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Healthy Skepticism Library item: 11827

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

MacLean DS.
Drug Overuse: ‘Get Your Doctors to Fix This’
Caring for the Ages 2007 Oct; 8:(10):5


Abstract:

“The doctors in this facility use too many drugs. Our quality indicator 3.1 on nine-plus medications is in the 85th percentile. You’re the medical director-get your doctors to fix this.”

-Nursing home administrator

Dr. L.I. Nasher, who founded geriatrics and published the first textbook on the subject in 1914, probably did not face this kind of demand. There were few effective drugs available in his time to prescribe.

By 1973, however, the first multiauthor geriatrics text devoted a chapter to “Hazards of Drug Treatment in Old Age” (Brocklehurst T.J.C., ed., Textbook of Geriatric Medicine and Gerontology. Edinburgh: Churchill Livingston, 1973). Dr. William Davison, who wrote the chapter, cited the advances in drug therapy of the preceding 30 years, the rise of the pharmaceutical industry (which by then provided easily-administered tablets, not mixtures compounded by pharmacists), and the thalidomide disaster in 1961 as reasons to be concerned about overuse of drugs. Dr. Davison observed, “Drugs are not the answer to all our patients’ problems.”

Dr. Davison’s reasons for concern about drug use in the elderly have only grown in the subsequent 30 years!…

• Previous Approaches

• Why No Fewer Drugs?

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909