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When the Patient Prescribes the Treatment!

12/1/2017

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There was a time when if you had some medical concern you'd simply make an appointment at the doctors and there was an established protocol that was followed by both patient and doctor. There would be a discussion about the symptoms and concerns that you had about your current medical condition. The doctor would obtain more information verbally and then conduct a medical examination in an effort to determine what might be causing the problem. Based on that examination and verbal history, the doctor would make a diagnosis and recommendation about the possible treatments available, including both the downsides and the potential for relief of your symptoms. The information that the doctor provided was based on his observations, knowledge of your condition, and his or her knowledge about the condition being observed. This procedure was time-honored and followed a precedent that had been set over a long period of time. But that has changed, and that is the basis for this post.
Since the advent of advertising on television, radio, and magazine print extolling the virtues of all of these new and wonderful medications available for almost any disease, condition, or concern about your particular illness, the patient now has what they consider to be useful information and the ability to make recommendations to the doctor. But the question must be asked; are these marketing advertisements really useful and do they contain enough information for a patient to be fully knowledgeable about their potential use for their condition?
Based on the barrage of these commercials on television the answer for me was is a resounding no! They are typically 30 second vignettes showing some medical condition and 30 seconds of side effects sometimes including death. They offer very little information that would help the consumer to be more well-educated and to really be able to make a suggestion to a doctor who knows and has seen many conditions that are similar or the same. It seems ludicrous to make a recommendation to the doctor based on a marketing tool that is designed to sell medications. Assuming that the patient does not have a medical degree or some expertise in their condition it seems unreasonable to expect that the doctor will accept the recommendation of the TV commercial. Of course it is possible that the patient has done a reasonable amount of research into the medication and can intelligently have a conversation that may assist the doctor in making a better decision. But how many patients really take the time and energy necessary to investigate all of the data about a particular medication and present it to the doctor for his consideration?
But it is also important to recognize that drug companies are constantly meeting with doctors trying to sell them on the idea that their medications are exactly what the doctor should be prescribing. At this point it is the doctors responsibility to recognize that they have an obligation to be aware of the potential applicability of this new medication for its intended purpose. Of course at the same time pharmaceutical companies are handing out free samples to the doctor so that he/she may prescribe them based on availability and not necessarily on all of the background information. We have to remember that the drug companies are in the business of making money and they depend on salesmanship to move their product. I would hazard a guess that most doctors are in a position where they have to make a decision to investigate on their own whether or not there is real potential for a new medication to truly be useful. But there is one complication and that is simply that doctors are under a great deal of stress to see as many patients as possible leaving them less time to search out information that may be helpful in their prescribing habits.
My own feeling is that there has to be trust in the doctor that you are seeing and that you become your own advocate and ask about contraindications, side effects, and potential use of a new medication. And if you do get a new medication that you read the data sheet that is included with the medication by the pharmacist. I also feel strongly that the FDA should ban these commercials ( as most countries do), based on the fact that they really are not useful but are simply advertising tools that promote the pharmaceutical companies and are not in the best interest of the patient. If we really want to be healthy we must be responsible enough to question not only the advertisers, but to challenge the doctor with good, well thought out, questions, and to promote a good interesting dialogue with your provider. To your good health!
 
 
 
 
 

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