A few days ago while I was conducting a screening event, an elderly man came up to have his blood pressure checked. While I prepared for this patient, he squirmed in the chair. After he filled out his consent form, I noticed his uneasiness and asked him if he was nervous. He said that he wasn’t, but there was a question that was bothering him. I leaned in toward him, lowered my voice to ensure some privacy, and asked him what was on his mind.

“Doc, my blood pressure is high”, he said.

I asked him, “how high?”

He said, “It’s “through the roof”.”

I said, “Let’s take it to see what ‘through the roof’ meant.” I took his blood pressure and he was right. His reading was 152/112. So, with a reading that high, I usually ask the patient if they want EMS to be called or if they are going to a clinic after leaving the screening table.

I told him the reading and the patient smiled. He was happy with that reading as it was lower than what his physician got 4 days ago. “Looks like my meds are working”, he said excitedly. I became a little weary at this comment. The patient went on to ask me the question that was bothering him. “Who do I listen to, doc?”

I looked at him questioningly. “Listen to?” I asked.

“Yes”, he said. He then proceeded to relate to me that he went to his cardiologist who prescribed a high blood pressure medication to begin right away. Then, he went to his primary care doctor who promptly told him NOT to take the medication. The patient was now confused. On one hand, a specialist prescribed him a medication to treat his medical condition, and on the other hand, his generalist PCP told him not to take it. So, to eliminate his confusion, he turned to me and asked, “Who do I listen to?”

I looked at him and asked him if either of his doctors knew the other or their care plan. He said that they didn’t. I then answered him, “If they are not on the same page with your medications, get yourself a good pharmacist”.

 He laughed heartily and said, “My mother told me the same thing years ago before she passed away. Maybe she was right after all.”

I then proceeded to explain to him that he should carry a complete medication list to his physician’s appointments, he should have his physicians talk to each other, and to find himself a very good pharmacist who can maintain order with his medications. He sat back and pondered this for a brief moment before he spoke again. 

“Doc, I like your answer. It’s time I stopped this nonsense. From now on, these two guys have to know what’s going on”, he said.

I smiled at him, thanked him for stopping by, and counseled him to call his PCP with the blood pressure result as soon as he could as I thought his medication dose may need adjusting. He stood up, thanked me and walked out the door.

A lot of patients have multiple practitioners who do not communicate with each other in caring for their patient. It’s up to the patient to make sure that their medical team is communicating among themselves. If you see yourself in this very real scenario, make sure to avoid potential medication issues and implement the safeguards offered in this blog.

Until next week, stay healthy.
Dion