I can’t fix everything.  Shocking, I know.  Lately though, I have become a bit annoyed by patient’s demands for a quick fix.  It seems that people want a magic pill for everything– and fast.  No time for rest, ice, compression and elevation- I need my sprained ankle walkable STAT.

Patient’s come to the ED with influenza, for example.  I inform them of their diagnosis and explain that they have a viral infection.  Unfortunately, we can shorten the course of illness and decrease severity with antivirals but the real fix for the flu is time and rest.  Patients can expect to be feverish for a few days but ultimately they will be just fine.  “Wait, but it’s my three-year old’s birthday tomorrow and I have to be better by then” they will often respond to my instruction.  “Oh, well in that case let me grab my magic wand from the back.  I hold out on most people but in the case of a toddler’s birthday party I can help just this once”.

Some people can’t even wait 24 hours after being discharged from the ED for their symptoms to improve.  They literally come back to the ED twice in one day.  Not because their symptoms have changed or worsened but because they just aren’t better yet.  My favorite scenario is patients who take multiple ambulance rides in the same day.  Of course your child’s otitis is not resolved- they have taken only one dose of antibiotics.  Yes, I realize tomorrow is Monday and if they can’t go to school you have childcare issues.  Doesn’t change the fact that Amoxicillin just needs a little time to do it’s work.

Maybe I’m not doing a very good job of managing patient expectations.  I’m probably not.  But I also think our society has lost some of it’s tenacity towards pain and illness.  Sometimes the only treatment I can give you is time and maybe some over the counter medication recommendations.  No, it’s not ideal.  It will disrupt the plans you have made this week.  Adapt.  Yes, it will be uncomfortable.  Tough it out.

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