Uncovering Hidden Medication Expectations

“What we need is more people who specialize in the impossible.”

Theodore Roethke
Poet

Uncovering Hidden Medication Expectations

TISA Description of the Problem: With regard to clinical interviewing, one of the perennially difficult tasks is uncovering the truth. Hidden truth is not always about deceit or conscious cover-up. It is often created by a client’s own unawareness of his or her feelings related to defense mechanisms, cultural biases, and/or lack of reflectivity. One place where it is important for both parties – patient and clinician – to be aware of the truth is the patient’s expectations of a medication. Prescribing clinicians generally have a concrete set of expectations for a medication. It is equally if not more important to know what the patient’s expectations might be. Whether a medication meets or does not meet these expectations is intrinsically pivotal for determining the person’s interest in taking the medication and the likelihood that he or she will follow through on this interest. In a simple interviewing tip, well worth using and teaching medical students, nursing students and physician assistant students, Linda Cunning, D.O. once again demonstrates that simple is often best, just ask.

Tip: I find that there can be much misunderstanding and misconception between patients and myself about a medication’s potential benefits. Such miscommunications can lead to marked problems with medication adherence. I try to address this openly by routinely asking my patients the following:

“What would you like this medication to do for you?”

TISA Follow-up: I really like the simplicity and directness of this interviewing tip. It is the type of tip that is useful to convert into an interviewing habit. Also, in addition to helping to maximize patient interest and follow-through with using the medication, it has an added bonus. With some patients the sophistication of the answer, the reasonableness of the answer, and the intensity of belief reflected by the patient’s tone of voice when answering can provide useful information on the patient’s intellectual functioning, cultural biases, genuine interest in the medication, and even personality style.

Tip provided by:

Linda Cunning, D.O.
Madison, Wisconsin