A doctor should know how to say no

Take the example of antibiotics. Almost everyone agrees that we consume too much of it in our country. What, in the long term, turns out to be catastrophic due to the phenomenon of resistance which risks making our microbes insensitive to these treatments and sending us back to the dramatic situation of infectious diseases at the beginning of the 20th century.^th century.
Another example is work stoppages. There is not a boss, not an employee to denounce so-and-so-and-so-and-so who is, supposedly, left at home with an imaginary back pain. Health insurance must be sensitive to it, which is now launching an information campaign on low back pain.

In these two cases, the system is accused and a culprit is designated: the general practitioner who has the dual power of prescribing drugs and work stoppages. But who apparently no longer has the ability to say no!

Doctors influenced by their patients

Because the general practitioners admit it without shame: “the demand of their patients influences their prescription” and as said a Parisian doctor “the writing of a prescription is always a kind of compromise between what the doctor thinks and what will be able to do his patient ”. Negotiation at the heart of the medical examination!
God, this is a notion that the medical student does not learn. But the problem is to know if this reference to the patient’s desire is dictated by a better prescription or quite simply by low clientelist considerations which obey the reasoning: if I do not do it, he will look elsewhere. And, as everyone knows, my colleague and neighbor will not have the same qualms as me.
To help my colleagues, it should be noted that the first cause of non-compliance with a prescription is the brutality of its decision. However, saying no is a mixture of discussion, waiting and directing – not easy – when faced with patients who have changed, mainly because of or thanks to the internet.

New doctor-patient relationship

So, are we guilty of explaining the evolution of medicine? Perhaps a little, but certainly less than the doctor who does not retrain, because better trained, better informed on the evolution of their discipline, doctors will better resist the patient’s request. And those who claim a fairly firm attitude admit that this first required a pedagogical reflection based on personal work and tools, models, diagrams or tables, and the collaboration of their patients.

Then, they admit spending time, much more time than the remuneration of a normal consultation supposes. But that is another story.