I was just looking at NPR’s health blog and I came across the interesting concept of doctors and pharmacists collaborating. I really like the idea of the two talking more, because it often seems like we’re having problems when they don’t talk. But the article raised some interesting points.
The first point was that patients are only following prescribed drug regimens half the time. Does that mean that half of the patient visits are basically a waste of time? I mean, if you go to your doctor and he prescribes something but you won’t take it or you can’t afford it, that basically means that your visit with him didn’t do anything for your health.
But in the same sentence they say that doctors only follow evidence based guidelines half the time. What are they doing the other half? And what is the overlap between your doctor prescribing you something without evidence and then you not fulfilling the prescription? It starts to seem like a foolish, expensive, and dangerous merry-go-round.
Preventable medical errors kill 1.5 million people a year? I’ve heard this argued about, but it seems both underestimating and overestimating. If a patient isn’t taking something as prescribed, whose fault is it? But if the patient is taking something as prescribed and they die, does anyone check and see if the medication was prescribed based on evidence, or just whatever was being handed out that day?
They also have an estimate on what it costs the health care system when people don’t take their medication: 290 billion dollars. Really? I just looked at the total cost of prescriptions for 2003: 179 billion. If half of those are being prescribed without evidence, then it looks like we could save 100 billion simply by requiring medications be prescribed based on the evidence. 100 billion here, 100 billion there, it could add up to real money.
But we have a huge issue with doctors and pharmacists in the same space. It sets up a cozy relationship that is ultimately not in a patient’s best interest. I’m for more communication, but not in the same living quarters. I see the best lab work being done by independent labs, not in hospital labs. I also see increased costs in hospital labs because they have a captive audience and have little need to keep their costs down.
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