Coming back to: Getting a referral rather than a refusal posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Prescription logistics: confirm whether it will be filled locally, requires mail order, or will be prescribed off-label and needs a compounding pharmacy. Different paths have different implications.
How to ask for what you need: rather than "should I take this", frame it as "I understand the evidence for this shows X benefit in people with my condition; would it be suitable for my specific situation?" That invites clinical reasoning rather than yes/no.
Post #31 is right about the mechanism and I think understates the practical bit.
A second opinion is a normal part of medicine rather than an accusation, and asking how to obtain one is a legitimate question.
On balance I think that is right, and I would not bet much on it.
On post #31 — agreed on the reasoning, with one qualification.
Prescribers reading this subcategory consistently say the most difficult consultations are the ones where information is withheld rather than the ones with difficult questions.
If this contradicts something upthread, the upthread version may well be the better one.
The arithmetic on Getting a referral is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it.
A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.
Worth stating the null on Getting a referral before we explain it: the observation may be nothing. That possibility deserves a sentence and usually does not get one.
A note on how Getting a referral gets discussed rather than on Getting a referral itself: the confident posts get the replies and the careful ones get ignored, and the careful ones have been right more often.
Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.
Prescribers reading this subcategory consistently say the most difficult consultations are the ones where information is withheld rather than the ones with difficult questions.
Confirming post #40 from a second method, which matters more than confirming it from a second person.
Small methodological point on Getting a referral: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.
I had written a reply contradicting post #42 and deleted it. Here is what survived.
Where I would push back on the Getting a referral consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed.
Prescription logistics: confirm whether it will be filled locally, requires mail order, or will be prescribed off-label and needs a compounding pharmacy. Different paths have different implications.
Where I part company with post #46, and it is a narrow parting.
Getting a referral: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which.
Collapsed as off-topic by two members at trust level 3 or above
Post #46 and I disagree about the size of the effect, not about the direction.
An update on my earlier Getting a referral post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.
Post #49 and I disagree about the size of the effect, not about the direction.
How to ask for what you need: rather than "should I take this", frame it as "I understand the evidence for this shows X benefit in people with my condition; would it be suitable for my specific situation?" That invites clinical reasoning rather than yes/no.
Taking post #49 at face value and following it one step further.
I have three months of notes on Getting a referral and the honest summary is that the trend is real and the week-to-week numbers are noise. I nearly drew the opposite conclusion from the first fortnight.
Reframing Getting a referral slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If it is "how often", nobody here knows.
A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.
This is the sort of thing that ought to be settled and apparently is not.
Building on post #53 rather than restating it.
If you have been doing something the prescriber does not know about, saying so is more useful than not. Clinicians here consistently say they would rather know.
Adding what did not work for me on Getting a referral, since the failures never get written up and they are half the useful information.
My position on Getting a referral is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.