When you last visited your doctor, were you given more types of medication than was necessary? Or worse, were you given drugs that could result in an adverse reaction?
Precautionary steps to adopt when consulting doctors
Consumers should beware of over-prescription. A simple ailment may just need one or more types of drugs but you may instead be given more. Not only are you made to pay extra for the extra drugs but you may be subject to their negative side-effects as well. Take the case of Stephanie, a 28 year-old school teacher.
Stephanie consulted a private medical practitioner in Boston for a fever and a sandy irritation in her eyes. She also felt tired and lethargic.
The doctor did not take her temperature; neither did he ask her if she was allergic to any drugs. Instead, he prescribed no less than four different kinds of medicine.
Two days later Stephanie was in hospital fighting for her life. The skin over her whole body was peeling off in great sheets leaving her flesh raw and exposed to infection. Her nails had turned black and were falling off. Her face was black and swollen, blood and pus oozing from it. Her eyes had crusted over. The reaction of the mucous membranes in the genital area was so severe; the doctors had to insert a catheter so that she could urinate. They expected her to die but she did not.
Stephanie was suffering from a severe drug reaction – she was allergic to the medicine the clinic doctor had prescribed. Doctors call it the Stevens-Johnson syndrome or toxic epidermal necrolysis which can be fatal.
“I can’t remember much about the first few weeks,” Stephanie recollects. “All I remember is screaming and screaming in pain every time the nurses came to change my dressings.”
Stephanie spent 56 days in the hospital but her ordeal was far from over. She had developed gynecological problems. She had a growth in her throat which had to be removed by surgery. The tear glands in her eyes are permanently damaged, resulting in her eyes always being dry and irritated. Her left eye is partially closed and her vision is blurred.
What went wrong, Blunderbuss General Practitioners?
Stephanie is a victim of the blunderbuss syndrome – a very common disease amongst some doctors. Doctors who have it show little interest in diagnosis – in finding out what is wrong with the patient, through examination, testing, questions and looking at the patient’s history. This takes time, effort and skill.
Instead, they have become drug pushers. They prescribe a whole range of broad-spectrum drugs designed to zap anything the patient might have. It is quick; it is easy; and, since the doctors are also selling the drugs, it is very profitable.
But the blunderbuss method is dangerous to the patient. Drugs are potent and can have many side effects. One in every thousand users is allergic to sulfonamides; five in every hundred react to penicillin and its derivatives, and so on.
Furthermore, doctors who hit every minor cough and cold or every viral fever with broad spectrum antibiotics have helped to create superbugs – bacteria resistant to antibiotics, causing infections which are difficult to cure.
Look what happened to Stephanie. She told the doctor she had fever. The doctor made no effort to find out what, if anything was wrong with her. He did not even take her temperature.
But he zapped her with a course of Bactrim – a fairly potent sulfonamide (sulfamethoxazole). This drug is usually used for urinary and genital infections, although it is also recommended for respiratory, stomach and skin infections. This drug should not be given to pregnant or breastfeeding women, patients with allergies, asthma or liver or urinary problems.
But the doctor asked Stephanie no questions before prescribing it. In addition, he gave her a second course of drugs, whose contents are still a mystery. For her eye irritation (there was no redness), he gave her eye-drops and ointment containing Chloromycetin and tetracycline, both potent antibiotics.
According to the Merck Manual, a medical dictionary, in cases of Stevens-Johnson syndrome, “identification of the causative agent is essential. A detailed history is required with persistent enquiry into all medications.”
But when the health authorities queried the clinic to find out what medicines Stephanie had been given, they did not get a satisfactory reply. It seems the clinic was more concerned with covering themselves from blame, than with saving Stephanie’s life.
One of the health officers thought that Stephanie had been given penicillin – a drug which causes so many allergic reactions that no doctor is allowed to prescribed it without first doing a “patch test” and waiting with the patient under observation until he is sure there is no reaction.
Whatever the second drug was, Stephanie now wears a medi-alert bracelet which warns that she is allergic to sulfonamides (Bactrim), penicillin, and Chloromycetin.
How Stephanie or any other patient with a mild fever should, be treated? Rest; drink plenty of fluids and a mild painkiller, like paracetamol, was the advice of several senior doctors.
“If there are no signs of infection, except for the fever itself, then it should be treated symptomatically – with something like paracetamol. And the patient should be told to come back in 24 hours if the fever persists – by which time other symptoms would probably have appeared to indicate what is wrong,” said one doctor.
The Quick-fix Doctor Hopper
But how many doctors will explain and tell the patient to come back? And many patients will go back to the same doctor, unless they get immediate results? Many patients suffer from the doctor-hopping syndrome. They want a quick fix. If they do not get an immediate cure, they hop from one doctor to another – and in some cases, may event consult an alternative non-medical healer in between – until their symptoms disappear. They feel they are not getting their money’s worth if they do get a whole bunch of different colored pills at each visit to the clinic.
The doctor-hopping syndrome and the blunderbuss syndrome support each other. The G.P. who hits out with a sledgehammer where a tuning fork would do is likely to be popular with this kind of patient. His clinic will be full (so will his bank account). And even if he loses a few patients to fatal drug reactions, it is unlikely that he will be called to account for it.
The more ethical doctor next door, who takes time over a diagnosis, asks questions and dares to give advice (“cut the beer and cigarettes, and get some exercise”) instead of a handful of drugs, will take a much longer time to build his practice.