Buying Medicine in Drugstore – Quantity – ROJoson Medical Clinic Advisory

ROJOSON MEDICAL CLINIC ADVISORY
BUYING MEDICINE IN DRUGSTORES – QUANTITY
Buying the quantity of drugs prescribed by the physician

You are and should not be required to buy the exact quantity of drugs after you are given a prescription by a physician even if you have enough money.
If the medicine prescribed is for one week and is for observation whether it will be effective or not and whether there will be side effects, just buy initially a quantity for a few days, say 2 to 3 days. If no side effects and the medicine is working, go back to the drug store and buy the rest of prescribed quantity.
This is to avoid wastage of the medicines. Physicians may change the medicine in a few days if there is a report of side effects and no improvement. You may find it difficult to return the unused medicine.

PART OF ROJOSON PATIENT-CENTERED CARE MANAGEMENT PROGRAM
PART OF ROJOSON PATIENT EMPOWERMENT PROGRAM

 



Today, 19oct12,  a patient of mine commented that she usually buys medicine in installment (or initially, fewer than the quantity wrote by the physician in the prescription pad). She said this is to avoid wastage (sometimes physician changes the medicine right away and difficulty in returning the medicine).
 
I told her I have been advising my patients to do the same (not buying initially all the prescribed quantity).
 
This conversation with the patient prompted me to issue this advisory so that other patients can learn from this approach.
 
Examples:
If I prescribe an antibiotic for an infection, although I will put the quantity number of the antibiotic amounting to a full treatment course supply, example 21 capsules, good for 7 days, I will advise the patient to buy good for 3 days initially.  I will advise him or her to observe the outcome of taking the antibiotics for the first 3 days, if there is side-effect and if there is response or not.  If there is no side effect and there is response or at least no progression of the infection, I advise him or her to go back to the drugstore and buy more for the next 4 days.  If there is a side effect or no response, he / she is allowed to call me for a decision making – to change the antibiotics and to shift to another antibiotic.  At times, I give the patient a reserved prescription for an antibiotic that will be substituted in case of side effect and no response to the initial antibiotic.
I try to help my patients in avoiding wastage (including money) in buying medicines.

ROJ@19oct12

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Gestures of Excellent Patient Experience

I consider the following as gestures of excellent patient experience with me:

  1. Delightful Feedback to ME
  2. Gifts (Foods and others)
  3. Pictures with ME (ROJoson’s Patient-Fans)
  4. Hugging

Delightful Feedback to ME

https://www.facebook.com/rjoson2001/media_set?set=a.10151089252480800&type=3

Gifts (Foods and others)

https://www.facebook.com/rjoson2001/media_set?set=a.10153204866350800&type=3

Pictures with ME (ROJoson’s Patient-Fans)

https://www.facebook.com/rjoson2001/media_set?set=a.10151780396430800&type=3

Hugging Patients


ROJ@19oct9

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ROJoson Medical Clinic Notices in Facebook – 2018 Continual Refinement

Will continue to post ROJoson Medical Clinic notices on clinic schedule and changes in schedule in Facebook.

I think I started posting ROJoson Medical Clinic notices in Facebook in 2013.  Here is the evidentiary record.  I have been doing this since then.

roj_clinic_notices_2013_first_posting

 

Latest:

roj_clinic_notices_2017_dec21_resume_jan4_2018

 

Continual Refinements for 2018:

  • Post at least 2 weeks before any decided changes.
  • Repost at least every week.
  • Post in FB Timelines; ROJoson Medical Clinic; ROJoson Breast Wellness Clinic; ROJoson Thyroid Wellness Clinic; Reynaldo O Joson 2; Reynaldo O Joson Page.
  • Place a tag (ROJOSON MEDICAL CLINIC NOTICE) for easy retrieval.
  • May post notices of NO clinics (if known) months in advance for the benefit of those patients from the provinces and abroad who will be availing of discounted air-fares.

Benefits for patients:

They know my clinic schedule.

They know changes in my clinic schedule.

They can plan their visits to my clinic.

They will be saved from unnecessary trips to Manila and to my clinic if I am not around.

rojoson_way

 

ROJ@17dec21


See also:

Advance notices on NO clinic sessions – ROJoson Medical Clinic

19oct1

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Advance notices on NO clinic sessions – ROJoson Medical Clinic

19oct1

AC, from Butuan City, came for a check-up today in my clinic.

She told me a story that I took into strong consideration in my Patient-centered Care Management Program.

As early as 3 months ago, she booked a round-trip flight from Butuan to Manila / Manila-Butuan to have a check-up with me (she is a breast cancer patient, Stage III, 5 years in remission now) on September 28, 2019.  She got the promo fare of P3K, one way. The regular fare is P5K, one way.

Unfortunately, when she arrived in Manila on September 27, 2019, she learned that I had no clinic on September 28, 2019 [Saturday] (which I had announced in my Facebook one and a half month ago).  Thus, she had to wait up to today, October 1, 2019 [Tuesday] for her to see me.  I was told that she had to rebook her return plane ticket.  She ended up spending P5K more (the plane ticket with promo fare is automatically cancelled with no refund allowed – she had to buy a new regular plane ticket to go back to Butuan – 5K).  Aside from the P5K extra expense that she incurred as a result of my NO clinic, she had to be absent from school teaching for 3 days.  Although she said it was alright, she was not blaming me for the inconvenience and extra expense, I still felt bad.  I told her I will still keep on finding ways to help my patients in such an issue.

In the past, I have tried my best to post advance notices on NO clinics on the average, one month before.

Evidence:  ROJoson Medical Clinic Notices in Facebook – 2018 Continual Refinement

This is to help patients from the provinces and also from other countries (such as Middle East) in planning their trips to see me in Manila.  Some patients would even message me if I will be available in such and such a date.  I really have done these as part of my patient-centered care management, to avoid “frustrated” trips and to help them get promo fares.  It seems that these are not enough.

To improve on this problem, but honestly no guarantee of solving the problem completely, best effort, I have made the following resolutions starting today (October 1, 2019) [I thank AC for telling me what she went through and  although she said “it is alright; it can happen; this is not predictable; etc” – I still want to reach out as much as possible]:

  • I will try to make advance notices of NO clinics as early as 3 months as much as possible (if I am not sure, I will place a notation of “possible NO clinics.”). I will post regular advance notices (good for 3 months) as much as possible every month, at the start of the month.
  • I will continue to entertain private messages and emails asking me if I will have clinics on such and such dates and if I will be around on such and such dates.

I will start now:

roj_clinic_notices_2019_ADVANCE_NOTICE_19oct2

PART OF ROJOSON’S PATIENT-CENTERED CARE MANAGEMENT PROGRAM.


ROJ@19oct2

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Prayers of Surgeon and Patient Before Operation

Before an operation, the surgeon and the patient can pray these ways together, one after the other:

For the Surgeon to Pray:

Heavenly Father, please take my hands and guide them.

Grant me the strength to help my patient (NAME).

The knowledge and wisdom to diagnose his/her surgical needs.

The skill to perform the needed operation effectively, efficiently and without complications.

 Please be beside me on this operation as I rely on you, the greatest of Healers.

Amen.



For the Patient to Pray:

Heavenly Father, please grant me full acceptance of the surgery which awaits me.  Let this be the relief which I seek for my medical condition.

Make skilled the work of my surgeon (NAME) and that of his team for it is unto their knowledge and skill that I entrust myself for healing.

I pray that this procedure will be done effectively, efficiently and without complications and that my recovery will be speedy and complete.

Amen.


ROJ@19aug5; 19sept14



I started this patient-surgeon prayer today – 19aug7 – MDH – patient for left hemicolectomy.

When I was doing the surgery, I thought of the prayers that I and my patient prayed just before anesthesia was given. The prayers made me more mindful of what I have to do in terms of effectiveness, efficiency and avoiding complications. After seeing and palpated the cancer and adherent to the peritoneal wall, after seeing the splenic flexure of the colon was high up in the left upper quadrant, I decided to increase the length of my midline incision, at the upper part. This was to reduce the risk of spleen lacerations when I mobilized the splenic flexure. I was successful in avoiding this risk (no resultant bleeding). When I palpated the presence of mesenteric lymph nodes, I slowed down and meticulously included them in the resection avoiding laceration to the big blood vessels. I approached the tumor last carefully excising a good margin of the peritoneal wall and was able to remove the whole tumor en bloc, in one big piece with good margins. When I was doing the intestinal anastomosis, I was mindful and vigilant of doing a good one,ensuring viable ends (with good blood supply and pinkish), placing sutures at a good distance between each other, etc.. In short, doing it effectively, efficiently and vigilant against complications. YES, THE PRAYERS THAT MY PATIENT AND I PRAYED BEFORE ANESTHESIA WAS GIVEN MADE ME MORE MINDFUL OF WHAT I HAVE TO DO TO PROMOTE AN EFFECTIVE AND EFFICIENT OPERATION AND TO BE VIGILANT AGAINST COMPLICATIONS. I HOPE GOD GRANT US THESE THINGS THAT I AND MY PATIENT ASK.



Prayers for effective, efficient operations, without complications and speedy recovery

Started this practice on 19aug7.

19aug7 – MT – MDH – Left hemicolectomy – Outcome: with complication of anastomotic leak, being managed conservatively (19aug16); anastomotic leak no more (19sept14)

19aug9 – SC – PGH – Total thyroidectomy – Outcome: NO COMPLICATION

19aug14 – AA – PGH – Left hemicolectomy – Outcome: with abdominal distention 2nd day postop (I considered surgical complications and prayed more) – abdominal distention turned out to be ileus – patient subsequently discharged in 10 days time.

19aug15 – EQ – MDH – Modified radical mastectomy – Outcome: NO COMPLICATION





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Patient for thyroidectomy praying with me – 19aug9
Huge thyroid cancer
We prayed for an effective, efficient operation without complications. Operation done within 3 hours with all tumors removed. No need for blood transfusion.
We continue to pray for speedy and complete recovery – GRANTED. NO OPERATIVE COMPLICATIONS – NO HOARSENESS, NO HYPOCALCEMIA, NO BLEEDING, NO INFECTION.


19sept14 – Edited the prayer:

…… greatest of healers (Healers)

……..the (my) surgeon


 

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Patient saved from unnecessary breast operation – JJ (#46)

19jul18

Patient saved from unnecessary breast operation (#46)

Patient JJ saved from unnecessary breast operation.

JJ came to me and was told by another physician she should have her breast masses removed as soon as possible.  She was told all breast masses should be removed as they may be cancerous.

After I examined her, my primary diagnosis was macrocysts on her right breast (5cm) and left breast (3 cm and 4 cm).  I recommended needle evaluation and aspiration. She agreed.  I was right in my diagnosis as I was able to obtain 12 cc of serous fluid followed by complete disappearance of the right breast mass; 7 cc of serous fluid and 8 cc of serous fluid from her two left breast masses, also followed by complete disappearance of the masses.

JJ was extremely happy that she did not have to undergo operation anymore and the diagnosis was macrocysts, NOT cancer.

She asked to have pictures with me and her husband and also her friend which she posted in her Facebook.

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DELIGHTFUL PATIENT EXPERIENCE
19jul18
Happy to be of help.
Cannot retired from medical practice yet. Can still be of help.
Avoided an operation for this patient who was told to undergo operation. Just aspirated 3 breast masses which completely disappeared after aspiration of 7cc, 8 cc and 12 cc of grayish fluid.- Macrocysts.
SLICE OF PRODUCTIVITY, CONTENTMENT, ENJOYMENT and HAPPINESS TODAY.


ROJ@19jul18

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ROJoson’s Registry of Patients Saved from Unnecessary Breast Operation – 2019

I will resume this registry starting today, July 18, 2019.  I stopped doing the registry in 2018 when Facebook kept on blocking me because my blogs on this topic contained pictures of “nudity” – picture of breast with nipple with a symbol of  unnecessary breast operation.

I will resume this registry today minus the pictures that will be blocked by Facebook.  I started this registry in June 23, 2012 and target was 50 patients.

I will pick up where I stopped in 2018.  I will back-track again.  Most likely, I have reached 50 patients whom I have saved from unnecessary breast operations.

The old files can be seen in the following link:

https://rojosonmedicalclinic.wordpress.com/category/patients-saved-from-unnecessary-breast-operations/

My criteria for inclusion in my registry consist of the following:

  • Those patients who were previously advised to have a breast operation (one that is more than a needle evaluation and aspiration with or without biopsy) and after my evaluation, I decided it is not needed and the patient appreciated my recommendation.
  • Those patients with BIRADS 4 who were supposed to be operated on by other surgeon but which later turned out to be BIRADS 3 on my repeated evaluation.  Thus, no operations were done.
  • Those patients in which in there is no dominant breast mass and no suspicion for malignancy on imaging procedures and for one reason or another another surgeon recommended operation.  I just advised monitoring and check-up and no operation was done and needed.

Target: 50 patients

No. 1-41: see https://rojosonmedicalclinic.wordpress.com/category/patients-saved-from-unnecessary-breast-operations/

No. 42 – 2017 – C. Casimilo

ROJoson’s Patients Saved from Unnecessary Breast Operations

No. 43 – 2017 – Rkoh

ROJoson’s Patients Saved from Unnecessary Breast Operations (#43)

No. 44 – 2017 – A.Y.

ROJoson’s Patients Saved from Unnecessary Breast Operations (#44)

No. 45 – 2018 – Bonita

Patient saved from unnecessary operation – SonitaB – March 2018

No. 46 – 2019 – Javier

Patient saved from unnecessary breast operation – JJ (#46)




History of ROJoson’s Project: ROJoson’s Patients Saved from Unnecessary Breast Operations – June 23, 2012 (Start of Registry)

Posted on June 23, 2012

Today, June 23, 2012, I had a patient, Elizabeth_C, 40s, a sewer, whom I saved from an unnecessary breast operation.  She had a macrocyst which I just aspirated.   Prior to seeing me, she was advised by another physician to have a breast operation.   No doubt, as a result of what I did, she was very thankful to me as I saved her from an unnecessary breast operation. I have experienced a lot of this kind of situation before, that is, patients advised to have breast operations but which to me are not necessary, either just a needle aspiration is needed or the patient just has a fibrocystic breast condition, which is considered normal.

Today, June 23, 2012, I start a project dubbed as “Patients Saved from Unnecessary Breast Operations.”  I will make a registry of patients whom I have saved from unnecessary breast operations.   The main inclusion criterion will be those patients who were previously advised to have a breast operation (one that is more than a needle evaluation and aspiration with or without biopsy) and after my evaluation, I decided it is not needed and the patient appreciated my recommendation.  I will target a total of 50 patients in the registry.  I can backtrack, meaning those patients that I have saved from unnecessary breast operations even before June 23, 2012 can be included in the registry. This will be another legacy that I will leave behind for my patients.  The other one that I have started in December 2011 is the ROJoson’s Cancer Survivors in which I am also using “50″ as a target.   As of December 11, 2012, I already have 50 survivors in the registry.  I have reached my target.  As of June 19, 2019, I already have 139 survivors in the registry. The ROJoson’s Cancer Survivors and the ROJoson’s Patients Saved from Unnecessary Breast Operations will be two of my end-points in which I can say I have lived a life that matters.


 ROJ@19jul18

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