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During any non-primary care rotation, should a MS encourage and counsel a patient to quit smoking and offer treatment options or should that only be limited to IM and FM?
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Quit Smoking Question
- Thread starter SpoiledMilk
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You can. It isn't going to hurt. I suppose you could always ask the doctor you are working with.
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Smoking, besides UC, makes everything worse. And I wouldn’t recommend it for that either. 
As a PCP, thus bias, I don’t think you’re out of line recommending cessation. Other specialties discuss it in regards to tumor risk, wound healing, surgical recovery etc.
As a PCP, thus bias, I don’t think you’re out of line recommending cessation. Other specialties discuss it in regards to tumor risk, wound healing, surgical recovery etc.
D
deleted480308
Always counsel to quit. Always.
offering medical assistance to quit is trickier because the urologist may not want to bother with chantix, tell to discuss options with their primary doctor
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As a vascular surgeon, I always discuss this with my patients and then provide resources such as our state sponsored tobacco quit line for another person to talk to and have accountability with. I routinely write for patches, gums, and lozenges. Then coordinate with their PCP about starting Wellbutrin vs Chantix if the patient is serious about it. Tangentially, I also start my patients on aspirin and statin if indicated and once again, coordinate with PCP so that everyone is on the same page. Always encourage the things that can be changed: smoking, diet, exercise. Cheers.
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When I ask about smoking, or other “bad habits”, I always ask “How much do we smoke”, rather than “Do you smoke”.
Was taught that it seems less judgemental when asked that way.
Additionally, if someone says “Not at all” when you ask, your immediate next Q should be “Ever?”.
My dad smoked for 40 years, dx’ed with cancer, quit for 3 months and then would tell his docs he didn’t smoke.
For drugs and sex Qs, I tend to wait till the end of the encounter, usually after I have told them the treatment plan, so they know I’m on “their side”.
Drugs - Do we take anything that we’re not supposed to? Or Do we take drugs, other than the ones a doctor has given you?
Sex - Do we have sex with men, women or both?
Was taught that it seems less judgemental when asked that way.
Additionally, if someone says “Not at all” when you ask, your immediate next Q should be “Ever?”.
My dad smoked for 40 years, dx’ed with cancer, quit for 3 months and then would tell his docs he didn’t smoke.
For drugs and sex Qs, I tend to wait till the end of the encounter, usually after I have told them the treatment plan, so they know I’m on “their side”.
Drugs - Do we take anything that we’re not supposed to? Or Do we take drugs, other than the ones a doctor has given you?
Sex - Do we have sex with men, women or both?
