It's interesting how the portion of the vignette in which it is acknowledged that mistakes the PCP made (in the context of rigid structures) resulted in the patient running out of medication (leading to opiate withdrawal) immediately precedes the paragraph in which the PCP felt uncomfortable with the patient's request for additional pills to rectify the situation.
I like to think that if the PCP had asked the patient more about their experience and reviewed pharmacy records for the dates the medications were actually filled, they might have been able to better understand the request the patient was making.
This seems to sit within the domain of addressing implicit bias. Some psychiatrists might call the discomfort the PCP felt counter-transference. How do we get providers to deal with this better? I would think the goal would be to have providers acknowledge these reactions of discomfort, while also being intentional about creating distance from them so that they can be questioned. I think this requires cultivating a kind of humility that is less common than it should be.
Do people have thoughts about how this can be addressed?
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