Interviewer: How do you diagnose these people, what’s wrong with them that other people couldn’t? What do you guys do? What’s your standard protocol?
Sarim Mir: Our protocol is that we listen to them. I can give you some examples. We will ask them about issues with their vision, eyesight, ask them if they have had any issues with their teeth, because so many times dental issues can also do that. We’ll also ask them about their posture, we’ll ask them about the type of work they do, because that has to do with that also. We’ll also ask them about their diet, we’ll ask them about their habits. We find that the biggest cause is stress, some people have family stress, some people have stress from work, some people have stress at home, sometimes people have psychiatric issues, people have anxiety, they have depression, sometimes they have fibromyalgia, so people may have those other problems which are causing headaches.
Talking to a Patient Can be Helpful in Remedying the Illnesses Afflicting the Patient
By talking to them we can discover more about their problems. We have found that so many times people have been on the same prescription, there are only a few prescriptions that we can give. So a person has been on the same thing before, which they say didn’t help, if we put them on the same thing, because of the way we talk to them, because of this whole process, the prescription that others gave them didn’t help, we give the same thing, that helps them.
A Neurologist Can Explain Things to the Patient in a Clear and Concise Manner
Interviewer: How come you prescribing them would help when otherwise it wouldn’t help? I don’t understand.
Sarim Mir: We would explain things to them. For example, a person with a prescription, they said: I couldn’t take it because I had side effects. We will start with a very low dose and we’ll bring the dose up over several days’ time. We would explain to them the side effects that can happen at the beginning. And we tell them, with time those side effects will go away. We tell them ahead of time.
We Educate Our Patients about Possible Side Effects of Medications and Slowly Titrate the Dose to Avoid Side Effects
We advise our patients not to be afraid if it happens, it will pass. We tell them, if you begin to have side effects, you don’t go up on the dose, stay on the same dose or we tell them to cut the dose in half. We prepare them. We also tell them how long it will take to help, because you have to meet people’s expectations. They need to have realistic expectations. So if it will take two weeks for it to work. We tell them that you have to be patient.
Competent Neurologists Gain the Trust of their Patients and Establish a Therapeutic Bond with Them
Interviewer: Is there any magic you feel like what you do? Or you just take more time with people and you just investigate further?
Sarim Mir: The way that we deal with people is to gain their trust so we can develop a therapeutic relationship with them. These days the doctor-patient relationship is under attack. Doctors are under pressure to see more patients because insurance is cutting the reimbursement, there are high-deductible plans, most procedures require preauthorization. Doctors have to use the EMR so they are on the computer all the time while seeing the patient. Despite all those factors, unless you are able to gain the patient’s trust, if the patient doesn’t come to trust you, anything you do wouldn’t help, but if the patient believes in you, believes what you are doing is best for them, gaining that trust has to be the first step. So the first thing we do is establish this therapeutic bond.