I don’t want to belabor the point (and perhaps I already have), but I know plenty of people who actually go to certain doctors for the very reason that that doctor takes more time to explain about meds, and only prescribes when necessary. These patients know something about problems in medicine such as the over-prescribing of antibiotics, for example, and are reassured when he explains why he’s prescribing something and/or why he’s not. He has a lot of patients and no problem making a very good living.

And of course this is not the majority of patients. But it is a substantial minority, enough to support quite a few doctors who wish to function that way. I don’t know the statistics about how many, but I suspect quite a few.

And these patients aren’t prescribing for themselves. They just want a doctor whose general philosophical attitude towards medicine agrees with theirs.

In your first comments, you indicated that the “worried wells” did not want to take meds:

I just love people who don’t ‘like’ to take meds, but go to docs nevertheless. We used to call them the ‘Worried Well’.

And I said most of the “worried wells” I know LIKE to take meds and want them, whether they need them or not:

Most of the “worried well” that I know LOVE to take medication, the more the merrier. It reassures them.

So then, in the response you wrote at 9:08 PM, you seemed to be agreeing with me when you said [emphasis mine]:

Your Worrieds may be different from mine. Mine all had complaints-that’s why they made appointments- and one has to rule out serious causes for their complaint(s) at a cost of time and money. When told nothing bad turned up, they were usually not reassured. Their complaints did not go away, and they found docs who would prescribe instead of appeal to their reason, explain, blah blah.

So we seem to be agreeing about who the “worried wells” are, not disagreeing.

My point was, and is, that your “worried well” population is not the population I’m talking about when I say I know a lot of people who don’t want to take unnecessary medication. That is a different group.

And I’m also saying that, that if a patient is less inclined to take medication at the drop of a hat, and doesn’t want a doctor who does things like prescribe antibiotics when they are not needed, then that person will gravitate to and choose a doctor who doesn’t do that.

So I think you are misunderstanding my points.

Your Worrieds may be different from mine. Mine all had complaints-that’s why they made appointments- and one has to rule out serious causes for their complaint(s) at a cost of time and money. When told nothing bad turned up, they were usually not reassured. Their complaints did not go away, and they found docs who would prescribe instead of appeal to their reason, explain, blah blah.

Actually, no I do NOT refer to the “worried well.” Most of the “worried well” that I know LOVE to take medication, the more the merrier. It reassures them.

I’m talking about people who don’t want to take unnecessary medication, who are aware that for many medications (as you yourself described in another comment of yours, I believe regarding statins) the research underlying them is iffy and the side effects can be worse than the problem. They also know that (as I believe you also acknowledged) some doctors push meds on their patients because they think they want them and because in some cases it is easier and they can’t figure out what else to do.

These are the people to whom I refer.

Of course I understand the principle that patients might leave; I though of that when I asked the question. But actually, I don’t agree that would happen all that much, at least not in the medical markets in places I’ve lived within the last couple of decades.

The reason is that so many doctors seem to be full up and oversubscribed with patients. Yes, they might lose some business, but for the most part they would retain enough patients to do just fine, especially if they act towards their patients as though they are more than faceless masses. Yes, they might sacrifice a tiny bit of income, but I know quite a few doctors who operate the way I’m describing and they are doing so well they have to turn patients away.

I also know lots of people who don’t like to take medication and are relieved when doctors don’t suggest it. So those doctors might end up attracting those patients.

I don’t pretend to know for sure, but that’s my guess, based on what I see around me.