There's A Pill For That

By Author: Matthew Brackman
Total Articles: 1
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When I was a resident in Boston back in the 90's, I was often aghast at the willingness of doctors to pull out a prescription pad and write a prescription like a horse flicks a fly with its tail. It was too much of a bother to think about the symptoms, or maybe they felt the problem was simple enough to solve with a pill, or maybe they just saw everyone else doing it. Nurses are often guilty of this too, wheedling or bullying doctors into prescribing something for in house patients to keep them quiet.

I still boil at memories from the Jamaica Plain VA hospital. When I was an intern, the head nurse instructed me to prescribe a paralytic medication to a young girl in the ICU with a head injury. She told me "everyone in her unit is on a paralytic". I tried to explain that this was old thinking, rife with complications, and there was a better way. It quickly escalated into a battle of wills, her refusing to heed a brash new doctor and me refusing to cut corners on diagnosis and treatment.

Now fast forward twenty years and the problem has only worsened. If there isn't an app or a pill that can keep our needs ...
... met with a swipe right then our impatience quickly turns to anxiety and then to anger. Sometimes authority, or those who wish to prove their ability to be authoritative, will label a child with ADHD and recommend Ritalin. There are teachers who do this without even the most minor effort at truly evaluating the accuracy of the diagnosis or the alternative forms of treatment. An OBGYN prescribed a young woman with fertility pills without even evaluating whether there was a problem with her partner and not her ovaries. Patients are guilty, teachers are guilty, insurers are guilty, we are all guilty.

Now we have a big, big problem. Our willingness to prescribe, and over-prescribe has led to a nightmarish situation in our communities. One which has no easy solution. We have given out too many narcotic pills to treat pain that either didn't exist, was over exaggerated, or was better treated in an alternative manner. Recipients of these prescriptions often "divert" the pills; handing them off to friends and family to cure their pain, or even selling them for profit. When we take them away, those now hooked turn to heroin. If we put as little effort into a solution for this dilemma as we put into the requests for pills in the first place, we are doomed. This problem will not go away with a flick of our tail, or a right swipe.