ppp 09-15-08

Quote of the day: One of the first duties of the physician is to educate the masses not to take medicine. Sir William Osler (1849 - 1919), Aphorisms from his Bedside Teachings (1961) p. 105

Cable TV has a show called "What not to wear". The format has 2 hosts who secretly film "the subject" in numerous situation in their normal attire. Friends and family are often part of the intervention in which the target is shown the clips and just how awful they look. The hosts go through closets and trash (donate) the offending garments and then take the victim on a shopping spree. When all is said and done the subject is now fashionable again and all of the stars are in alignment for a happy life.

I propose a new reality TV show called "What not to take!" with a pharmacist as host. (Yes I am available). The "subject" would be just about any patient taking 6 or more prescription drugs and at least 2 physicans. (It is a 30 minute format). Between contraindications, warnings, side effects, and drug interactions with other drugs/food or lab tests the pharmacist just might be able to offer some tips, tricks, and suggestions on how therapy could be improved. This would have to meet the approval of a physician co-host who has the power to ACTUALLY change the therapy. Of course OTC meds and herbals would play a part in the drams with the patients happier and healthier as they drive their golf carts into the sunset.

"Judge Judy" only has to deal with legal questions and is immensely popular and well paid. She, however, does not face 2 great obsicals. I'm sure that HIPPA and the FDA would want to have their own say in the programming and that might just kill any chance at syndication of "What not to take".

Maybe you should treat every patient as if they were on your own, personal "What not to take" episode. There are plenty of physicians who are driving the "what to take" part but who may not know about the drugs prescribed by the patient's other specialists. You may not gain fame and fortune but would be providing a great service.

ps. Best answer this week to the question "How are you?" was "Super wonderful"

Pay for performance (aka P4P) seems to driving physicians to “over treat” patients with prescription drugs… especially antibiotics. The intent of P4P programs is to encourage better patient care but seems to be linked to other problems. Pressure now exists to treat before the diagnosis can be confirmed.

The list of drugs compiled by FDA experts was to be used to give all a “heads up” on concerns that the FDA will investigate. Patients (and lawyers) will likely go crazy over this stuff. Some patients who are looking for any reason to stop taking a drug will glom onto this and quit with potentially serious consequences. If you (as a patient) are starting or intend to stop taking any prescription drug PLEASE be sure that you discuss it with your physician. (You helth professionals should be telling your patients the same thing)

Not the regular programming but the advertisements for drugs between the major plot threads. This site will direct consumers to what can and cannot be said about prescription drugs. They don’t tell us how to deals with the overwhelming onslaught of ED commercials. At least wee will have the diversion of irritating political ads for the next 2 months.

After a brief hiatus, Chantix ads will return to the airwaves soon. Ads were pulled after concerns over potential psychiatric side effects surfaced. The company will ease back into marking now that the initial brouhaha has passed. Side effects take up about half of the 90 second spots. Enjoy!

New York pharmacists now authorized to administer influenza vaccinations (when properly trained.) This is all about access to preventative healthcare and not about turf. (Yes, New York state was the last holdout).

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