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Studies show that in 10% of office visits, patients ask for specific medications. To evaluate physician strategies for saying no to such requests, U.S. researchers assigned 18 trained and scripted standardized patients to visit physicians and to request antidepressants. The patients were insured middle-aged white women who presented with histories consistent with depression or adjustment disorder and with low back pain or wrist pain. The visits were recorded, and transcripts were analyzed.
Patients requested antidepressants during 199 visits; prescriptions were denied in 36% of visits in which patient histories were consistent with depression and in 53% consistent with adjustment disorder. Strategies used for denying requests included:
Patien…