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Oh, Dr. Google

During the last month I met a lovely older lady who I had interviewed about her medications prior to coming into hospital. One of the questions that we routinely ask is if the patient smokes or drinks alcohol at home, as withdrawing from both of these can be quite nasty.

We ask this because abruptly stopping drinking can result in seizures and delirium, whilst withdrawing from nicotine can result in irritability and alters the way someone will metabolize medication. In any case, I asked this sickly lady if she smoked, and in return I got a story that made me think.

This lady had been a nurse 40 or so years ago in a rural town. Even today, with the wonders of modern technology, rural towns can seem far removed from civilisation. So you can imagine the pressure that would be on the only nurse in the town. She cared for any and all patients who came her way until a doctor came to aid her or the patient was transported to another location for more treatment. It is little wonder then that she became stressed and went to see a medical doctor for some advice, who subsequently referred her onto a psychiatrist.

By this stage in her story I had almost tuned out, as the number of times I have asked a simple question such as: ‘Do you take aspirin?’ And received an answer along the lines of: ‘Well 9 years ago…’ Part of me is too polite to cut the patients off. I figure that listening to a story may take up a few minutes of my day where I could be checking a chart but if the patient talks and lets out a little bit of information that can be beneficial then listening is worth the time. Also, it can be quite nice to be thanked for simply having a chat with an older person, especially the ones who are alone for the majority of the time.

So the patient’s psychiatrist suggested that she take up a pastime to help her relax. That pastime was smoking. Now, 40 years later, she is suffering the consequences of what at the time was considered good advice from someone she trusted.

Now this made me think- what if the information I give someone now results in long term harm such as this?

This came up in a discussion with a fellow pharmacist. A patient is a consumer of the healthcare system and needs to have an input into their care. If the physician, pharmacist or other health care professional makes a decision then they must be held accountable for what happens or does not happen to the patient.

This is part of the reason that as a pharmacist we counsel patients on their medication and their side effects. However, where do we draw the line at the information that we give out? Do we tell a patient about the most common side effects only, or do we include the side effects that occur in only 1 in a million or fewer cases? Sure it may be rare, but if that side effect occurs to you and there are long term and debilitating consequences…..

Do we go down the path of the US, where lawsuits are common, and adherence to product information is strictly adhered to? Rather than bent to suit the situation as is often the case here?

It is important when there is a decision regarding your health care that you make sure you are informed. Do not be the patient who used Dr Google to diagnose chest pain as reflux and then had a gigantic heart attack and heart failure.

One last request, for the patient who googles everything – this can be a good start, but does not replace an adequately trained healthcare professional so please visit your GP or other health care professional for advice.


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