Stimulus - Learn Tools to Crush It in Your Medical Career

62. Primum Non Nocere | How 8 doctors practice 'first do no harm'

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Oct 18, 2021
Guest
physician educators
Leading physician educators discuss the core principle of patient care: primum non nocere. They explore topics such as doing what's medically right, reducing opioid prescribing, and prioritizing patient interests in medical decision-making.
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INSIGHT

Recenter Medicine On Avoiding Harm

  • 'Primum non nocere' reframes medicine's keystone as prioritizing avoidance of harm above defensive or satisfaction-driven choices.
  • The phrase asks clinicians to examine whether actions help or instead expose patients to iatrogenic risk.
ANECDOTE

Admitting To Defensive Medicine

  • The host recounts admitting low-risk chest pain patients to avoid legal risk, calling it 'don't be a hero.'
  • He admits this protected himself far more than it helped patients and caused downstream harms.
ADVICE

Limit Opioid Prescriptions

  • Avoid routine opioid prescribing; discuss risks and alternatives with every patient before giving opioids.
  • Prescribe fewer pills, and expect many patients will decline opioids when informed.
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