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Editor's Note
January 2018

Physician Denial of Inappropriate Patient Requests—What If I Say No??

Author Affiliations
  • 1Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 2Associate Editor, JAMA Internal Medicine, Chicago, Illinois
JAMA Intern Med. 2018;178(1):92. doi:10.1001/jamainternmed.2017.7367

Today, patients routinely come into our offices, describe the symptoms they are experiencing or the illness they are managing, and make straightforward requests. Many times, the requests are clinically appropriate, and we would have taken these actions regardless. But at other times, such as when we hear, “Doctor, this congestion won’t go away. It must be an infection. Can you prescribe me antibiotics?”, or “Doctor, I’ve had terrible back pain for over a week. Can you order me an MRI and refer me to the orthopedist?”, we would not have. And invariably, as we deny the request, explaining why to the patient, we wonder to ourselves, would it have been easier to just say yes—less time and less effort—and would the patient have left our office more satisfied with their care?

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