said that patient requests are common, arising in up to 15 per cent of outpatient visits, and have likely been fueled by direct-to-consumer marketing of pharmaceuticals and other medical services.
Patient requests for potentially harmful or low-value services may put clinicians in the difficult position of attempting to promote patient satisfaction while exercising their best clinical judgment.
The article posted a list of situations where physician and patient negotiation would be warranted:
- A 45-year-old man with uncomplicated acute low back pain wants immediate MRI (magnetic resonance imaging) diagnosis.
- A 19-year-old woman with mild acne who has not tried first-line therapies asks to see a dermatologist.
- A 52-year-old man with chronic musculoskeletal pain asks for an early refill of oxycodone …