Global Health Systems 1st Edition by Margie Lovett Scott ,Faith Prather

Exercise 10

Andersen is a 68-year-old, African American male who recently recovered from a Trans Ischemic Attack (TIA) commonly known as a mini stroke. He has a history of hypertension and takes Metoprolol 50 mg and hydrochlorothiazide 25 mg once a day. He is just completing his follow-up visit with his primary care provider. As the visit is winding down the physician writes a prescription for Plavix 75 mg (a 90-day supply) with directions to take one tablet every day. He also tells him to take 1 baby aspirin a day. As the physician proceeds to write the prescription he stresses repeatedly the importance of taking both medications without fail in order to "prevent another TIA."
Unknown to Mr. Andersen, having a first TIA puts him at great risk of having a second one. Mr. Andersen works his way through the packed waiting room to the front desk. The receptionist glances down as she is scheduling Mr. Andersen's next appointment. Seeing the prescription Mr. Andersen is holding, she buzzes the physician over the intercom stating, "the patient has no insurance so he will have to pay out-of-pocket for the Plavix, what do you want him to do?" Out comes the physician who, as he rips up the prescription, tells Mr. Andersen to just take the aspirin, assuring him he would be just fine.
What prompted the physician to make such a dramatic turnaround in his advice to Mr. Andersen?