- Review claims one-tenth of drugs prescribed by GPs are unnecessary
- Doctor Max Pemberton referred a patient to talking therapy instead of medication
- NHS psychiatrist reveals visiting zoo helped after trauma
There is a pill for every disease. At least that’s what doctors like to believe. It comes from a good place – people see us with a problem and we want to help. That’s why we prescribe medicine, because that’s what doctors do, isn’t it?
But it’s not always the best way. Putting drugs left, right and center is not only expensive, it is potentially counter-productive as they all come with side-effects.
What’s more, there is growing evidence that many of the medications doctors prescribe are not actually necessary.
A government-ordered review published last week showed that a tenth of the drugs prescribed by GPs are unnecessary and that patients should be offered alternatives such as exercise, talking therapy and social activities.
The study found that patients are regularly being harmed by a ‘culture’ of oversubscribing, with a fifth of hospital admissions among pensioners due to drug adverse effects.
A review published last week showed that a tenth of the drugs prescribed by GPs are unnecessary and patients should be offered alternatives (file image)
It seems that sometimes reaching for a prescription pad can cause more problems than it solves.
I have seen this a lot while working with great people. I remember working as a junior doctor in geriatrics. In my very first ward round, I was surprised to see that the counselor at almost every patient’s bed took out his pen and, in a flourish, passed out the medicine they had been taking before admission.
Standing there I thought he must be crazy. Surely the doctors prescribed the drugs, didn’t stop them? But I learned that many of the pills we take cause just as many problems as they solve and can lead to a vicious cycle of over-intervention from doctors.
I remember we saw an elderly woman who was transferred to our team after a hip operation. About a year ago she went to her doctor because she was having trouble sleeping. She was in her 80s, was in good health and had never taken regular medication. She had no idea how it would all change in the next 12 months after that one appointment.
The GP prescribed a sedative to help her sleep, which she took. Side-effects include urinary incontinence, blurred vision, dry mouth, constipation and, as you would expect, sedation. Therefore, she returned to her doctor complaining of these symptoms several times over the next few months. She was prescribed two types of laxative, a medicine to help her urinary problems, and drops for her eyes.
One morning, when she fainted from the initial sleeping pill, she collapsed and fractured her hip. After fixing it, the surgeons gave him medicine to strengthen the bones, which caused a burning sensation, for which he was given medicines.
With a simple complaint, she ended up on seven drugs.
Dr. Max Pemberton (pictured) said he was able to help a patient get his laughter back after he suggested giving the zoo a year off rather than prescribing medication.
The counselor stopped all his medications and suggested that, instead, the next time he couldn’t sleep, he tried listening to World Service – it would be much safer.
I like the idea that there are solutions to medical problems that are not based on prescribed pills. I often wanted to give advice on haircuts. If you want to help people, there’s nothing worse you can do than be a hairdresser.
Of course, going to the hairdresser has a ritual that can be therapeutic in itself. Grooming plays an important role in the lives of most sociable primates, and humans are no exception.
Sitting at the hairdresser and talking about my life is a lot like sitting in front of me in an outpatient clinic and talking.
As the lockdown ended, I saw a woman who had gone through a series of traumas – her husband had died, she had to go home, her car was stolen and insurance refused to pay , and his son had gone home. another country. She was completely broken. I could have prescribed medicine but that wouldn’t have really changed the situation, would it?
‘I just want to laugh again, Doctor,’ she said touchingly.
Instead of giving her medicine, I referred her to talking therapy but suggested that, while she waited, she try something different.
We made a list of all the things he remembered that made him laugh. We tried to connect it to things from the past, so that she could feel closer to her husband again—like re-watching sitcoms she enjoyed with him, to new things that would kick her out of the house.
‘Penguins,’ she eventually said, ‘they always make me laugh – I love them.’ So I determined the penguins – well, I suggested she get a year pass to the zoo.
Now, every week without fail, she goes to the zoo to see the penguins. What happened to him hasn’t changed. It’s still been incredibly difficult.
But, thanks to the penguin, she’s laughing again.
keep silence in front of a harsh curse
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