Doctors' most common story that every patient must read...

I strongly believe that this is one of the most common scenario in doctors' daily practices and every doctor wish their patient understood this as soon as possible. I will share with you one of my recent ( hilarious but worth reflecting) case. A 3 minute read.. please bear with me ..

A healthy male, 34 years, chef in a well known Five Star Hotel, arrived with a frustrating cough for more than a month.

Patient: Doc, i m having a bad cough for a month and it is not getting any better. Despite many good and expensive meds from pharmacy ! ?

The patient handed me a few bags of different pharmacy meds..

Antibiotics, Anti Cough etc..

Me: Ok khrab. How about you keep these meds and let me ask you a few questions about your cough details like onset, duration, phlegm , night time etc...

After exploring his cough details and a few differential diagnosis in mind..

Me: Ok khrab, now let me have a look at your throat and perform a few physical examination...

The patient was sent for a few tests and X ray in order to exclude some diseases...

This is one of the most common scenario that doctors encounter in their everyday practice, and this will continue as long as public do not recognize the importance of breaking this bad habit.

Recently, i was invited as a speaker to share knowledge with sub specialist doctors on how to handle cases with chronic cough and update current evidence on chronic cough. This is the most frequent ask question wherever I go :

" Winai... patients come in with higher spectrum antibiotics already and claimed not improving.. they ask for stronger meds ! ? ...how can we break the habit of prescription without examination.. "

I laugh ( as I always do... ) and end up with my evergreen suggestion ..

" When in Rome, do as the Romans do..."

If patients have the freedom to antibiotics without examination, they also have the freedom to the consequences. This the era of social media, it's time we ,doctors, adopt social media and start giving more good contents that will target on issues that public need to reflect. Focus on mass media rather than explaining patient one by one.

"It is our job to help them reflect before getting any antibiotics, using their trusted social media"

Help patient think of these questions whenever they step out to buy meds :

1. Do i really need antibiotics?

2. Did " the seller" ask me details about my cough ?

3. Did " the seller" check my throat?

4. Did " the seller" listen" to my lungs ?

5. Will I increase risk of antibiotic resistance to my future?

6. Do i apply this habit to my kids or elderly at home ?

7. Will it really safe my cost and time ?

Anyway, getting back to the patient..

His lab results and X ray were normal. Upper Airway Cough Syndrome was diagnosed. Treatment plan, expected outcome, time frame of improvement and prevention tips were explained. The patient listened very carefully and nodded his head at interval. His doubtful eyebrow expression can't let my eye off him and finally i had to ask:

Me: It seems you understood everything i explained. Is there any doubt ?

Patient: Yes yes .. i really got everything and no doubt i have ..

Me: Well ok then , see you next 2 weeks for a follow up..

Patient stood and walked towards the door and suddenly he stopped and turn back ..

Patient: I still don't get it.. i had wasted money on expensive antibiotics and cough medicine .. it should have worked as my judgement and treatment was closer to your diagnosis ...but it didn't worked ...

I was smiling and happy to hear my inner voice said ..

"I was right,I told you..!! He had something in mind ... you better listen to me more"

Me: You are a chef right.. Well, can you come up a pattern of recipe for TomYum Kung that will please every guest ?

Patient: Cannot. Taste is personalize and a good recipe is one that matches individualize taste preference.

Me: Thank you. Your cough was from your nose, the cough medicine didn't target the nose. Simply put .. your recipe didn't match.. ( while smiling at him)

Patient: hahaha ( burst out loud) ... yah doc ... thank you .. see you next time :)

Currently, the chef is back to business. Working harder. Cough is much improved and so does his lifestyle.

Bottom Line: It's ok and fair enough to get yourself medicine. However, once "the seller" decides to give you antibiotics... just take a step back and consider getting yourself a check up. You may or may not need antibiotics. Trust me, you actually safe more than you think. Have a great week ahead :)