On the other hand, I have some patients who really make me wonder why they even bother coming. They stop their meds, they go back on old ones (sometimes expired ones), they change their dose, they don’t get their tests done; all that in addition to the usual lack of lifestyle modification. I will usually conduct a typical visit anyway: history, physical, plan. I explain the whys and wherefores, I discuss the potential consequences of non-adherence to the plan. And I do take the time to explain to patients why they need to take certain drugs, what side effects to look for, why they need to get tests done, etc.

But at some point in this doctor-patient relationship, when the typical modus operandus fails, I stop entering things on the computer, fold my hands in my lap, lean back in my chair, and say, “So why are you here?” Sometimes it’s followed by, “How do you want me to help you?” or “What would you like me to do for you?” or “What would you like to happen now?” http://www.physicianspractice.com/bl...s?CID=p2widget

But by and large, I do find that patient finally “get it” when I throw up my hands and admit I don’t know how else to help them without them helping themselves.