Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: Prescribing Missteps: Sharing the Blame

U.S. physicians are in the midst of a prescription drug tsunami.  New drugs are coming to market faster than physicians’ ability to assimilate everything they need to know about them: when to prescribe, when not to prescribe, safe dosages under different circumstances, potential side effects and adverse interactions with other prescription and over-the-counter medications.

On average, 12 drugs are prescribed for every American each year, compared to seven per person in the 1970s.  “More than 1.5 million people are hospitalized and more than 100,000 die each year from largely preventable adverse reactions to drugs that should not have been prescribed as they were in the first place” (  Avoiding the missteps of improper prescribing begins with an awareness and sensitivity to the underlying causes.

First and foremost, physicians rely too heavily on drug company data and the FDA.  According to Consumer Reports, “More than half of all prescription drugs cause adverse effects that aren’t detected until AFTER the FDA approves them” (July 2015).  The side effects are often serious and sometimes life-threatening.  “Unfortunately, the system for detecting risks after approval has been the weakest link in the drug-safety system.”

Direct marketing of new drugs to consumers is another factor.  Making matters worse, drug companies routinely exaggerate a new drug’s benefits while minimizing or glossing over its side-effects.  Implanted with the notion that a new drug is nothing short of a miracle, patients are encouraged to ask their doctor if it’s “right” for them.  Bending to pressure from from their patients and armed with “free” samples, doctors are all too willing to “give it a try.”

Under the guise of continuing medical education, physicians are targeted through various venues such as the monthly medical society meeting where medical experts from drug company speakers bureaus give well-scripted presentations about the benefits of their new drugs.  Side effects and adverse interactions with other drugs are rarely mentioned or, at best, minimized.

Of course, it can be argued that there are legitimate reasons for the increase in prescription drug use.  The average American is older, heavier, and is more likely to have high blood pressure, high cholesterol, osteoporosis, osteoarthritis, and other acute and chronic ailments controlled or relieved to some extent by prescription drugs.  Physicians need to avoid the trap of assuming a new drug is always better than an older, better-understood drug.

Following a few simple guidelines can help avoid some prescribing missteps: (1) Don’t start treating a problem with more than one drug at a time, (2) Don’t automatically give in to the patient’s request for the new drug they saw on TV, and (3) Don’t be brainwashed into thinking that all FDA-approved drugs are both safe and effective.