- Besides rapport building, not caring about what they think about you is a good start.
- Being confident in your medicine is helpful too. Often times I see people give out Rx "just incase". There should be this scenario, as it leads to patients only being blinded to them getting what they want.
- The other technique that I personally use is to tell them its a URI, viral. Just follow up with them in 48-72 hours, and see how the patient is, this makes them feel good generally, at which point you can suggest other symptomatic therapies. This is helpful for those that make the UC their PCP office, so you would have built a ''rapport''. So next time they come in, and you tell them this, they trust you..
- Sometimes explaining pathophysio is important too.. i.e. 3 days of cough, than ST.. this is likely mechanical vs. getting Strep.
- At the end of the day, even if you do all of this, there will still be 1 or 2 who will call you a ****ty doc/threaten litigation because you didn't give them an "Z pack". For them its much easier to do this and than go else where. PCP's wouldn't face this because than they know they don't have any good follow up options besides establishing a new PCP (which can be a pain in the ass).