Yes , the world often fails to deliver .

Alamy

Dr Pam Rachootin GP in Adelaide , SA .

GOT an earful from an octogenarian when I requested some blood work to assess eGFR should she require antivirals .

“ Your chance of getting me to do blood tests is absolutely zero ,” she said . “ Blood tests never give good news — I know that from my friends .

“ Blood tests are why everyone is being diagnosed with diabetes or has high cholesterol and is put onto statins . What a rort ! If God wants to take me , I ’ m ready to go .

“ Why , I haven ’ t had a blood test for 30 years ,” she bragged .

I looked at my notes to verify her claim . “ Actually , we did a blood test 13 years ago .”

“ Well , you must have got me at a weak moment ,” she admitted .

This was clearly a case of my great expectations versus her fate expectations .

I documented our conversation in my notes .

“ I ’ ll tell my daughter , too ,” she said . “ So she won ’ t accuse you later with , ‘ Why didn ’ t you check Mum for this or that ?’”

Another patient had great expectations on getting a 60-day script for her antihypertensive .

She does not have a concession card and usually pays $ 15.99 for a 30-day supply of olmesartan .

So she was very surprised — under the new system against which the Pharmacy Guild of Australia fought tooth and nail — to receive a 30-day supply of the drug for $ 30 and the second 30-day supply for free .

Neither of us had envisioned that the new 60-day system would work this way — isn ’ t it meant to be protecting patients from out-of-pocket costs ? According to my understanding

now , the pharmacist has discretion to price any prescribed medication that is under $ 30 up to the $ 30 limit .

So they are minimising their losses from double dispensing by upping the price that they were previously charging , at least for patients

who aren ’ t on a concession card ?

Another expectation

disappointed .

I also love how some of my

patients have great expectations for alternative practitioners .

These patients may have a complicated , multifactorial illness .

They go on the internet for five

minutes , look up a narrow aspect of their problem , anoint themselves as experts and cast a shadow of doubt on the treatment that has kept them alive for the past 10 years .

Then they want a full copy of their file sent to a gypsy who reads palms .

So they are minimising their losses from double dispensing by upping the price that they were previously charging ?

Alas , I should not be surprised . I am reminded of the historical nature of the search for cures when I look up from my surgery desk to see a collection of antique and unusual bottles adorning the window shelf .

Among my treasures is a bottle embossed “ Saco — The Only Cure for Consumption ” and another with

PICTURE CREDIT

“ Essence of Life ” ( unfortunately empty ).

There is the manufacturer of safes who decided to diversify into medicine with “ Warner ’ s Safe Cure ”, featuring a strongbox embossed on the glass . True to name , it was a safe product because it was harmless coloured water sold at a hefty price .

And of course , “ Pink Pills for Pale People ”, purported to be a cure for anaemia with a bit of arsenic thrown in for good measure .

The modern patient who prefers to pre-empt the search for cures through avoidance of diagnostic tests definitely might have had an advantage in years gone by .

I too am subject to that greatest of expectations — that prescriptions will actually say , in unambiguous terms , exactly how many times the

patient will get supplied with their medication .

This would replace the longstanding confusion that has me explaining ( once again ) that the patient still has one repeat left because there was the initial supply plus five repeats .

Unfortunately , that great expectation has become even more complicated .

Now , they can have a medication that is eligible for double dispensing with a 60-day script ( or a 56-day script if the medication comes in a package of 28 tablets ), and the doctor has indicated two repeats , in which case they have a six-month supply requiring three visits to the chemist .

Another twist to an already complicated plot .

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