Friday, July 28, 2006

That's Not Right...

If there’s one thing about America I’ll never get used to, it’s the sheer commercialization of your health care system.

In England, healthcare is just that, healthcare. Over here it’s big business.

For example, in America, you have advertisements for prescription drugs, something that is unheard of in England. I mean, we have ads for all the over-the-counter cold and sore throat remedies…but nothing you need a prescription for.

Now, this isn’t really an England versus America debate. It’s just that I think ads for prescription drugs are absolutely useless…and in a way, dangerous.

You see, here’s the way it’s supposed to work. You get sick, you visit your doctor, explain your symptoms, then he examines you and makes a diagnosis. Then, after all that, he writes you a prescription if you need one.

The doctor spent years of his life learning about the human body. He’s a professional. It’s his job to work out what’s wrong with you.

So why are prescription drugs being advertised to us? Shouldn’t it be down to the doctor what medication you receive? Why do I need to know about these drugs when, if I ever need them, my doctor will diagnose me and prescribe them for me? I don’t need to know all about them. I just need to know that if I swallow the pill the doctor gave me, I’ll get well again.

Well, I’ll tell you why. It’s all about dollar signs.

There’s an ad currently running on TV for a prescription drug for irritable bowel syndrome. During this ad, the announcer actually says:

“If you just mention constipation to your Doctor, he’ll probably just suggest fiber and laxatives. If you tell him that you have constipation along with bloating and abdominal discomfort or pain, he’ll probably suggest (Drug Name).”

Is it me, or is that coaching people on what to say to the doctor to make sure you get this particular drug? I even checked this drug’s website (They actually have one) and it has a whole page on what to tell your doctor.

Let me let these people in on a little secret. The only information you need to share with your doctor is your current symptoms and any existing conditions. Not a script from the drug companies in order to get a prescription of their particular drug.

Now many people may take the view that these ads are simply advertising what they’re for and what they do. That there’s nothing sinister or back-handed about it. However, think about that for a minute. If someone actually has those symptoms, they don’t need an ad telling them to tell their doctor about them. If I was ill, I’d go see a doctor and tell him everything I was feeling. Also, sticking with the above ad, yes, the doctor might only suggest fiber and laxatives first…but that’s the whole point! Try the cheap and readily available remedies, before starting someone out on a course of a very powerful and expensive drug! It’s like replacing the whole engine because the car won’t start, before checking the cheap and easy fixes first.

You see if an asprin will cure your headache before going for the CAT-Scan.

Again, this shows the difference between the British and American healthcare system. In England your visit to a doctor is always free. (For the benefit of the Americans in the audience, it’s like all British citizens are permanently on Medicaid. If you want to pay for a private doctor, that’s up to you).

So, British Doctors don’t have to worry about you walking and finding another doctor, because you can’t get cheaper than free, and their pay doesn’t depend on how many patients they have. You leaving to find a private doctor to write you a prescription just means they have a lighter workload.

However, with healthcare being such a big business in America, doctors are in competition with one another. Basically, ads like these are so hypochondriacs will see them and march into their doctors office and demand a prescription…and if the doctor refuses to fill that prescription, the ‘patient’ will simply leave and find another doctor who will.

Then we come to the point that a lot of prescription drugs won’t actually do any harm to a healthy person. I mean, obviously, a drug designed for high blood pressure might make a healthy person’s blood pressure drop dangerously low…but a drug that simply helps regulate your digestive tract?

So imagine you’re a doctor with your own private practice. Someone marches in and demands a particular drug. They don’t need it, but they’ve seen the ads and convinced themselves that it’s the miracle cure for whatever they think they have. You know that it won’t do them any harm to take it, and they’re threatening to leave and find another doctor unless you fill the prescription. When it comes down to a few grand a year walking out the door, how many doctors can afford ethics?

The other point is that it’s like someone walking into a garage and demanding that the mechanic let them pay him a huge amount of money to write down that their car needs the hood painted red to make it go faster. Why the hell not? If someone wanted to pay me a large wad of cash to get something they don’t need, and told me that unless I do, they’ll find someone else who will…I’d do it!

However, the most dangerous part of this is the ‘coaching’ on what to tell your doctor. There’s plenty of stuff that a doctor can’t really test for (How can you prove or disprove if someone has a headache?) So in many ways a doctor depends on your description of your symptoms to start a diagnosis. If someone walks into a doctor’s office and starts reeling of symptoms that point to a textbook case of a particular ailment…why would the doctor think the patient was lying?

So, it’s a case of someone who eats too much spicy food and continually gets indigestion. They see an ad on TV, walk into their Doctor’s office and quote all the symptoms they’ve heard on the ad. Then, they leave with a prescription that while completely harmless and beneficial to people with the disease it’s intended to treat, but potentially harmful to someone who just needs to lay off the chili for a few days.

It’s madness. Plain and simple.


OzzyC said...

For what it's worth, the idea that pharmacy companies can advertise makes me sick as well. I wonder if they have a pill for THAT affliction

mistyforeverlost said...

Yes Ozzy they do, but it will create irritable bowels, headache, nausea and cotton mouth. The more serious side effects would be high blood pressure and above normal cholesterol so you may want to check with your doctor so you make sure those scripts are filled as well.

Good write-up. I agree and wish the American public would educate themselves a bit better and not buy into these marketing ploys.

MBB said...

My view UK side of he Atlantic is take a Pill and come see me again if it does not get any better.

What ever happened to 'Do no harm?'

Big business.

Big money.


Anonymous said...

It used to be illegal to advertise RX drugs HERE as well as the UK. Somewhere btwn (i think) the 50's - 70's big pharma decided the cut out the middle man - your doctor. It took them a while, however, you're seeing the results of that action now. Reminds me of when the US government granted HUMAN rights to corporations, come to think of it. Great post!

Daniel Haszard said...

Eli Lilly is a big drug company that puts profits over patients.
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