Updated: Oct 2, 2020
After spending 25 years in medical device sales I have seen the good, the bad, and the ugly of Western medicine. I have spent even longer (48 years) as a patient and have seen the distrust that western medicine has created from both sides of the fence. The problem is multi factorial and I will be covering these factors in a series of post.
Are we being over prescribed?
A lot of the misgivings about medicine in the United States are not unfounded. The US is run by the pharmaceutical industries. Most medical professionals have become useful messengers for the industry. Prescribing medications to patients for anything and everything. My personal physician has said that "antidepressants should be in the drinking water." This has been propagated by an army of pharmaceutical reps, providing free lunches, samples, other benefits to prescribers. There are also an unending reel of commercials touting the benefits,of the latest drugs that the companies are promoting. In fact, In 2016 drug companies spent over 6 Billion dollars on direct-to-consumer advertising. These heavily promoted the benefits of the medications while offering very little transparency in terms of harm.
I view this as predatory advertising. Hoping to reach patients that are looking for a quick solution to their ailment. Studies have shown that when patients ask their doctors about a drug, doctors are likely to prescribe it. Even if the medication is not indicated.
This is a two pronged strategy to maximize its profits: increasing prices and consumption. While the high price of prescription drugs has gained attention from politicians and advocates on both sides of the aisle not enough emphasis is being placed on over prescribing. Over prescribing adds to the cost of drugs but also harms millions of Americans each year. How will lowering the cost of drugs affect prescribing? In my opinion this will only magnify the problem.
Western medicine has failed us by placing prescription drugs on a pedestal. Studies show that over 50% of older adults take one or more unnecessary prescriptions. Between 2002 and 2012 the proportion of adults taking five or more medications nearly doubled to 15%. Today nearly 42% of older Americans over the age of 65 are on five or more medications. Are my comments overblown? When you consider that there are negative clinical consequences to polypharmacy. Each additional medication that is prescribed increases the probability of adverse reactions. These points are where this mistrust is well founded. There is a time and a place for pharmaceutical intervention but they should not be used as a primary line of treatment.
This problem is also compounded by a society that values instant gratification without a need for personal accountability or inconvenient lifestyle changes. It is disconcerting how many people don’t understand that many of their chronic conditions are treatable and preventable through improvements in diet, nutrition and excercise.
Next week I will be diving into how this “magic pill” system was propagated and how medical schools and the medical system have failed physicians.