LET’S TALK with Dr Faraaz

By DR FARAAZ

Welcome to my article series! I am a doctor in Emergency Medicine and I hope to start an interesting discussion on issues that affect every community and ones that are hopefully interesting for you. In my upcoming articles for the Asian Sunday I will be exploring ideas, some with no particular answers, and others with plenty – and my aim is to get the conversation going. So let’s talk!

I would encourage readers to take what I say as just my opinion and not out of context. The articles aren’t intended to take the place of medical advice and if you do have any medical concerns then seek advice from your doctor.

dr faraaz bhattiToday I want to touch on whether or not as a population we live in a pro-medication culture. What do you think, do we? I am not going to use any fancy statistics except for a story or two from my own experience. Treatments are very important for our wellbeing and man (or woman) has been using them in some form or another for thousands of years. Once upon a time leaches were used to suck away illness when applied to the skin – whether or not that worked is not my point, my point rather is that they were not used for every cough or cold a person had. Surely, if they were used that irresponsibly it would render any person anaemic! It is a silly thought, but in today’s world this can be likened to antibiotic use for a common cold. It simply doesn’t work and only creates resistance!

Over the years we have shown how we strive as a species to live longer, healthier and sometimes we do whatever it takes to be the best we can be. This may be in sports, education, our work, in health and so on. Let’s focus on health for a minute. We are always trying to be better and in doing so, we as a human race create new medicines and treatments. But buying a new medicine, or demanding its prescription isn’t like upgrading from your old Corsa to a brand new Mercedes is it?

Let’s put this into context: we have an ageing population, right? Well that means a greater percentage of older people – so if we live longer our health needs become greater as we have more time to ‘collect’ illnesses (putting it simply). In order to keep up, medicine is advancing at rapid speed. But are medicines always good? And how many are too many?

As a doctor I would say that medicines should be used as prescribed by a medical professional and taken appropriately. For example, if an asthmatic were to take steroids every single day, inappropriately and not as directed, would you expect there to be a potential for some quite serious side effects? That is not to say steroids are bad, not at all – if used in the right circumstances. But remember, one person’s medicine is another’s poison – and that is why medication reviews with your General Practitioner is so vitally important.

There is a school of thought that every visit to the doctor should mean you leave with that green piece of paper that gives you access to a medicine that no-one can pronounce.

There is a school of thought that every visit to the doctor should mean you leave with that green piece of paper that gives you access to a medicine that no-one can pronounce. What it does? What its side-effects are? … Well that doesn’t matter at that precise moment in time. After all, what use is the package insert? The feeling of success that some may feel has been achieved by having their doctor scribble their signature on the line for a medicine is more than enough to start the process of feeling better. My grandmother won’t mind me saying this but she has always visited the doctor expecting not only reassurance, but also a prescription. This was engrained in her from childhood, a time when good doctors prescribed and bad doctors, well didn’t! So whether its asthma, or a cold, the doctor should prescribe tablets regardless. Is there a placebo effect to this? And is there a psychological component? Are we happier with prescribed advice and reassurance or if we leave our doctor’s surgery with a prescription? These are all rhetorical questions of course and I don’t know the answers!

Doctors are humans and we are influenced by a whole variety of factors – including clinical need and a patient’s wishes. If you were to take new medicines every time you visited the doctor, or even if I visited mine for that matter – we’d be eating tablets with milk in a breakfast bowl every morning. Not only are inappropriately- prescribed medicines bad, they may interact with others that you are on. Every medicine has potential for side- effects, even paracetamol!

So the bottom-line surely should be that if you think you are taking too many medicines, then you may well be. Always discuss what you are taking with your doctor and don’t cut them out (or add them in for that matter) on your own!

Sometimes we have to take multiple medicines as a fact of life, but sometimes we take them because they were prescribed to us ten years ago, or because it worked for the next door neighbour’s great aunt’s second cousin. Despite the tongue-in-cheek humour in this article, this is a serious topic and we must take responsibility for our own medicines.

You can follow my Twitter feed on @Faraaz_Bhatti and let’s talk about important health issues. If you would like me to talk about any specific issues, then feel free to let me know. However, for any medical concerns or queries talk to your doctor.

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