Sunday, March 1, 2009

Difficult Patients

I was able to access the study from work, but now that I am home I cannot access it. It has been written about in newspapers, blogs, and magazines across the country. The main gist: doctors who see more "difficult" patients are also more burned out, more stressed, and tend to be younger-than-average female physicians. The article does not make any attempts to establish causality, though the relationship between seeing difficult patients and stress levels would seem directly proportional to common sense.

What I found more interesting were the most common attributes of patients that made them qualify as "difficult." Over 1/3 of the difficult patients were so categorized for insisting on an unnecessary medication. Another ~10% were difficult for having unrealistic expectations for their care, and ~10% were unsatisfied with the care they were receiving. I have complained before, but the US is only one of two countries (the other is either Australia or New Zealand) which advertises prescription-only drugs in the media. It is creating a culture in which people who know nothing about medications and physiology of the body to demand new, expensive name brand drugs despite their doctors' medical opinions. When a physician has a full waiting and exam rooms, he is pressed for time and often does not feel he has the time to explain why the advertised drug is not as good as the currently prescribed medication, or why the drug is not needed at all. It has gotten to the point that dangerous surgical procedures like gastric bypasses are being advertised on television!

I admit that if a patient has a physician who has not kept up-to-date with the ever growing field of medicine, then bringing new medications to his attention could do some good. However, over half of the "new" drugs released each year qualify as "Incrementally Modified Drugs", in which a different but equally potent version of the same chemical is being advertised as a new drug. Honestly, I think pharmaceuticals should not be advertised through any media PERIOD.

No comments:

Post a Comment