Anonymous Doctor

Patient's daughter: "Can we give my mother [other drug] instead of [drug she's on]? I used to be a drug rep for [other drug]."

What in the world is the correct answer to a patient's daughter asking if we can switch her mother's medication because she used to be a drug rep for a competing pill?

I mean, besides, "no."

Or, "actually, we make drug decisions based on the drug we-- your mother's doctors-- think will be most effective, not based on who manufactures the drug, because, frankly, I don't even know the trade names of most of the stuff we provide, and who makes it, and don't care."

Drug reps get a hugely bad rap, and I really can't speak with any expertise about them, because they're banned and we never see them, they're a non-factor for residents. But for a patient's daughter to think that having been a drug rep for a certain drug is a reason why we might switch her mother's medication-- that's bizarre to me, and a completely off the wall request.

Not that we don't get off the wall requests all the time. "Can you do that later? We're currently visiting," is a common one. I understand it, sort of-- you come to visit your family member, and, sure, it sucks if a doctor comes in to wheel him away for a test. But they're here for tests, they're here to hopefully get better, and there's no way we can coordinate a schedule around the visitation of family members. He needs an MRI, the MRI is available, he's getting the MRI, even if his twelve kids just flew in from Antarctica to visit. He'll be back, don't worry. He'll be here all night. But the MRI technician won't be, and that's the priority. And yet people act like we're being horrible if we insist on getting the patient to the test. Or if we insist on interrupting the family visit to take blood, or give medication. Guess what? If you stop arguing about it, it'll take two minutes.

Okay, this post sounds angry and I don't mean it to sound angry. It's just frustrating to have to keep explaining to people that what we're doing is important, needs to be done, and will make their family member better (we hope). We're doing it for their benefit, not ours. And it's so hard to get the MRI scheduled-- too hard, absolutely, and I don't entirely understand why it has to be as hard to manage these schedules as it is-- and I don't want to lose the day, nothing good can happen from being pushed to the next day and having to start the process all over again, for any of these things. And it's hard when families don't understand, even though I sympathize with them wanting to see their family member, and not having all day to visit, and traveling distances and being squeezed by their real lives. But at the end of the day, I have to believe that they would rather their visit be cut short and their family member get better than they get all the time in the world to visit a dead person. That sounds harsh, and it is, and I don't mean it to. And of course it is better for family members to visit than not visit, and we shouldn't make it harder than it needs to be for them to visit and get to spend time with their family member. It's just hard to balance 15 patients, their families, the specialists we're dealing with for each of them, and the techs actually doing all of the tests, that's all.

But, regardless, no, being a former drug rep for a competing drug to the one your mother is on is not a reason for us to switch drugs. Sorry.