Does DIY medicine ever work?
Cost of living is at an all time high.
As a result, studies show that patients delay treatment longer than necessary, or try and stretch out medications to save on cost, especially if not subsidised by the PBS.
Occasionally they may source cheaper alternatives through other sources. These may be reputable or not.
In 2025, this has become an almost regular occurrence.
So much so that at least once a week, I have to advise a patient that if they wish to:
- use prescription medication at a reduced frequency than recommended for results;
- obtain scripts from someone else in the interim especially via telemedicine;
- source their own provider for medications that are unregularted pharma;
…that I may not be the right doctor for them.
“But it’s just a script.”
How hard can it be, right? It’s just a script!
Except…it is never “just a script”.
The making of a prescription…
A prescription, if appropriate, is prescribed after a thorough workup of:
- your specific concern,
- an examination if appropriate and
- a discussion regarding treatment options which may include doing nothing.
It also involves a discussion around how long we anticipate you taking that medication and some additional lifestyle changes that go hand in hand with that prescription.
It is a decision arrived at with you, after determining:
- if a prescription is in your best interest,
- if you will take it as intended,
- for as long as intended.
In the case of many chronic conditions, this may be longterm or for life. Is this acceptable to you?
Some medications are not commercially available.
In this case, a prescription carries more responsibility, written with a “recipe” in mind designed to work for you and only you. Unlike regulated medications, which are commercially available, these need to be made to doses as instructed by your doctor (me).
In this case, we work with a compounder. While there are clinical guidelines, the final “recipe” is arrived at through trial and error with a compounder with whom we achieve reliable formulations that produce the same results in our patients with minimal side effects.
Finally, the person writing the prescription carries the responsibility of ensuring that it is prescribed with your safety in mind, in the way it is intended, after thorough consultation with you and your consent which includes financial consent at the time of prescription.
What happens when you find someone else to do it differently?
There is a lot of medical distrust, misinformation and disinformation out there. Increasingly patients come in having googled what they believe they need (I encourage this) or now, even ChatGPT diagnoses and treatment plans.
All of this supposes that your google search is equal to my decades of experience.
If the ability to establish trust fails, or you remain unconvinced, or decide to do your own thing, it is your right to do so.
It is also my right, as the doctor and prescribing physician, to encourage you to seek your ongoing medical care elsewhere if we cannot see eye to eye on the best path forward.
The role of telemedicine
In recent years the role of telemedicine has expanded rapidly since Covid.
More and more people are relying on telemedicine for their general health out of convenience for issues that cannot be dealt with via phone calls, emails and text messaging.
Competition is intense and the wholesale nature of these businesses drives patients into believing that the care and attention is equivalent to what we offer face to face.
Sometimes this may be true, especially when it is hard to access a doctor due to distance, and for issues that do not need a physical examination.
In fields such as skincare and medical aesthetics, this is an incorrect assumption.
We often see patients present after failed telemedicine and prescriptions via some of these services.
Sometimes their skin or other condition is worse on the wrong drug because of poor lighting on photos, wrong angles and lack of detailed examination such as dermoscopy.
During this time, they’ve often spent hundreds if not thousands of dollars chasing the wrong results. Occasionally they end up worse than where they began.
Duty of Care
As a general rule, I make it clear everywhere – on my website, on social media and if you contact us – that all new patients need a paid consultation to determine :
- What your concern means
- If I can help you
- What that looks like
- What is expected from you if we work together
- A timeframe of how long it will take for us to see results
- Whether you will be involving other physicians/clinicians in your care or splitting care of the same issue across multiple doctors.
- If you have the budget, time and ability to follow the treatment plan to the end.
Most concerns that have taken years to develop cannot be treated in a single session or two. It is important you understand this. It is equally important I have your consent to remind you when you forget.
Based on this we determine if we will work together and then we correct as we need to.
It is a process, not a one-and-done solution.
It needs ongoing maintenance and at times, depending on what is involved, there may be setbacks, unexpected side effects and anxiety.
My team and I will be with you at these times until the issue is resolved. In order to do this, we need to know if we are working exclusively or if there are other cooks involved that may be contributing to the broth.
This is crucial, because in my experience involving too many other clinicians will dilute the outcome for you because none of us will be taking ownership of your concern to help you.
In summary….
In my clinic, it is never “just a script”.
We do not quote for treatment until we’ve met you and assessed you in person to see what your actual problem is.
I am happy to hear what Google or ChatGPT told you the problem is, so we can address if it is right or wrong, and why.
After that, we get down to work, you and me. If you are not ready to do that, then I will always suggest we are not a good fit.
The more medically discretionary the work, the more important it is that you have one doctor/ clinician running the show with you.
The risks are higher, for both of us.
In my clinic, if we agree to work together, the unstated expectations are clearly stated:
- We work together exclusively
- We meet regularly
- We work through your concerns one step at a time
- We will be taking months to arrive at results
- You will show up when you say you will
- You will ask for help managing your frustration with setbacks and not quit
- I have your consent to remind you when you forget our agreement
Otherwise, what got you here, will get you to the next doctor and the one after that, with a problem that beyond a point, will become unmanageable.
You don’t get results by doing more of the same thing that has not worked.