Most doctors don’t like prescribing pills

I am a medical doctor.  I am also called an allopath, someone who practices “Western medicine.”

We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials.  We want to know the “mechanism of action.”  We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them.  We feel more confident about our treatment plan that way, and let’s be honest, we’re less likely to lose a lawsuit if something goes awry.

Here’s something you might not know.  Most of us don’t like prescribing pills.  If there is a safe, natural, noninvasive solution to your problem, we’d prefer to use that.  Shocked?  Consider this:  the more pills you take, the more potential adverse reactions are possible, the more responsible we are for a bad outcome.

It surprised me recently when a well educated accountant accused me of being a pill pusher.  He said, “We all know you doctors get a kick back from the drug companies for every prescription you write.”  What? Not only is that extremely immoral, it’s illegal.

Actually, the more medications we prescribe, the more money we lose.  Think about the time involved in deliberating  the risks vs benefits of prescribing a medication for someone.  Then consider the time involved in evaluating possible drug interactions with your other medications.  Then consider the liability we assume for the possibility that you might have an unforeseen reaction to the medication which results in injury or death.  And don’t forget the time and hassle of writing and faxing and calling them into your pharmacy and then haggling with your insurance company.  Prescribing medication is not a money maker.

Occasionally prescribing medication is gratifying, when you see a severe infection resolve or watch someone’s pain improve.  I am sure the oncologist feels great when a patient’s chemotherapy cures his cancer, or it is gratifying to the rheumatologist when her patient’s rheumatoid arthritis improves.  Medications are absolutely crucial to treating and occasionally curing disease.

In my opinion, most medications prescribed in the primary care setting just allow people to avoid taking responsibility for their own well-being.   Those cholesterol, blood pressure, and blood sugar pills can prolong your life, but they won’t make you happy or well.

I don’t have any randomized, double-blind, placebo-controlled trials to back me up, but I am willing to go out on a limb here.  I believe that most people don’t need more pills.

What they really need is permission to live long, healthy, happy lives.  Sounds silly, right?  Yet I’ve seen it over and over.  My clients and patients repeatedly sabotage their best efforts to adopt healthy lifestyles because they just don’t believe they can or deserve to be happy and well.  They’re waiting for someone to give them permission, for someone to say, “Yes!  You absolutely deserve it!”  So until you can give that permission to yourself, I am writing you a prescription:  a healthy dose of joy, wellness, inner peace, and satisfaction to be taken as many times a day as needed.  Number of refills:  infinite.

Melanie Lane is a family physician who blogs at The Doctor Weighs In.

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