This blog is by Dr. Rob, a primary care physician who practices in the Southeast. He is a featured blogger on Medpage Today.

The whimsy with which he chose his blog name hints at a physician willing to say whatever he thinks.

He does.

Make no mistake. This is a serious and good doctor.

Below you will find the first two of his 10 Rules for Good Medicine. Please read it. You will be a much better informed patient and a more active one.

Each one of these rules is worth your full attention.

For example, patients often don’t understand why doctors make only one or a few changes at a time. Patients often think, “Let’s get this finished so I can get back to my life.”

When too many changes in a treatment plan are made at once—if the patient does not get better—the doctor is stuck with why? Which one of these medications is the culprit?

Read on. You will be glad you took the time.

Musings of a Distractible Mind

“Rule 1:  It’s the Patient’s Visit

:The visit is for the patient’s health, not the doctor’s income or ego.  This means three things:

1. All medical decisions should be made for what is in their interest, including: when they should come in, what medications they are given, what tests are ordered, and what consults are made.
2. Patients who request things that are harmful to themselves should be denied.  People who ask for addictive drugs or unnecessary tests should not get them.  Patients who are doing harmful things to themselves should be warned, but only in a way that is helpful, not judgmental.
3. All tests done on the patient should be reported to them in a way that they can understand.”

“Rule 2:  Minimize

“Many doctors and patients have a “more is better” mentality.  This not only costs more money to the system, but it can cause harm to the patient.  Here’s what I think should be done:

1. Patients should only be seen when a visit is appropriate.
2. Use as few medications as possible, and when necessary, use the cheapest one that will do the job.
3. Order as few tests as possible.  No test should be ordered for informational purposes only; the question, “What will I do with these results?” should always be answerable.  If it is not, the test should not be done.
4. When changes are made, make only a few at a time.  Many simultaneous changes make it hard to tell what helps and what hurts.”

Source: Musings of a Distractable Mind, May 23, 2010