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Gold, incentives and meh

The drugs don't work, so why worry about shortages?

Copperfield 

Call me weird, but I reckon there’s a positive spin to the acute-on-chronic medicine shortages debacle.

True, discovering that a haemorrhoidal patient’s analgesic suppository of choice is mysteriously and suddenly unavailable is proctalgic to both parties.

It’s also true that we’re reaching the point that shortages are even affecting the alternatives, and when there’s no alternative, there’s no drug.

But actually, for me, that’s the positive. Because, frankly, I think we doctors prescribe far too many drugs.

What I also believe is that, when the drug unavailability issue whips the therapeutic rug from under my patients’ feet, then – with a few obvious exceptions, like diabetics and epileptics – they don’t just keel over.

They mumble, they grumble, then they miraculously carry on unmedicated.

Assuming shortages continue, and extrapolating this effect, hopefully loads of patients will stop loads of drugs.

When the drug unavailability issue whips the therapeutic rug from under patients’ feet, they don’t keel over

A few might suffer, but I’d argue a net benefit on the basis that many won’t notice any difference, and a significant number will probably feel better.

Plus, being uncharacteristically doctor-centric for a moment, less prescribing means a reduction in review appointments, side-effect consultations, monitoring and tedious repeat scripts, etc etc.

It would salve my conscience, too.

After all, I know that when I prescribe antibiotics to the demanding, antidepressants to the sad and statins and antihypertensives to the Q-risked, I do so with minimal expectations of really doing much good.

I’m simply trying to follow guidance, meet expectation and survive the day unscathed.

In fact, if things carry on as they are, I might even achieve my career-long ambition of getting through a whole surgery without prescribing a single drug.

I’ve come very close, being thwarted on one occasion by my final appointment with a couple who’d come for a repeat of the pill.

They insisted, despite me pointing out that it’s important not to wait too long to start a family. Being 15, though, they probably had a point.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (3)

  • Marvellous opportunity to discuss stopping hrt with the elderly users who have not yet succumbed to breast cancer or stroke.

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  • To be more grim than you Cops, it won't last....

    Especially in Scotland where prescriptions are free....

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  • Well said

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