December 07, 2006

Just Like A Pill

An Alecia Moore tune. But you probably know her as Pink. Babygirl got a helluva voice. & ya have to appreciate an artist who wears a t-shirt that says "Die Napster Scum". But it's a solid little rock tune (no; not that kind of rock) with a pop edge to it. It's also kind cute in a metaphoric sense because her mother was a medical professional. Her dad was a Viet-Nam vet btw & while I have no idea what her stance on guns is she is an avid supporter of PETA & denounces those British soldiers who wear bearskin hats while guarding some palace or another. Anyway here's the vid & as usual here are the lyrics.

I almost titled this post "A Socialized Healthcare System Would Solve These Types of Problems" but didn't want to send anyone into shock (after they checked the page a few dozen times to make sure the url was correct). I still believe it would but I'll save the particulars for the end.

The problem in question is this:

"Many Americans, including those with college degrees, have trouble interpreting the instructions on prescription drug labels, a new study finds."

What seems to be the nature of the confusion? "Take two tablets two times daily for seven days is perplexing to too many folks according to the article. It gets better though:

"And 9 percent of all those interviewed had trouble with the instruction, 'take one tablet by mouth once each day."

I don't wanna know where they were taking them if they got those directions wrong.

It seems to be a potentially serious problem though:

"The issue of 'how we can confuse patients less' about the drugs they take is of growing importance, Wolf said. He estimated that perhaps 500,000 adverse events occur each year in this country because people misread their drug instruction." (emphasis mine)

The solution? Higher literacy requirements? Actually teaching consumer math skills in secondary schools? Doctors learning basic penmanship? Nope. It's even better:

[The problem of misreading medication labels is] "Important enough for the American Academy of Physicians Foundation to appoint a new advisory committee, headed by Wolf, to come up with better ways of making sure that people know how much of a drug they should be taking, and when.

The committee probably will recommend 'some regulatory oversight to standardize dosage, of a kind we've never had before,' Wolf said."

That's it. Why educate when you can regulate right? We don't need literacy, we need bureaucracy!. There's nothing preventing folks from asking their doctor or pharmacist to explain in detail what the hell the instructions mean. I know that some docs can be hard to deal with but I've always found that by pointing to an appendage & asking which bones you'd break if said appendage was snapped in two that even the most tight lipped docs will tell you anything you need to know & seem happy to discuss things with you no matter how rushed they looked before (I jest. Don't try that even at home, no matter how tempting). Really though it is a person's responsibility to look after their own well being. If that means asking a doc or pill-pusher a few questions then so be it. Abrogating the responsibility to a committee who in turns proposes new regulations is missing the cause of the problem: people not being responsible for their own health.

I never understood why doctors intimidated folks so. I know some people, some of them family in fact, who would not only not figuratively question a doc's assessment but assume that if the doc hadn't told them something they just didn't need to know it. I believe that more than anything causes a hesitation in folks who should be clarifying what their medication dosage is. Course that's just anecdotal observation & I could be mistaken. Also i don't have a healthy respect (bad puns are always intentional) for most docs. I got that through watching my grandfather outlive four of them who each took great pains to tell him that those cigars of his would kill him. He lit up while reading each of their obituaries. :)

But as I promised I'll explain how a socialized medical system would eliminate the problem discussed above: there'd be such a shortage of medication that you'd only be able to take one pill a day once a day for one day. Problem solved thanks to Marxism. (I wonder if they've reconsidered my application for a professorship at Father Guido Sarducci's Five Minute University?)

Posted by Publicola at December 7, 2006 07:19 AM | TrackBack

At least in an interview I read last summer, she mentioned growing up shooting, and said that she used to carry concealed sans permit.

Posted by: Bob at December 7, 2006 09:20 AM

Well, during the decade or so that I worked in a pharmacy we had to deal with regulations to reduce this very problem. In fact about a decade ago a new federal law, or regulation with the power of law, was put into effect that REQUIRED a pharmacist to 'counsel' a patient on exactly how to take their meds etc... the first time that patient had their prescription filled. It was later amended to allow patients to decline the counseling. It was also amended to allow mail order pharmacies to just include a written counseling form explaining al of the above. THis has NOTHING to do with a doctor's penmanship. That is a whole 'nother problem, which is diminishing. While the problem stems from doctors scribling too fast, I think it also stems from their not recalling the exact speling of the meds they want to prescribe so they camouflage that by writing a legible first letter and then using a series of hills and valeys with some random dots. Yes, we used to look at the cuneiform on the prescription pad, look at the dose, mode of administration (e.g. orally, rectally, topically, etc...), the frequency (once a day, etc...) and sometimes patient history. Most of the time it was easy to figure out. FOr those times it was not we got to call the doctor. WHat this really means is that the pharmacy calls the doctor's office and speaks to a nurse who thinks that she is God. Admittedly, there are a few GOOD nurses out there, nurses who actually look at the patient's chart before making a pronouncement from on high. The expereince that embittered me was actually on the day of Christmas Eve years ago. I had to call a doctor's office to verify dosing or quantity to dispense for a patient's insulin. The prescription did list out which insulin, but it said for the patient to use it "as directed" and that we should dispense a 90 day supply. Well, since we had no idea how often or how much the patient was using we had to cal the doctor. I spent 45, yes FORTY FIVE, minutes on the phone with the nurse before she finally said in exasperation, "Fine, I'll get the chart!" This was not an isolated occurence.

What I don't understand are teh people who blindly take the prescription to the pharmacy and then just take whatever they are given. I consider my health and well being to be MY responsibility. It is in MY best interests to make sure that I don't inadvertantly kill myself. Yes, the doctor, pharmacist, etc... will have legal problems if I die due to a misfill, but that won't help me.

So, talk to your MD, talk to your Pharmacist, heck talk to your nurses, they actually have quite a bit of knowledge, but overall take responsibility for your own health. If the pill color changes ask questions, if ANYTHING looks odd to you, ask questions. Pharmacy personnel are more than happy to quadruple check that you received the correct med. We know how easy it is to confuse them which is why most pharmacies have at least 2 sets of eyes checking each prescription AND each fill.

Sorry about the ramble.

Posted by: Renn at December 7, 2006 01:43 PM