Interview Question

[cwb]

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Hi everyone,

Just wondering what some ideas for responses to the interview question:

How would you handle a patient who didn't follow your advice?

I'm having a tough time coming up with an answer because I'm not exactly sure what a physician can and can't do when it comes to this situation.

Thanks in advance.

 

[drmota]

that's a pretty good question. all interview questions like this are basically there just to see how you reason through it. off the top of my head I would say something along the lines of how I would spell out the consequences to my patient and if they still weren't willing to follow my advice, I would consider letting his/her loved ones know what they could do to try to help (considering that their condition is not a private matter). other than that, being healthy is highly up to the individual and isn't anything that should be forced. There's only so much for me to do. I would move on to the next patient who was willing to take my advice. I didn't go to med school for nothin.
-mota

 

[CoffeeFreak]

Be careful with this one. The question will reveal your critical thinking ability.

I am in consulting (non-health) and I'd say only 20% of my clients respond to my advice. I find it very frustrating but I also respond with an illustrated story rather than telling them the consequences.

I would be creative with this one.

 

[Law2Doc]

Hi everyone,

Just wondering what some ideas for responses to the interview question:

How would you handle a patient who didn't follow your advice?

I'm having a tough time coming up with an answer because I'm not exactly sure what a physician can and can't do when it comes to this situation.

Thanks in advance.

It's a patient autonomy question. Bottom line is you can't force your patient to take your advice (good though it may be). All you can do is document what you advised, so that when things go awry, you don't get blamed for not suggesting the appropriate course. This kind of question also tends to lead nicely into the DNR type issues, where patients opt not to be rescussitated/intubated notwithstanding some possibility of recovery in some cases.

 

[SanDiegoSOD]

I would seek to find the reason that the patient is resisting treatment. Carefully probing questions may be able to reveal why the patient isn't following your advice. Bare in mind that this is a skill that physicians learn over time, not something that one figures out as a third year medical student. If you can find the root of the problem, you may be able to create an improved treatment regiment that the patient will follow more closely. However, if you do your best to work with the patient to find a suitable treatment regiment and s/he still isnt complying, there isn't much you can do... patients always have the ultimate decision (unless you're dealing with the mentally impaired, but that's another discussion)

 

[CoffeeFreak]

There is no perfect answer but I'm leaning towards what was said earlier by the lawyer. There is a spectrum here with MD ADVICE on one end and PATIENT'S SOVERIGNITY(spell?) on the other. Your answer is somewhere in between.

Essentially your answer must display respect for the client while eterming the most effective means of treating. Spending time and researching the patients history to consider the resistence is a good pt. too.

 

[CoffeeFreak]

From the earlier post. READ [All you can do is document what you advised, so that when things go awry, you don't get blamed for not suggesting the appropriate course.

No flame intended here but I love lawyers. M.O. is always CYW is #1

Seriously I find your posts very insightful and helpful but I couldn't resist. 🙂

 

[nrddct]

I was asked this question in a mock interview. I responded by saying that I would find out why try to accommodate or persuade the patient to comply.

The interviewer said he wanted to see if I was willing to take a stand and actually make the patient follow my advice.

So maybe the interviewers are trying to see if you can take charge of a situation?

 

[Law2Doc]

I was asked this question in a mock interview. I responded by saying that I would find out why try to accommodate or persuade the patient to comply.

The interviewer said he wanted to see if I was willing to take a stand and actually make the patient follow my advice.

So maybe the interviewers are trying to see if you can take charge of a situation?

There are laws against "making" the patient follow your advice. You probably were supposed to take a stand with this interviewer. 🙄

 

[beanbean]

Some things to consider when posed this question:

Is the patient competant to make decisions re: their medical care? Examples of patients that are not: minors (with exceptions that vary state by state), some mentally ill patients, patients with dementia, etc.

Patients who are competant to make their own decisions ultimately have autonomy over their medical care.

It is important to note if the patient was provided with adequate informed consent and are they capable of understanding the risks and benefits explained to them.

Do not lie to a patient regarding the treatment in order to get them to comply with what you believe is the best treatment option.

Try to understand why the patient is not compliant or reluctant to follow your advice. What are the patient's reasons? Financial? Risks? Embarrassment? Fear?

 

[Jaykms]

In the real world you would first document that the patient didn't listen to your advice. You would try to get the patient to understand why he/she should follow your advice and maybe try to figure out what the reasons are that the patient isn't following the advice. But in the end if the patient is continuously not listening to anything you say, you would advise them to try a different doctor (to save yourself from liability). Maybe this isn't what the adcoms are looking for though.