As a hospitalist I sometimes come across patients who, for what ever reason, refuse to take the medications prescribed by their in-patient doctors. Some patients refuse out of fear. Some doctor told them years ago that taking medication X would make them worse. Some patients refuse out of ignorance of their disease process. Most of the time however, they just don’t understand why the medication is necessary. Some patients just refuse out of stubbornness. And some patients refuse because they have a really good reason.
However, when you’re dealing with critical illness and the only thing that’s going to save your patient’s life is a treatment plan they are refusing, sometimes you have to be in their face with reality. So how do I handle situations with patients who have the capacity to make poor medical decisions but refuse life saving medications? How do I convince my hospitalized patients to take their medications I’ve prescribed?
Happy: The nurses tell me you are refusing to take the life saving medications that have been prescribed for your illness. Is that right?
Patient: I don’t think I need them.
Happy: I’ll tell you what, I’m going to ask the end of life doctor to come talk with you since I have nothing further to offer you. You are very sick and could die without the medications I’ve prescribed.
Happy: You’re very sick. If you don’t want the medications I’ve prescribed, then you are probably going to die. So I’ll ask the end of life doctor to come talk with you.
Patient: I’ll take your medications. You’re the doctor.
For some people, the real fear of death can be a powerful motivator. For some folks, that’s how you convince your hospitalized patients to take their medications you’ve prescribed.
*This blog post was originally published at Happy Hospitalist*