Wednesday, April 11, 2012

A Pill for Every Problem

Some of my Facebook friends were lamenting the other day over a perception that “doctors and some people" think that a pill will fix anything. Well, this is at least partially true. I think some people, in fact, many people, think that there is a pill for anything that ails you. You find a lot of these folks rushing to the ER or spending week after week in a doctor’s office or convenient care clinic searching for a cure for the most trivial of complaints. Since most of these people also seem to think that someone else should pay for their healthcare, then the costs are multiplied exponentially, but that is another story.

I think most doctors realize that many things are not curable with a pill, in fact many things we see on a daily basis don’t even warrant a visit to the office. Nevertheless, we see the same old unnecessary stuff day after day. The problem with many of my colleagues is that they just can’t seem to say NO, and it’s easier to capitulate and prescribe a pill to every blithering hypochondriac that darkens the door rather than take the time to explain that certain “medical conditions” require no treatment. Since many of these hypochondriacs will visit multiple providers, they often collect a variety of unnecessary medicines. Sometimes these combos can turn out to be downright dangerous. And of course the hypochondriac will never seem to share previous practitioner visits with the current provider.

Many of my colleagues will over-prescribe simply to be liked by the patients and to keep them coming back happy. Allow me to relay a little story:

Little Johnny has a fever. Little Johnny’s mother RUSHES him immediately to the convenient care clinic. Of course she never bothers to give little Johnny any Tylenol or ibuprofen. The practitioner at the clinic diagnoses an “upper respiratory infection” and prescribes for little Johnny a somewhat expensive antibiotic. The practitioner had just been detailed about this new antibiotic by an oh so friendly pharmaceutical rep. Little Johnny’s mother is not worried since her insurance will pay for the antibiotic and she is just THRILLED to get this brand new high powered treatment. She just knows little Johnny will be all better by tomorrow.

Two days later, little Johnny is not doing any better so mom RUSHES little Johnny to the ER where the friendly Dr. GROUCH is on duty. Dr. GROUCH examines little Johnny, sees the expensive antibiotic he has been prescribed and tells mom that her child has a COLD which is caused by a VIRUS and that she can probably expect little Johnny to be sick several more days as the virus runs its course. Friendly Dr. GROUCH suggests mom make a trip to Walmart and stock up on Tylenol and an over the counter decongestant. This does not sit well with little Johnny’s mom, since she will have to pay for the Walmart items herself.

Two more days pass when finally little Johnny’s mom RUSHES him to his friendly family healthcare provider. The friendly family healthcare provider just can’t believe that the first practitioner would prescribe that antibiotic for this severe infection and is appalled that the evil Dr. GROUCH would do nothing for her son other than send her to Walmart. The family healthcare provider prescribes yet another expensive antibiotic and declares that if things do not improve soon, a visit to a specialist may be warranted!

Miraculously, by the very next day, little Johnny is much, much better! Little Johnny’s mother is convinced that the first provider just didn’t know what he was doing and that evil Dr. GROUCH was just an uncaring asshole.

Of course the truth here is that little Johnny had a virus and no matter what he was given, he was going to be sick until the virus was done. The friendly family practitioner came out smelling like a rose because he was able to slip in the miracle drug the day before little Johnny would have gotten better anyway.

And so we get a bit of a glimpse into why many doctors and other practitioners capitulate and prescribe pills just to appease the worried well. In the case above, Dr. GROUCH made the correct diagnosis and prescribed the proper treatment, and yet he was perceived as the uncaring asshole.

One of my favorite TV commercials showed a mother RUSHING her feverish child to the ER in the middle of the night. In the next scene, she is back home with the smiling child explaining to Papa that the hospital prescribed Tylenol! I’m sitting there thinking, “You’d think someone with half a brain could have figured this out without RUSHING to the ER.”

Back when I was a kid, my Momma didn’t take us to the doctor unless we were half dead and we NEVER rushed to the ER. Yet, 60 years later, I’m still alive and kicking. We’ve been programmed by the gubment, the media, the drug companies, nosy grandparents and neighbors, and many other sources, that we are absolutely helpless and we can’t do anything for ourselves. At the slightest sniffle many frantically rush to their weary healthcare providers demanding a quick, easy, and immediate fix! Money is no object since someone else will pay for it!

So we find ourselves in this vicious spiral of a pill for every problem and the cost of healthcare out of control. It is indeed mind boggling.

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