Wednesday, March 29, 2006

Pill Nazi

One of the funniest characters in the Seinfeld sitcom was the Soup Nazi. Anyone who has seen the show can visualize his cold stare while uttering the words “No soup for you!”.

Now we have the Pill Nazi.

The patient had high cholesterol and, according to medical guidelines, should have been taking a drug to lower it.

But her doctor didn't write a prescription. The drug was unlikely to help someone who was 100 years old and had advanced cancer. It wasn't worth the cost, side effects and hassle of taking yet another pill.

Seems the economics of medical care is invading geriatrics. What else lies ahead?

Researchers offer several case examples.

One case involves a 75-year-old woman with high blood pressure, high cholesterol, arthritis and diabetes. With a remaining life expectancy of 17 years, it makes sense to keep taking drugs to treat those conditions, researchers wrote.

But in the case of a 72-year-old man with congestive heart failure, emphysema and a six-month life expectancy, the doctor should stop prescribing drugs intended to provide long-term benefits.

Paging Dr. Kervorkian.

Elderly Americans who live independently typically take three or four prescription drugs a day. Nursing home residents typically take seven or eight prescriptions.
Studies have found that patients who take at least five prescriptions have a 90 percent chance of suffering side effects or complications from drug interactions. About one out of five elderly patients takes a drug that has a high risk and low benefit, Holmes said.

I do agree that we, as a general population are entirely too dependent on meds. But where does it stop?

Patients are bombarded with drug ads, and have been told for years about the importance of taking their medicine. So doctors might be reluctant to discontinue their prescriptions.
Nevertheless, 65 percent of all office visits end with the doctor writing a prescription. "It makes us feel good to hand something to a patient," Holmes said.

Is it any wonder why Rx claims represent almost 20% of premiums?
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