Client is not always right...

Such a great thread idea.

How about the doctor isn't always right? A couple years ago I started my post-PharmD Clinical Pharmacy residency (an optional program after pharmacy school & rotations). I was working in a prominent hospital (with many doctors with inflated egos).

2 weeks after I started my position, a patient had been taken off her 300mg lamotragine/Lamitcal (very high dose) due for a week due to health complications that had now almost entirely resolved. The doctor ordered to restart the 300mg of lamotragine all at once. This drug if not slowly tapered up can result in a variety of dangerous reactions. There is even an FDA black box warning regarding this.

I denied the order and suggested a taper back up to 300mg. The doctor denied my denial. I brought it up with my supervisor who was also denied by the same doctor, quite rudely in fact. So the patient got 300mg and the dispute was documented.

Sure enough within a few days this poor woman's back was covered in a "rash"- and by rash I mean her skin was literally peeling off her back, in addition to her tongue. She was diagnosed with Stevens Johnson Syndrome, a life threatening and extremely painful condition- a direct result of lamotragine not being tapered appropriately.

I wish I had the balls to say "I told you so"... so I guess I'll say it here

See attached pictures (contained in the spoiler) of SJS to see how horrifying of a condition I'm talking about.

Spoiler

 

I think we can all agree that no person/company is "always right". People need to be open to dialogue and discussion.