There has been a significant change in the practice of medicine in
the last decades. A study done at UCLA in the early 90's confirmed that
the primary reason their medical students were going into the field was
high financial remuneration. The second most popular reason cited was
prestige and down the list at number three was to help people. That is
probably the most telling research and explanation for the changes in
medicine in recent years.
Gone are the bedside visit [at least in the USA], and the close
personal relationship between doctor and patient. This has been replaced
by the assembly line style of office visit and where one-size-fits-all
treatments have become the norm and which includes generalized medication
prescriptions and dosage. By the way, it was Hippocrates many centuries
ago, who cautioned physicians to 'know thy patient' and 'to do no harm' -
two injunctions that seems to be ignored today.
A recent study showed 49,000 to 98,000 people a year die in US
hospitals from iatrogenic causes. Yet recently doctors in several states
and large cities protested, not over the deteriorating health care
provided here [with higher costs and increasing uninsured] but because
their malpractice insurance is rising. Given the above figures it is not
surprising that insurance costs are rising but instead of cleaning up the
profession, they demand less accountability.
On the other side, doctors are delivering a poorer product for
spiraling cost. They are rarely aware of, nor do they have the time to
read about or communicate to patients the barest of information, including
of course information about the drugs so routinely yet often mistakenly
prescribed to patients. I can cite numerous first hand examples just from
my own life, those of relatives and from 23 year practice. I know that
most any other nurse could easily do the same.
Rarely do doctors know the dangerous side effects or drug
interactions of the medicines they prescribe or generously give as free
samples. As a result they come to rely very heavily on the drug company
representatives for information. These are the same people providing perks
[bribes] such as gifts and free meals [which by the way is given to other
prescribers - I have personally been to one for Nurse Practitioners yet
not Registered Nurses who are unable to prescribe by law]. Is there any
question that the information is biased? Does anyone imagine these reps
pushing the drugs of another company that might be better suited to a
patient or perhaps a generic counterpart that is cheaper?
Only persons outside the medical professions would not understand the
need for immediate change in the delivery of medicine. Yet doctors
themselves have been unwilling, except in rare instances, to change the
way medicine is delivered. Only one portion of the problem is reflected in
the area of medication but with the burgeoning use of drugs, a most
critical area to address immediately.
Rapid Response:
Medicine As Big Business
There has been a significant change in the practice of medicine in
the last decades. A study done at UCLA in the early 90's confirmed that
the primary reason their medical students were going into the field was
high financial remuneration. The second most popular reason cited was
prestige and down the list at number three was to help people. That is
probably the most telling research and explanation for the changes in
medicine in recent years.
Gone are the bedside visit [at least in the USA], and the close
personal relationship between doctor and patient. This has been replaced
by the assembly line style of office visit and where one-size-fits-all
treatments have become the norm and which includes generalized medication
prescriptions and dosage. By the way, it was Hippocrates many centuries
ago, who cautioned physicians to 'know thy patient' and 'to do no harm' -
two injunctions that seems to be ignored today.
A recent study showed 49,000 to 98,000 people a year die in US
hospitals from iatrogenic causes. Yet recently doctors in several states
and large cities protested, not over the deteriorating health care
provided here [with higher costs and increasing uninsured] but because
their malpractice insurance is rising. Given the above figures it is not
surprising that insurance costs are rising but instead of cleaning up the
profession, they demand less accountability.
On the other side, doctors are delivering a poorer product for
spiraling cost. They are rarely aware of, nor do they have the time to
read about or communicate to patients the barest of information, including
of course information about the drugs so routinely yet often mistakenly
prescribed to patients. I can cite numerous first hand examples just from
my own life, those of relatives and from 23 year practice. I know that
most any other nurse could easily do the same.
Rarely do doctors know the dangerous side effects or drug
interactions of the medicines they prescribe or generously give as free
samples. As a result they come to rely very heavily on the drug company
representatives for information. These are the same people providing perks
[bribes] such as gifts and free meals [which by the way is given to other
prescribers - I have personally been to one for Nurse Practitioners yet
not Registered Nurses who are unable to prescribe by law]. Is there any
question that the information is biased? Does anyone imagine these reps
pushing the drugs of another company that might be better suited to a
patient or perhaps a generic counterpart that is cheaper?
Only persons outside the medical professions would not understand the
need for immediate change in the delivery of medicine. Yet doctors
themselves have been unwilling, except in rare instances, to change the
way medicine is delivered. Only one portion of the problem is reflected in
the area of medication but with the burgeoning use of drugs, a most
critical area to address immediately.
Competing interests:
None declared
Competing interests: No competing interests