Fam Pract Manag. 2011 Mar-Apr;18(2):39.

Dialogue with patients about over-the-counter medications

My patients usually avoid telling me about any over-the-counter medications or supplements they use. They have a variety of reasons for withholding this information, but most commonly it's because they're afraid of being judged or they believe their prescribed medication isn't working as well as it should. My old approach was to ask them leading questions like, “You don't take any herbals, supplements or over-the-counter drugs, do you?” The predictable answer was almost always “no.”

Now I take a different approach. To obtain accurate information and open a meaningful dialogue with my patients, I use this simple, two-fold approach: First, I start with a non-judgmental statement such as, “Many of my patients find that their prescriptions are expensive or don't work as well as they would like.” Next, I ask, “Do you ever have to skip medications, take over-the-counter medications or use supplements?”

This approach opens an avenue for discussing why the patient is using over-the-counter medications or supplements and which ones.

Go green for the environment and your bottom line

Going green not only helps the environment, but it can in the span of just a few years. Reducing your practice's waste is an easy first step.

One way to reduce waste is by using washable and reusable products. For example, instead of using disposable silverware in your break room, invest in flatware. Paper gowns and exam table covers can be a significant source of waste as well, hurting not only the environment but also your bottom line. Consider using cloth gowns and table covers washed in an eco-friendly detergent. Changes like these may require a small investment up front but will pay for themselves several times over.

Recycling plastic, paper, metal and glass will also reduce the amount of waste your practice is contributing to landfills. Most U.S. cities offer recyclable pickup with the regular waste pickup, and if it's not offered by your city you can hire a recycling company to haul away your recyclables for a small monthly fee.


Ulrich N, Baum N. Going green in the medical office is more than wearing green. J Med Pract Manage. September/October 2010:109–111.

Registering for the EHR incentive programs


I want to participate in the electronic health record (EHR) incentive programs offered by the Centers for Medicare & Medicaid Services (CMS). How can I register?


Register online using the Medicare and Medicaid EHR Incentive Program Registration and Attestation System. Before you attempt registration, go to to download either the Medicare or Medicaid step-by-step registration guide created by CMS.

Eligible professionals must have an active National Provider Identifier (NPI) number and have a National Plan and Provider Enumeration System (NPPES) account. You will use your NPPES user ID and password to log into the registration system. If you don't have an NPI or an NPPES account, go to to apply for an NPI or create an NPPES account. If you have an NPI but you're not sure what it is, go to to track it down. Contact the PECOS help desk at 866-484-8049 if you can't remember your password.

For more information, read Dr. Jason Mitchell's blog post in FPM's “Making Health IT Meaningful” blog.



Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


Copyright © 2011 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Sep-Oct 2021

Access the latest issue
of FPM journal

Read the Issue

FPM E-Newsletter

Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights."

Sign Up Now