This is not an uncommon thing. I’ll give an common example of a situation I see in clinical practice regulary.

There is a class of drugs called “SSRI” These drugs are also called “antidepressants.” There have been times when patients have been perscribed one of these medications – often for pain, hot flushes, or migraine, where they can be very useful! – but choose not to take them after Googl’ing the drug. “I’m not depressed.” or “I’m not taking those – can’t believe the doctor thinks this is all in my head.”

In other cases, patient has had feedback from online forums or other patients about how “bad” the side effects of a drug are. This is particularly challenging for patients with new diagnosis of diabetes who need to start drugs to control their blood sugar. It’s not that the patient should take a medication without hesitation or question – but ask the question. I find it just an unfortunate loss of time when I see a patient for follow-up – still in discomfort – and nothing has changed or gotten better since the last appointment and we’ve lost all that time to make progess on their health. If we had address the question earlier, they could either have been reassured or, alternatively, we could have made a new plan of care.

I always like to remind patients that:

1) there is no such things as “Big Pharma” payouts to docs. It makes no difference to us whether you take the drug or where you buy it.

2) No doctor is looking for business. We are all overwhelmed. We aren’t prescribing to keep you attending us nor are we scheduling medication reviews that aren’t needed for safety.

3) All doctors are happy to discuss whether or not you can do something that is not medicine: such as a change in diet for pre-diabetes or adding physical activity for joint pain.

Sedation for children when flying has 2 problems. One is something called “paradoxical hyperactivity.” Yes – that drug that you thought would make them sleepy has them now bouncing off their seat. It’s a real thing. It can make the situation worse. Secondly, especially in children under 2 in whom these medication should not be used, in-flight is the worst possible time for a medical emergency. Travelling with young children is very, very difficult. No two ways about it. But the safer options are just to pack the bag: load it up with comfort objects, favourite snacks, remember a sippy cup for in-flight juice, bring small new books/toys, or load up the tablet with favourite cartoons or audiobooks This is the one time where ALL the screentime is the healthier option!