I’ve been shouting this for years; “Too Many People Take Too Many Drugs”

While that is undoubtedly true, another issue parallels it. Too many people have too many tests and engage in too many treatments.

In an article in the June 7, 2010 issue of Drug Discovery & Development titled, “Overtreatment A Serious Problem in the US”, Lauran Neergard reports that, “Anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary, and avoidable care is costly in more ways than the bill: It may lead to dangerous side effects.”

I could repeat Ms. Neergard’s extensive list of excess here, but it would be best if you read her complete article – even though her reporting may itself make you ill.

Americans are generally technology-loving people. We seem to want every possible test and treatments form – even when there is little clinical reason. This passion has rubbed off on our doctors – and their professional cohorts in the laboratories and pharmacies. People want these tests, drugs, and procedures, and their doctors comply.

Back in the 1980s, I asked a pediatrician why he ordered antibiotics so frequently – especially for ear problems that were most likely caused by a virus (not treatable with antibiotics). The doctor explained that if he failed to write the prescriptions, the mothers would take their children elsewhere. They wanted – and demanded – that pink liquid. The doctor agreed with the mothers so his business wouldn’t suffer.

We ought to be turning to our doctors for their professional help, not to coerce them into doing our bidding. I place most of the blame for overuse at the feet of the heavy advertising that bombards us at every turn. Those ads work on us and we come to believe we will be better off if we use them – for whatever ailment they’re supposed to relieve. Instead of taking a rational, professional approach to our whining requests, our doctors commonly roll over like a good doggy and give in. They seem to allow their clinical judgment to be trumped by drug advertising and the demands of their “customers”. That is clearly unprofessional. Even worse, it’s unethical.

To be fair, I can’t place too much of the blame directly with the doctors – even though I suggest they really ought to know better. The medical education system is a massive failure and it prepares graduates to be mere pawns in a system that places the customers’ demands above best clinical judgment. And, let’s not ignore the strong influence exerted on medical students by the ever-present drug detail people. Doctors are TRAINED to order tests and prescribe drugs. Yes, truly trained because, like Pavlov’s dogs, they are regularly rewarded for doing what their trainers want them to do. Who are the trainers? The same folks who bring drug advertising into our living rooms.

If you have ever asked a doctor for a prescription or if you have ever asked for a special test, you are part of the problem. Ms. Neergard reports that 20% to 33% of what happens in health is unnecessary. I think her numbers are low. Regardless, wouldn’t you think that cutting the gross excess can go a long way to making health care in the United States more affordable?

Tell me what you think.