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A.J. Smith, a pseudonym of course, walked into my office today, unhappily.  Most of her topical medications for acne caused too much irritation.  The ones that didn’t, weren’t working.  The doxycycline caused photosensitivity in the past.  But her friend’s dermatologist gave her isotretinoin, better known as Accutane, and she completely cleared.  As such, that’s what my patient demanded.  There was only one problem.  The degree of her acne didn’t warrant such an aggressive approach.  I explained the risks at length with her, and I explained politely why she wasn’t a candidate.  This fell on deaf ears.  She wanted what she came in for. As a medical provider, I never downplay a patient’s complaint and how it affects their lifestyle.  A minor malady for one patient can be the equivalent of cancer for another.  If I have a patient whose livelihood depends on their appearance, it’s my job to make my patient whole again, judgments aside.  I do, however, need to adhere to the Hippocratic oath.  First, do no harm. In the digital age, a side effect of this thinking is that of a negative Yelp or Healthgrades review.  With a negative review comes decreased patient visits and, by extension, decreased revenue.  As most of us realize, today’s medical corporate culture puts more emphasis on volume and dollars generated than it does on well-being restored.  Hermes and Hippocrates would have surely found another vocation, had they been alive today. Continue ...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs