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Clinical · Prescriber conversations · continued

Coming back to: Preparing for an appointment: one page, three questions posts 121–150

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

OV
o.vogelTL212 Dec 2024#121

A second opinion is a normal part of medicine rather than an accusation, and asking how to obtain one is a legitimate question.

This is where my knowledge stops and I would rather mark the edge than blur it.

0 likes 20mo
MD
m.duarteTL214 Dec 2024#122

Thank you for the correction. I would rather find out here than later.

31 likes 19mo
LA
l.aguirreTL215 Dec 2024#123
t.pereira, post #34: Adding the measurement that post #31 says would settle it. Take the actual numbers and the actual dates. A printed table beats a description and takes the first five minutes out of the appointment. Go to post

Post #119 put the caveat in the right place and I want to underline it.

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

That is all the detail I have. Someone else will have more.

11 likes in reply to #34 19mo
FF
f.fenwickTL3Regular16 Dec 2024#124
integrator_trace, post #7: Reading rather than answering, but this is the post I would point somebody at. Go to post

Preparing for an appointment: bring recent bloodwork, a list of current medications with doses and timing, and any questions written out. Written questions get better answers than questions asked on the fly.

I am describing what is, rather than arguing for what should be.

3 likes in reply to #7 19mo
KV
k.vanheckeTL218 Dec 2024 · edited#125

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

1 like 19mo
KF
k.fonsecaTL219 Dec 2024#126

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

0 likes 19mo
RD
r.danquahTL220 Dec 2024#127

Where I part company with post #123, and it is a narrow parting.

Written summaries after an appointment are available in many systems and are worth asking for, because recollection of a consultation is unreliable.

Worth checking against a second source before it gets quoted onward.

16 likes 19mo
RV
r.villalobosTL221 Dec 2024#128
b.dumitru, post #20: 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. The answer changed when I changed how I was measuring, which was informative. Go to post

Post #127 is the version of this I will quote in future. One addition.

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.

That is my reading. Someone else read the same page differently and was reasonable.

6 likes in reply to #20 19mo
RA
r.aldana_pharmdTL4Pharmacist23 Dec 2024#129
Norrington, post #80: 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. Speaking for myself and not for anyone else who has posted here. Go to post

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

Not disagreeing with anyone above, just adding the bit I keep having to look up.

32 likes in reply to #80 19mo
AV
a.vukovicTL224 Dec 2024#130

Take the actual numbers and the actual dates. A printed table beats a description and takes the first five minutes out of the appointment.

17 likes 19mo
NR
n.rowntreeTL3Regular25 Dec 2024#131

Prescribers reading this subcategory consistently say the most difficult consultations are the ones where information is withheld rather than the ones with difficult questions.

The general answer and the answer for your case may diverge here.

12 likes 19mo
KK
k.kuuselaTL226 Dec 2024 · edited#132
customs_ledger, post #70: Answering the question post #68 raises rather than the one it answers. Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation. Two sources, same conclusion, and I could not rule out that one copied the other. Go to post

Questions about dose: asking "how will we determine whether this dose is working for me" gets at the monitoring plan. Asking "can we start lower" or "can we escalate slower" opens that conversation.

That is all I can say without guessing.

26 likes in reply to #70 19mo
FE
footnote_entryTL3Regular28 Dec 2024#133

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

Happy to expand any of that if it is the useful part.

0 likes 19mo
HC
h.castellanosTL229 Dec 2024#134

Post #132 describes the usual case. This is about the unusual one.

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.

4 likes 19mo
K
KStephanopoulosTL3Regular30 Dec 2024#135

Asking about the plan if the first approach does not work is a good use of an appointment and is rarely done.

Adding it in case it saves somebody the afternoon it cost me.

8 likes 19mo
TI
t.ibarraTL21 Jan 2025#136
a.vermeulen, post #58: Post #57 answers the question as asked. The question underneath it is different. A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. That is the shape of it. The detail is where I would expect to be corrected. Go to post

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

That much is documented. The rest is how I have interpreted it.

19 likes in reply to #58 19mo
I
IsaksenTL3Regular2 Jan 2025#137

Clear enough that I do not think I have a follow-up, which is unusual.

0 likes 19mo
TB
t.batistaTL23 Jan 2025#138

Answering the question post #136 raises rather than the one it answers.

A pharmacist can answer a great many of the questions people save for a prescriber, faster and often better, particularly about interactions and formulations.

2 likes 19mo
BP
bench_peakTL34 Jan 2025#139
MN
m.ndiayeTL26 Jan 2025#140

Post #136 put the caveat in the right place and I want to underline it.

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

13 likes 19mo
KR
k.roosTL27 Jan 2025#141

I read post #138 twice before replying, because I had assumed the opposite.

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.

That is the honest state of it as of this week.

8 likes 19mo
AW
a.weissTL28 Jan 2025#142

Post #141 answers the question as asked. The question underneath it is different.

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

Correct me on the arithmetic if it is wrong; I would rather know.

2 likes 19mo
DF
d.fontaineTL29 Jan 2025#143

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

0 likes 19mo
KS
k.salinasTL211 Jan 2025#144
d.achebe, post #79: Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation. The variance between people here is larger than the effect being discussed. Go to post

Written summaries after an appointment are available in many systems and are worth asking for, because recollection of a consultation is unreliable.

27 likes in reply to #79 19mo
MM
m.malinowskiTL212 Jan 2025#145

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

13 likes 18mo
HM
h.mukherjeeTL1Member13 Jan 2025#146

Post #145 is right about the mechanism and I think understates the practical bit.

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.

I would want a second opinion before relying on that.

4 likes 18mo
AA
a.almeidaTL214 Jan 2025#147
r.villalobos, post #128: Post #127 is the version of this I will quote in future. One addition. 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. That is my reading. Someone else read the same page differently and… Go to post

Sensible. I would want the same detail before I acted on it either.

0 likes in reply to #128 18mo
PS
p.silvaTL215 Jan 2025#148
c.tulloch, post #96: A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. I am not the right person to answer the follow-up to this. Go to post

Take the actual numbers and the actual dates. A printed table beats a description and takes the first five minutes out of the appointment.

0 likes in reply to #96 18mo
VS
v.szaboTL3Analytical chemist17 Jan 2025#149
t.marchetti, post #2: Prescribers reading this subcategory consistently say the most difficult consultations are the ones where information is withheld rather than the ones with difficult questions. Go to post

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

2 likes in reply to #2 18mo
OV
o.vukovicTL218 Jan 2025#150

If the answer is no, asking for the reason is reasonable and the reason is usually specific. It is also what makes an appeal possible where one exists.

0 likes 18mo