Once upon a time if you wanted to practice medicine you had to graduate from college, spend four years in medical school, pass rigorous medical board exams and do several years of residency. After this trial by fire you had acquired a lot of knowledge and experience that qualified you to treat patients.
This system hasn’t changed much, but nowadays almost anyone can purchase powerful medicines to treat conditions they have self-diagnosed. Drug companies encourage the idea that people can diagnose and medicate medical conditions themselves.
Turn on the evening news and you’ll see ads for antidepressants, powerful migraine medicine, cholesterol-lowering compounds or drugs to relieve fatigue associated with chemotherapy. Most of these commercials urge patients to ask the doctor for drugs available only by prescription.
TV spots frequently emphasize the benefits of a medication while downplaying the risks. Even when major side effects such as liver failure or heart problems are mentioned, the visual images on the screen are distracting. The actors are often having fun while the voice-over lists dire consequences. Such tactics may lead people to overlook dangers and badger their doctors to prescribe the advertised product.
In theory, such decisions should be based on years of clinical experience. But many doctors feel coerced by the full court press prompted by the pharmaceutical industry. Sometimes it’s easier to call in a prescription than to explain why a new medicine is inappropriate.
If a doctor refuses to cooperate, some patients just go to the Internet and order their prescriptions online without any direct medical supervision. Web sites offer antidepressants including Paxil and Prozac, powerful prescription pain relievers like Vicodin and Fioricet, diet pills such as phentermine and Xenical, sleeping pills including Ambien and Sonata and of course the always popular Viagra.
Internet pharmacies that don’t require prior prescriptions frequently ask customers to fill out electronic forms. These are supposed to allow a virtual doctor to review the request and spot a medical condition that would make a medicine dangerous.
Of course, there is no way an online doctor can take a blood pressure reading, listen to the heart and lungs or check for kidney function. And someone desperate for Viagra or Vicodin might not tell the entire truth about his medical situation.
Bypassing the physician and pharmacist to buy drugs represents a huge risk. Side effects and interactions can be life threatening. If a serious problem occurred because of a mistake, it would be almost impossible to hold an online pharmacy in Sri Lanka responsible.
A patient who sees a TV ad for Imitrex to treat migraines may beg a doctor for a prescription. If later she decides she is depressed and buys Effexor from the Web, the combination could be deadly. A rapid buildup of serotonin could lead to uncontrollable muscle contractions, confusion and loss of consciousness.
Physicians study for years so they can diagnose and prescribe appropriately. Assuming you can do as well based on a TV ad or spam e-mail is like playing a dangerous game of Russian roulette.

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