The Right Thing To Do

While discussing the novel we’ve been reading for class, Susannah Cahalan’s Brain on Fire, we addressed the roles of the doctors in her, Susannah’s, story.  More specifically the roles they had in “diagnosing” and “treating” her as her symptoms became worse.  Among the things discussed something that arose was a point regarding medications and their distribution to patients irresponsibly by physicians.  In Susannah’s case, by the psychiatrist that diagnoses her with bipolar disorder, which Susannah tells her as her self diagnosis, and prescribes Zyprexa, an anti-psychotic, after only seeing her once for what seems to be a short visit of about an hour.  What this brought to mind was the problem of doctors prescribing medications not so much for the necessity of the patient, but for the monetary perks awarded by pharmaceutical companies to the doctors who prescribe their product.  Not to say that the psychiatrist was in fact on the take so to speak, the author never really tells us at this point, but in checking my facts, the psychiatrist, according to Susannah’s account, seemed to have failed to follow the book on diagnosing her.

In doing a little research I came across a page written by the NIH on bipolar disorder and it’s diagnosis.  Along with the symptoms that are characteristic of the disorder, the NIMH states that “The doctor or mental health professional should discuss with you,[the patient], any family history of bipolar disorder or other mental illnesses and get a complete history of symptoms. The doctor or mental health professional should also talk to your close relatives or spouse about your symptoms and family medical history.”  Based on this ideology, as posed by the NIMH, the psychiatrist should have followed up on her hunches of bipolar disorder with an interview of Susannah’s family and look into her family history.  Along with this should have gone a further look into the thoughts of the doctor who referred Susannah to her, the neurologist who thought that she was binge drinking 2 bottles of wine a night, when Susannah only reported drinking 2 glasses.  But that is neither here nor there.  With this oversight and quickness to agree and prescribe this drug, I can’t help but feel that the psychiatrist did not fully rule out all other possibilities for Susannah’s change in mental state before prescribing something that may not have been totally necessary.

I also did some other research regarding abuse of prescription writing by doctors and found an article in New York Post from December about a pharmaceutical company addressing this problem.  The article states that Glaxo Pharmaceuticals, one of the largest pharmaceutical companies in the world, has decided to change the operation of it’s company to prevent this abuse which has apparently become quite common.  Glaxo states that it will no longer pay for doctors to attend conferences and to speak at conferences to praise it’s products and to speak to other doctors about the products benefits and effectiveness.  It also claims to change from a system in which its sales representatives’ wages are based on the number of prescriptions a doctor they sell to writes, leading the representatives to lie about the use of the respective products and their applications for treatment to increase the amount of times the doctors may write a prescription and thereby increase their pay, to a system in which their pay is based on their product knowledge and customer satisfaction.  But the catch is that this won’t take affect until 2015.  So there will be another year in which sales reps can lie and misrepresent drugs to doctors and get paid for it.  This all only after the company has been charged with paying off not only doctors but also government officials in China to lift drug sales. . . I don’t have a lot of faith in this change, but hopefully I’ll be proved wrong.

So in conclusion, with all this being said, I just have 3 questions:

1) Why has this become an issue when peoples’ lives and well-beings are the things that are on the line?

2) Why has it taken this long for something to be done about it, not only in the US but also on a world wide scale?

and

3) Why are some doctors, the ones entrusted to care for and save our lives under the hippocratic oath, showing a lack of care for the individual in light of the care that they may receive from pharmaceutical companies and blatantly not doing the right thing?

NIMH: www.nimh.nih.gov/health/publications/bipolar-disorder-in-adults/index.shtml

New York Times: www.nytimes.com/2013/12/17/business/glaxo-says-it-will-stop-paying-doctors-to-promote-drugs.html?pagewanted=1&_r=2

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