Doctor Mike

Like we know all medications carry risks, not even medications, therapies carry risks, surgeries carry risks, vaccines carry risks.

And yet, if we put the focus on the scary part only and really blow up the fear of the risk, that can carry repercussions across the board.

Where I remember there was, I forgot the name of the movie, I'm blanking on it now, where some very famous actor said that Merlot is trash, the wine.

Yeah, sideways.

Sideways.

And as a result, Merlot sales just, again, had nothing to do with the quality of Merlot.

So I think about that and I'm like, oh man, how quickly we can harm the medical system by doing something like that in modern media.

At the same time,

How do we allow for authenticity and encourage authenticity from people who have been hurt by these things?

Yeah.

How do you decide, or I guess, what is your approach in discussing with a patient side effects of a specific medication when you know that discussion on its own can raise the likelihood of those side effects occurring?

So you don't see the nocebo effect?

Yeah, I think my mind's going to an example of like a statin, a cholesterol lowering medication, which in pop culture has been associated with muscle aches.

And take me for someone in their 60s who's not having a muscle ache.

That's an age group that experiences frequent muscle aches.

So I always try and balance that conversation with,

with the type of patient I'm having the discussion with, because some of my patients I'll outright say, hey, do you want to go down the list of the situations that can go wrong with this medicine?

Or are we comfortable monitoring and you bringing it to me and we deciding together if this is a side effect of the medicine?

And it's an approach that has worked well, but I feel like could not work perfectly every time because patients sometimes say, I don't want to know full on because they believe that they will have that side effect if they're aware of it, almost like they're expecting it.

And that happens to me a lot surrounding pain and discomfort where patients who are guarding, basically if they've had a low back strain and a few days go by and they say, I'm still getting up very slowly and gingerly because I want to protect the area.