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Clinical · Prescriber conversations · continued

Coming back to: Preparing for an appointment: one page, three questions posts 61–90

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

FS
f.sjobergTL220 Sep 2024#61

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.

3 likes 22mo
DO
dr_okonkwoTL4 Moderator22 Sep 2024#62
a.delgado, post #42: That matches what I have seen, for whatever a single anecdote is worth. Go to post

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

11 likes in reply to #42 22mo
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m.lehtinenTL223 Sep 2024#63
m.strand_rph, post #1: Posting this under the heading it deserves: Preparing for an appointment: one page, three questions Everything below is what sits behind that. A question about how to describe something to a clinician rather than about the thing itself. I have a set of observations, dated, with what I was doing at the time. What I do not have is a sense… Go to post

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

I would want to see it done twice before believing it once.

32 likes in reply to #1 22mo
CC
c.cardosoTL225 Sep 2024#64

Coming back to post #61, because the follow-up matters more than the original answer.

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

A partial answer, offered because a partial answer beats none.

0 likes 22mo
NB
n.brobergTL226 Sep 2024#65

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.

Old habit: I write down the expected answer before I calculate it.

6 likes 22mo
OO
orbitrap_olaTL3Mass spectrometrist28 Sep 2024#66

Agreed, and I will stop repeating the version of this I had been repeating.

16 likes 22mo
MP
m.perrinTL229 Sep 2024#67
ak.kravchenko, post #8: A pharmacist can answer a great many of the questions people save for a prescriber, faster and often better, particularly about interactions and formulations. Go to post

Confirming post #65 from a second method, which matters more than confirming it from a second person.

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.

The uncertainty is in the assumption, not in the calculation.

0 likes in reply to #8 22mo
SK
s.karlsen_rphTL3Pharmacist1 Oct 2024 · edited#68

I had written a reply contradicting post #64 and deleted it. Here is what survived.

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 have said this before in a thread nobody could find, so it is worth repeating.

1 like 22mo
CV
c.vasquezTL22 Oct 2024#69
q.zhao_qa, post #17: 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. The confident version of this sentence would be wrong, so here is the hedged one. Go to post

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

I would hold that lightly until someone with a larger sample weighs in.

0 likes in reply to #17 22mo
CL
customs_ledgerTL3Regular4 Oct 2024#70
f.villalobos, post #33: Where you have a specific worry, name it. "I am worried about X" is more useful to a clinician than a series of questions circling X. Go to post

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.

4 likes in reply to #33 22mo
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i.ilungaTL25 Oct 2024#71

Where you have a specific worry, name it. "I am worried about X" is more useful to a clinician than a series of questions circling X.

1 like 22mo
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sleep_logTL2Regular7 Oct 2024#72
ak.kravchenko, post #8: A pharmacist can answer a great many of the questions people save for a prescriber, faster and often better, particularly about interactions and formulations. Go to post

Taking post #71 at face value and following it one step further.

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

0 likes in reply to #8 22mo
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r.weissTL28 Oct 2024#73

Grateful for the specificity. Vague answers to this question are what sent me looking.

16 likes 22mo
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i.aranda_esTL2Translator · ES9 Oct 2024#74

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.

One case, stated as one case.

6 likes 22mo
SA
s.adebayoTL211 Oct 2024#75
q.zhao_qa, post #17: 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. The confident version of this sentence would be wrong, so here is the hedged one. Go to post

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

Take it as a starting point and not as a specification.

0 likes in reply to #17 22mo
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formulary_notesTL3Regular12 Oct 2024 · edited#76
s.adebayo, post #75: A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. Take it as a starting point and not as a specification. Go to post

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

31 likes in reply to #75 22mo
LV
l.vukovicTL214 Oct 2024#77

Coming back to post #75, because the follow-up matters more than the original 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.

11 likes 21mo
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weekly_pinTL2Regular15 Oct 2024#78

Post #75 is right about the mechanism and I think understates the practical bit.

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

One more caveat and then I will stop qualifying: the sample selected itself.

3 likes 21mo
DA
d.achebeTL217 Oct 2024 · edited#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.

5 likes 21mo
N
NorringtonTL3Regular18 Oct 2024#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.

1 like 21mo
AK
ak.kravchenkoTL219 Oct 2024#81
c.grimaldi, post #36: 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. 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.

3 likes in reply to #36 21mo
AD
ambient_draftTL3Regular21 Oct 2024#82

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

I am reporting what happened, not recommending it.

10 likes 21mo
MA
mi.amankwahTL222 Oct 2024#83

Adding thanks rather than a view. I do not have a view worth the space.

23 likes 21mo
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LJankowiakTL3Regular24 Oct 2024#84

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

0 likes 21mo
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a.cardosoTL225 Oct 2024#85
OTeixeira, post #29: 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. The interesting part of this is the exception, and I do not understand the exception. Go to post

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.

1 like in reply to #29 21mo
BR
buffer_reviewTL3Regular26 Oct 2024#86
a.kirchner, post #48: Everything in post #46 holds. The case it does not cover is the one I have. A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. I have changed my mind on this once already, so take it as current rather than settled. Go to post

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

6 likes in reply to #48 21mo
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a.norgaardTL228 Oct 2024#87

Taking post #84 at face value and following it one step further.

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

This is the version I would want a new member to read first.

16 likes 21mo
TI
trough_indexTL3Regular29 Oct 2024#88

Post #86 and I disagree about the size of the effect, not about the direction.

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

I would treat that as a working assumption and revisit it.

32 likes 21mo
NR
n.ramosTL231 Oct 2024#89

Post #88 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.

Happy to be the one who is wrong here if it settles the question.

30 likes 21mo
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IHollingworthTL2Member1 Nov 2024#90
weekly_pin, post #78: Post #75 is right about the mechanism and I think understates the practical bit. A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. One more caveat and then I will stop qualifying: the sample selected itself. Go to post

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

0 likes in reply to #78 21mo