Patients who ruminate or obsess


Senior Member
10+ Year Member
Jul 28, 2005
    I'd like to know if you have any suggestions for how to deal with patients who seem to have these behaviors (I use the words descriptively, not diagnostically) in my circumstance. Let me explain:

    I'm a pharmacist. Very occassionally, but frequently enough to be a pain in the ***, I'll get a patient that brings me an rx for a new medication for a disease they didn't know they had (think htn, diabetes, glaucoma) - not normally a psych drug. They tell me they didn't know of the disease because they only went to see their Dr for a cough or their glasses broke or they had an ingrown toenail, whatever. Uniformly these kinds tend to doubt the diagnosis & tell me that. I expect lots of questions & frequent questions - for my business thats normal.

    I'll fill the rx, review the directions, give standard warnings - just what they extra stuff to worry about. The normal in my business is they go home, then think of stuff to ask & either call me or come in, often once...sometimes 2 or 3 times. No problem. When I don't seem to offer enough reassurance, I encourage them to call or see their Dr again to discuss.

    Now...this is when it gets difficult for me. Within a few calls or visits back to the MD, they starting coming or calling me saying the MD says to not come back for 3 weeks (or whatever time) & now the questions get bizarre. (Do you think he really wanted 10mg, the pill seems so big, my buddy Frank only uses 1 drop in his get the idea).

    I've tried patiently talking, setting limits on what we talk about (I NEVER second guess a Dr!), reasurrance,suggesting another Dr contact, but I admit I do get short tempered & use my tech to call me away for a phone call that doesn't exist :oops: . I want to tell them to do whatever they want!!, but I've restrained so far. These are not always older folks, but it seems they all have access to information (books, magazines, internet) so they come with, unfortunately, too much information. They do all seem to have time on their hands.

    So sorry for the long question specifically, what methods can I use that work with folks like these to limit the behavior earlier. I'll answer any drug question & even multiple times - I know folks don't always hear things the first time. But...I'm feeling it gets out of my control & I get caught up in their spiral...(this will go on for these folks daily for weeks!) Thanks for any suggestions!


    Your Digital Ruler
    Moderator Emeritus
    10+ Year Member
    Verified Expert
    15+ Year Member
    Feb 19, 2003
    The innocent shall suffer...big time
    1. Attending Physician
      Pleasant but firm early limit setting is your friend. Especially with psychiatric patients who demand constant reassurance.

      The internet is the greatest invention every, and is the bane of doctors. As we know, a little information is dangerous, and that's what these people have. There is a HUGE subset of the population that is somatically preoccupied, and their narcissistic and histrionic qualities are filled by having all around them wrapped up in their vortex of the sick role, their illness, pain, suffering, and prognosis. It's the physicians and pharmacists and nurses who bear the brunt of it.

      I would think a simple, "I provided you with this pamphlet," or "this is the correct medication and dosage that your doctor prescribed, see how you feel on it and revisit your doc in 3 weeks" or something to this effect should suffice in many cases.

      As we know, many is not all, or even most.
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