Friday, March 23, 2007

Why Do Some Drugs Require Doctor Prescriptions?

Ostensible Answer: To keep uninformed patients from harming themselves with complex, and potentially dangerous, medications.

Cynical Answer: Because the AMA pressures the FDA to force patients to pay a new doctor bill whenever they need a drug.

Although physicians have a financial interest in lobbying for legislation as described in the the "cynical answer", we'll set that issue aside and instead focus on the "ostensible answer".

There are three types of patients who need drugs:

1) Knowledgeable people who know which drugs they need, or have the ability to find out by way of free readily-available references on the Internet.

2) People who have no idea of what drug they need, and want to pay a doctor for his specialized knowledge.

3) People who don't know what they are doing, and take the wrong drug and/or dosage, and harm themselves.

Prescription drugs impose a big cost on Group #1 (forcing them to pay unnecessary medical bills, and delaying their drug therapy if they, say, develop a sudden and painful toothache on Saturday evening), a small cost on Group #2 (prescription drugs increase the demand for a fixed supply of physicians, resulting in higher costs and/or longer waits), and, assuming they follow the law, benefit Group #3.

So, here are some secondary questions:

- Why should people in Group #1 and Group #2 being harmed for the benefit of Group #3?

- Should, say, all home repairs be illegal except when done by licensed home contractors? Competent do-it-yourself types (Group #1) would have to pay a lot for contractors, but inept know-it-alls (Group #3) would be protected from their own renovation mistakes.

- Should all cooking be illegal except when being prepared by licensed cooks? Capable do-it-yourself cooks would no longer be able to enjoy their own efforts -- but then, those who don't understand the basics of food handling (Group #3) would suffer fewer incidents of food poisoning.

- Why are any drugs over-the counter? How can people be trusted to self-medicate with anti-inflammatories, decongestants, and antihistamines?

- For that matter, how is it that people can be trusted with over-the-counter nicotine and alcohol, but not with acne creams and codeine?

- Oh, wait. People can be trusted with codeine in the UK and Canada.

- How is it that the punishment for using drugs without a prescription (fine or jail, presumably) is preferable to simply releasing these "criminals" with perhaps a comment like, "Glad to hear that your tooth feels better."

No comments: