Salem family physician Dr. Dale Margolis expressed frustration with the recent spate of calls he has received from patients taking Nexium (Esomeprazole), the so-called “Purple Pill”, who have been following instructions in the product’s latest advertising campaign to “call your doctor if you experience persistent diarrhea”.
“Obstinate diarrhea is certainly a potentially serious side effect with Nexium, as well as its generic equivalents”, Margolis confirmed. “But evidently AstraZeneca has launched a new television campaign in which it (persistent diarrhea), along with a litany of other side effects, are described, and they implore patients to call their doctors if they experience any of the symptoms.
“Well, over the past couple of weeks, I’ve literally been receiving five to ten calls per day in which patients are describing, in graphic detail, the characteristics of their stool. I have yet to hear from a patient that had uncorrelated output (unusual stool consistency based on food intake). One would think that a fully-functioning adult would know whether or not they were suffering from diarrhea, but evidently not.
“In an even more revolting development, our recently launched internet ‘Patient Portal’ allows them to attach files. So I have had a few patients who have been photographing the results of each days’ bowel movement and uploading them to the site. Thankfully, the email alerts go to my MA (Medical Assistant) Cheryl, so she takes care of most of them and responds without my intervention.”
Margolis’ frustration primarily centers on the fact that simple lifestyle changes related to diet and exercise would ameliorate symptoms and the need for medication in the vast majority of cases he treats, but he has been unable to convince many patients to attempt even the most basic behavioral modifications. Additionally, he expressed concern that the time spent to process the calls or emails is not easily billable to insurance or directly to patients.
“In most of these cases, I have to just eat the costs, because the insurance companies would fight these ‘consultations’, and it would alienate my patients if I started billing them for each call we take or ‘pile picture’ that we look at. But if the contact keeps up at this rate, I will have to take drastic steps, and then the excreta will really hit the flabellum.”