Good doctors are hard to find and when you’ve found one, you’re still not out of the woods, as even the better ones can often impose undesirable outcomes, especially when it comes to medications. With IV drugs and the sensitivities involved, the mistakes can prove irreversible and even kill. According to the Institute of Medicine, up to 5% of medications are faulty. Each year, some 2000 die.
Frankly, you need to have your wits about you to intuit when to say no to your doctor’s prescription. Despite the ritual of your supplying their office with your prescription and medical history, doctors rarely review your medications for potential interactions with the new prescription. They may also prescribe an excessive dosage or promote an antibiotic too often or for too long, or lack sensitivity to the special needs of the elderly patient.
You may rightly want to ask your doctor to review your present medications to filter out potential interactions and side effects of your new prescription, only to be disappointed. I asked my urologist about the side effects of her recent prescription, only to get a “You’ll have to check with your pharmacist,” this from a physician rated as a “best doctor” at her university online site who has presumably been prescribing this medication throughout her long career.
Just the other day, my GI prescribed librax to help relieve my occasional stomach cramps. Lo and behold, it’s a benzo with a strong addictive history and you take it three times daily. It’s also contraindicated, meaning don’t take it if you have BPH, which seems the ultimate fate of most of us men. He’s a good doctor, but he didn’t get it right on this, simply because he prescribed, like most physicians, off the top of his head.
It makes me wonder, by the way, as to how many doctors stay tuned to the latest research. I like Dr. David Agus’s own observation in his informative The End of Illness: “I implore you to ask your doctor, How do you stay current? Ideally, you want someone who stays up-to-date with the latest literature and technology. Asking this question isn’t a threat . . . .Playing nice won’t result in you being treated better or your disease being diagnosed sooner. Much to the contrary, playing too nice and not challenging your doctors when they need to be challenged can leave you in the dust—literally.”
While it’s true your pharmacy always gives you an FDA spec sheet with each of your prescriptions, too few of us read the fine print. This begs, the question anyway, since each of us is different and one person’s cup of tea is another’s poison. Because pharmacies dispense only what a doctor prescribes, this means doctors need to scrutinize medications carefully to maximize healing and/or maintenance while minimizing side effects, some of which can prove profoundly dangerous.
Often there’s no right answer and there may even be several for what ails us. This means you and I play a key role in researching creditable sources, many of them now available online. I recommend the prestigious and objective Cochrane database as a best source (http://www.cochrane.org/about-us/evidence-based-health-care/webliography/databases). Ask your self, given my medical history and age, what new relevant studies have appeared? I also recommend drugs.com for tracking drug interactions and, for just $15 a year, Best Pills, Worst Pills (http://www.worstpills.org/) for its no nonsense approach.
The bottom line is that drugs are latent with side effects and tradeoffs. Should I take androgel for low testosterone to minimize osteoporosis and a hip fracture, knowing it may increase my risk for prostate cancer?
Aspirin has shown itself a potent cancer and heart disease preventative, but is it wise to take it if I have chronic gastritis?
All the more why you and your doctor, in tandem, need to exercise a thorough cautiousness in finding the best fit. Just a short while ago, our health establishment gave a rich endorsement of the analgesic rofecoxib (Vioxx), which has now been found to double the risk of a heart attack.
If I were reduced to giving one maxim for medical safety, it would come down to this: Be your own doctor first.
–rj
Additional: See state seeks to suspend medical licenses following 12 deaths linked to doctors’ prescriptions
Brimmings: up from the well 