Saying or hearing “no” in any circumstances involves setting a limit with others or having them set a limit with you. It invariably involves some degree of confrontation. Although learning to say no can be liberating, most people would prefer not to be put in situations where setting limits is necessary.
One of my least favorite but necessary tasks as a physician is saying no to patients.
In the ideal world, doctors wouldn’t have to deny patient requests. Patients would read information only from reliable web sites. Direct-to-consumer marketing of pharmaceuticals would not exist. Patients with addiction histories wouldn’t ask for potentially habit-forming pain and anxiety medications. Doctors would always listen carefully to patients. Doctors would arrive at carefully thought-out formulations of their patients’ problems and then would explain all reasonable treatment options thoroughly. Ultimately patients would then make informed, logical decisions about their health care. Everyone would be happy!
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Those with mental health and substance abuse problems have long faced discrimination from third-party payers. Payment for such conditions has typically been handled differently from “physical” health problems.
A news release today from the U.S. Department of Health and Human Services today explains that the Obama Administration has issued new rules that will require parity in the treatment of mental health and substance use disorders.
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