My father (a retired doctor) is not one for pronouncements, though I do remember him offering me one piece of advice about how to be a good doctor: listen to your patients. I was reminded of this simple but sagely dictum recently on the reading of a study which assessed the response doctors give to the reporting medication-related side effects. In this research, 650 adults were surveyed with regard to possible side effects from taking statin (cholesterol reducing) drugs including muscle pain and cognitive impairment.
Of this sample, 87 per cent of individuals had a discussion with their physician about the possible connection between statin use and their symptom. In the vast majority of cases, this discussion was initiated by the patient, not their doctor. The study found that that doctor were reportedly more likely to deny than affirm the possibility of a connection.
Rejection of a connection was even found to occur when there was good evidence in the scientific literature to support such a link.
One problem with this, of course, is that patients with legitimate adverse drug reactions may be allowed, quite frankly, to suffer in silence. And also, if doctors do not recognise adverse reactions to drugs, then such reactions are not going to get reported to and recorded by the appropriate bodies. Which compounds the problem.
The authors of the study make the point that there is the argument from gathering adverse reactions data directly from patients.
But why should this be necessary anyway. One of the central tenets of medicine is not to do harm wherever possible. So, why aren’t we as doctors paying more heed to our patients when they report side-effects?
Well, one reason relates to the fact that while pharmaceutical companies are falling over themselves to tell doctors about the supposedly beneficial properties of their products, they are less keen to be upfront about their potential downsides. Of course another potential problem here is that some doctors just don’t listen to their patients.
1. Golomb BA, et al. Physician Response to Patient Reports of Adverse Drug Effects: Implications For Patient-Targeted Adverse Effect Surveillance. Drug Safety. 2007;30(8):669-675.