Hear No Evil, See No Evil, Speak No Evil

Americans love to plug and play. We don’t want to waste a second reading manuals. We just want to plug in the new computer, turn it on and start surfing the Web.
That may be an OK strategy for computers or a new flat-screen television or even a microwave. The worst that can happen is that the device won’t work as expected, at least not until we break down and actually read the instruction booklet.
When it comes to pills, Americans are also popping and swallowing without a moment’s hesitation. The results can be disastrous.
At last count, 150 million of us take at least one prescription medicine each day. Older people and those with health problems frequently swallow a handful of pills daily without a moment’s thought. Many of the drugs are crucial for good health, but if patients do not know what side effects and interactions to be alert for this casual approach can be a prescription for disaster.
Sadly, too many doctors are enabling this plug and play pill mentality. An article in the Archives of Internal Medicine (Sept. 25, 2006) suggests that way too many physicians are cavalier in how they prescribe new medicine. Researchers at UCLA and UC-Davis performed a clever experiment. The “Physician Patient Communication Project��? involved patients who visited family physicians, internists and cardiologists in Sacremento, CA. Physicians were surveyed, patients were surveyed and audiotapes of the visits were analyzed.
The results of the study were shocking. Not only did doctors frequently fail to tell patients basic information about dosing or duration of use, they only mentioned potential side effects about a third of the time.
I knew there was a problem with patient-phsyician communication about pharmaceuticals, but I never imagined it was this bad. How can a physician send a patient out the door without some inkling of potential side effects? Every medicine has the ability to cause some adverse events for some patients. It is inconceivable to me that two-thirds of the new drugs prescribed in this study were accompanied by NO WARNINGS from the MD. It’s hardly any wonder that patients are popping their pills without a moment’s hesitation.
Perhaps these physicians hope that if they speak no evil, nothing bad will happen. That is magical thinking. It flies in the face of everything we have learned over the last 30 years. The Agency for Healthcare Research and Quality encourages patients to ask lots of questions about prescription medicines.
Until doctors start supplying answers, wise patients had better find other ways to learn about side effects and interactions.