You may not be aware that it’s far easier to start patients on new medications than to take them off. If I prescribe a medicine, patients take it with great hopes, and the placebo effect runs deep. Never mind that they may get better with or without the med. Side effects are just that. “I’m sorry you seem to be one of the few to have suffered a side effect. Shall we try something different?”
On the other hand, removal of a medication comes with far more stress for doctors and patients. “My last doctor said I’d need this? What might happen to me?” All side effects from absence of the med are in the doctors’ lap alone.
Once a diagnosis has been determined, unless you need a splint or sutures, my tool belt in the ER is essentially a prescription pad. And after hours of waiting, patients aren’t keen to hear “I think you should eat less. Please stop smoking. Daily exercise would help you immensely. Your job and your boyfriend are damaging you… Please drop both.” Many people want, or they’ve been trained to want, pills.
From the ER most of my prescriptions are for short courses of medications to deal with infections, pain, allergies, nausea, breathing problems, anxiety. That’s 98%. My presciptions help get patients through a few nights. But they aren’t the cash cows mentioned on this NBC report Rising Prescription Drug Costs Stirs Consumer Outrage.
The medications causing so much controversy, are those which patients need (rightly or wrongly) to take for their entire lives to deal with chronic problems like diabetes, hypertension, depression, anxiety, hypothyroidism, cancer, congestive heart failure. These are prescribed largely by internists, psychiatrics, and family practice docs and I don’t envy them. I could be wrong, but I’d venture to guess that most prescriptions come from doctors who have no clue about their costs as well. Until GoodRx.com I was one of them.
Here’s the Pre-R sell… While I don’t want to undermine other doctors, if you would ever like to run through your meds lists pill by pill in search for simplification and possible cost savings, I’d be happy to help. After 3-5 pills per day, error rates, drug interactions and side effects soar, and I sometimes encounter patients with shoeboxes of 10-20 meds. Our pill popping to bankruptcy culture is crazy, and maybe Pre-R can help a bit.