On drugs, the internet, and lazy doctors

[Argus]

So about four years ago I started getting these throbbing pains in my thigh and lower back. Like every good citizen, I went to my doctor. Now, now all doctors are created equal, and mine is no great prize. In four years, he's never ventured the slightest guess as to the cause. I've had various blood tests, X-rays, Cat scans, etc. etc. None ever showed him anything, nor did that ever seem to bother him much.

Didn't bother me unduly either, since with one pill a day, I didn't have to worry about pain. I've been taking Celebrex, you see, which is a pretty widely prescribed drug, even though it's supposed to only be for arthritis and short term pain. Every now and then I'd ask him about what it was and he'd order more tests, and nothing ever happened except inconvenience, and then continuing to take my pills.

They weren't cheap. Well, they were cheap to me, given OHIP had a negotiated rate below what most would pay in the states, and that my union benefits paid 80%, and I have a high income. But someone was paying most of the freight, one way or another.

So a short while back I started worrying about taking this damn pill, for maybe the next thirty or forty years. What was that going to do to my system? There are a lot of potential side effects which include strokes and heart attacks the longer you're on it. So I went to my doctor and he prescribed some other pill he said was safer, and newer. Yay.

And then I started looking things up on the internet. I started typing in symptoms, and reading all kinds of diagnoses and descriptions of various ailments, most of which were fairly easy to dismiss as not being mine. And then I found one that kind of sounded right, though I didn't have all the symptoms. I found some videos of physiotherapists, and even a doctor, demonstrating a variety of stretching exercises, and I started doing these seriously.

Well, the doctor gave me a sample of the new pills, along with a prescription if I found they worked and weren't too hard on my stomach. The upshot was that I never took any of them, and have found, after about three weeks of not taking any pills, that I don't actually need them. I'll take an occasional ibuprofine, but that's it.

And this got me to thinking about the fact that we, as a society, have a lot of lazy doctors who prescribe drugs to relieve symptoms rather than trying to figure out the underlying causes, and a lot of people who are perfectly content with that. The cost must be almost unimaginable, of all those expensive pills that people shouldn't be taking. And then there are all the side effects millions of people suffer from.

I can't help thinking this is all due to the fact that doctors make more money the faster they push people through their office, and that if they want to be millionaires, they can't stop and take a lot of time to really try to work on them and figure out what they really need. Pills are way faster, and you can turn to the next customer, er, patient. It seems to me this is all grossly wasteful, and there needs to be a way around it. I'm just not sure what the route is, because human nature and the economics of medicine aren't likely to change. Maybe if we flood the market with doctors they'll have to work harder to keep their patients, and demonstrate more interest in finding out what's wrong with them then getting them out the door.

[cybercoma]

I don't think it's entirely fair to blame the doctors. If you want to invoke "we as a society," then it's only fair to look at what we as a society expect from doctors. When people go to the doctor, they expect to get something. This is why you almost always walk out with a prescription whether you need it or not. It gives the patient the feeling that the doctor has given you something. We as a society expect this. Doctors who buck this trend tend to upset their patients who feel as though they're not doing enough. Even if your pain could be treated effectively without medication, most people in your situation expect and would even demand that their doctor prescribe them something. So kudos to you for not being one of those people. I wish the medical establishment would buck the trend of writing patients prescriptions as an act of giving them something or giving them what they expect. Doctors generally need to be better at bucking this trend of medicating when it's unnecessary.

By the bye, Celebrex is awful for your system. It's good that you're off it. You should never use it for extended periods of time.

[Argus]

I don't think it's entirely fair to blame the doctors. If you want to invoke "we as a society," then it's only fair to look at what we as a society expect from doctors. When people go to the doctor, they expect to get something. This is why you almost always walk out with a prescription whether you need it or not. It gives the patient the feeling that the doctor has given you something. We as a society expect this. Doctors who buck this trend tend to upset their patients who feel as though they're not doing enough. Even if your pain could be treated effectively without medication, most people in your situation expect and would even demand that their doctor prescribe them something. So kudos to you for not being one of those people. I wish the medical establishment would buck the trend of writing patients prescriptions as an act of giving them something or giving them what they expect. Doctors generally need to be better at bucking this trend of medicating when it's unnecessary.

By the bye, Celebrex is awful for your system. It's good that you're off it. You should never use it for extended periods of time.

I agree that when people are in pain they expect their doctor to do something about it. I'm not against doctors prescribing pain medication. I'm all for it, in fact. Pain is a terrible, debilitating thing. What I don't like is them leaving it at that without making every effort to determine the source of the pain, and find a way to deal with it that doesn't involve extended time on drugs.

[cybercoma]

Don't get me wrong. I'm not against doctors prescribing medication either, but they're overprescribing these days. Even research in medical journals suggest as much. Most of them attribute at least part of the reason to patient expectations. They expect to get something literally from their doctor. The prescription serves as these transactional item. Of course, the pharmaceutical companies play another large part in this situation.

You're right about some doctors being lazy though. How often do we hear about people turned away from emergency rooms with the doctor telling someone to take an Advil or Tylenol, only to have the patient return with much more severe problems.

[Bonam]

Don't get me wrong. I'm not against doctors prescribing medication either, but they're overprescribing these days. Even research in medical journals suggest as much. Most of them attribute at least part of the reason to patient expectations. They expect to get something literally from their doctor.

Doctors should be there to serve the health of their patients and the health of the public, not to fill uneducated patient's expectations. If this is really a reason, then the doctor profession needs to take a long hard look at itself and figure out what its goals and principles are. If necessary, compensation incentives for doctors can and should be re-aligned so that doing the best possible job for their patients gets them the greatest reward. And that means the patient's long term health, not filling some "expectations".

What I don't like is them leaving it at that without making every effort to determine the source of the pain, and find a way to deal with it that doesn't involve extended time on drugs.

As you said before, not all doctors are equal. When a doctor fails to put forth every effort to get to the bottom of a problem that a patient is having and instead just prescribes drugs, it is up to the patient to seek the opinion and help of other doctors, as well as doing their own research so that they can ask doctors intelligent questions and get useful information. Doctors that are annoyed, reluctant, or impatient to answer a patient's questions are trash and the patient should promptly find a new one.

Edited January 20, 2014 by Bonam

[Topaz]

There are many reasons why doctors today hand out meds, one is they get paid by the drug companies to push their drugs, although, in Ontario and maybe now across Canada, they government is cracking down on that and not allowing doctors to do so. Another reason is doctors, maybe some, can't find the cause so they give out pain killers. I listening to a doctor in the US and she started out as a medical doctor and went back to school to earn her degree in Natural Medicine, and that helps her treat her patients because she knows how to find the cause and treat it naturally and IF she can't she has excess to man-made medication. There are many people who just can't take the man-made meds because of the side-effects and natural doctors are their only hope and that's why I think that natural doctors and medical doctors should work together and it would help bring down the cost of health care.

[Argus]

As you said before, not all doctors are equal. When a doctor fails to put forth every effort to get to the bottom of a problem that a patient is having and instead just prescribes drugs, it is up to the patient to seek the opinion and help of other doctors, as well as doing their own research so that they can ask doctors intelligent questions and get useful information.

Certainly true, Bonam, but difficult given the current shortage of doctors a shortage caused, in no small measure, by doctors wanting to restrict how many people are in the profession, and what other professions can do in terms of medical help.

[jacee]

By the bye, Celebrex is awful for your system. It's good that you're off it. You should never use it for extended periods of time.

Yup.

Ulcers.

And what I really needed was a better desk setup.

.

[GostHacked]

I agree that when people are in pain they expect their doctor to do something about it. I'm not against doctors prescribing pain medication. I'm all for it, in fact. Pain is a terrible, debilitating thing. What I don't like is them leaving it at that without making every effort to determine the source of the pain, and find a way to deal with it that doesn't involve extended time on drugs.

I had a very unfortunate incident with a doctor at a clinic one time. Years later STILL looking for a family doctor for myself.

Anyways, I had some serious pain in my nuts. Felt like that ache after you been kicked in the nuts. Constantly. So as my pants are around my ankles and this 'doctor' originally from Vietnam had my balls in his hand, he started asking questions. After asking him to clarify 'How long have sex, you know f*ck, f*cking'. I said it's been a while, he replied 'it's just build up', but that gets taken care of. The next couple days it got worse and I went to ER. Waited some time, but the doctor sent me up to get a ultrasound scan on my boys. Turns out it was something called 'hidrocele' With some anti inflammatory medication it cleared up in days. If not taken care of, you could damage or even lose them.

I don't trust walk in clinics anymore.