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Wednesday, 1 March 2006

Drama on Friday

 

Went to visit Dr. E, A GP in my locality, as part of my job, which is to promote cost-effective prescribing. I monitor their prescribing trend, make sure they don’t prescribe large quantity of sleeping pills and harm patients etc. It was my first meeting with Dr. E, as I am new to this job.

First thing on the agenda: Atorvastatin and Simvastatin, both are used to lower cholesterol level in patients. Atorvastatin cost £18.01 per 28 tablets, while simvastatin cost only £3.89. I showed him the literature where all clinical trials were tabled and showed him the effectiveness comparing atorvastatin and simvastatin.  10mg of Atorvastatin and Simvastatin 40mg decrease cholesterol level by 37%, ie at that dose, they both do the same job, same level of reduction. I showed him the evidence. To my dismay, he chose to live in DENIAL.

“This is not true. I don’t believe this”

How do you response to people who chooses to live in denial?

I told him that the result was from 164 clinical trials paper and is the highest level of information in terms of credibility.

“How many GPs have you visited and how many has agreed to simvastatin as first line?”

“I have visited three”

“Who are they?”

“Dr. G, Dr. D and Dr. W”

Dr. E picked up the phone and called Dr. G in front of me. I couldn’t hear the other end of the conversation, the last word from Dr. E was : “ Yeah, they don’t listen to us”

Dr. E turned to me and said “ Dr. G said he agreed because of your persuasion”

To be honest, I don’t know what is the whole argument about, because when I asked him which statin does he use as first line, he answered: Simvastatin !!!

I prayed in my heart for wisdom and for self-control.

As written in the bible, Proverbs 12:15 : A fool shows his annoyance at once, but a prudent man overlooks an insult.

In the end I told him, … just when I spoke the third words, he interrupted me. I said, please give me a chance to speak and let me finish my sentence. I can’t control you, my job is to lay out the evidence before you, share our interpretation of those result and our opinion, and by the end of the day, you can do what you want. You are a health care professional, I am a professional too.

The rest of the conversation went well.

Quite a drama.

3 comments:

  1. I found this is a very good illustration for people denying truth. Sometimes, we don't want to believe no matter how many people telling us and how many evidences we are facing....

    It's hard to do anything to a harden heart,isn't it?

    ReplyDelete
  2. rachel, i know *who* are you referring to. I believe it takes time.

    ReplyDelete
  3. Congratulations Irene, I think being level headed at times like these is a very difficult thing to do. I tend to avoid confrontation myself. So I think you did really well in this case.

    ReplyDelete

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