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Hear No Evil, See No Evil, Speak No Evil

Joe and Terry's Blog October 8, 2006

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.

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Comments

My daughter experienced this problem, with severe consequences. She was prescribed Reglan to enhance lactation; suggested by the lactation consultant at the pediatrician's office; she called her OB/GYN's office and the nurse said it was so fine to take; no side effects; the MD called the Rx in. Result: after 12 weeks, depression; then severe reaction after stopping the drug on her own. Still on medications for extrapyramidal symptoms.

I cannot believe how many folks are on medication these days. Everywhere I go the talk is all about what eveyone is taking. I am fortunate to be blessed with good health, and the strongest thing I take is a tylenol when I get a cold. I think the mentality on our nation is that a pill can fix anything and everyone uses something as a crutch.

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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.

© 2006