Customer is always right
An article in the British Medical Journal (BMJ May 2015) urged doctors to stop over–treating patients in ways that do not help and could even harm. It suggests some patients are given pills or have tests that they do not need but doctors feel under pressure to act. As the UK has just gone through a general election for the new government and the NHS has been a hot topic throughout the build-up to the vote, you can’t help thinking that the pressure on budgets might have something to do with the timing of the BMJ article. However, that aside, isn’t what they are ‘suggesting’ not just common sense? Get to know your patient better and then deal with the whole condition? A bit of future proofing?
Shouldn’t doctors be doing that anyway and aren’t they trained that way? The simple answer is No they probably haven’t been trained that way if the BMJ are now urging them to do it, perhaps like most training it’s assumed they know it and then do it. And despite it being common sense, the evidence from the BMJ suggests it’s not common practice either! 
“Rather than urging and suggesting – why not tell doctors to do it – it is after all, the right thing to do?”
Some, like the doctors in my surgery thankfully buck that trend, looking my overall health and not prescribing instant solutions for the problem (the effect) I tell them about. Thankfully in the 10 minutes allocated (oh yes that’s part of the problem too!) they get to the cause, well that’s what their aim is!
Know your customer?
What happens elsewhere? Isn’t what the BMJ suggesting just what every leader or business owner knows? That if we know the customer well we can satisfy their wants and needs and have a good long term relationship of mutual benefit?
Yet are doctors really to blame at all? Are they the victims of unrealistic patient pressure?
Doctors are undoubtedly part of the problem however, years of unrealistic beliefs and expectations by patients that the solutions to their illness can be found in a pill are driving this over-prescribing.
The Evidence
Go into any chemist and the shelves are stacked with pills and potions for every imaginary ailment. Many of us routinely carry pills in our pockets or handbags. We are subjected to advertising campaigns from the suppliers of those products that all you need to do to return to good health is to shove a chemically enhanced pill or potion into your system. We’re all bombarded by adverts about instant results (shiny objects) and wonder drugs…
“the best anti-aging cream that ….” “the instant cure for those with weight problems….”
Not too different than a CEO wanting an instant result in far too many ways! We think it’s easy by popping a pill, or rubbing in creams. Very few of us take real responsibility for our own health. We eat, drink and smoke too much and as the damage to our body builds – we get the wake up call and we turn to the doctor for a cure. Not enough of us take the initiative and exercise, eat well or properly, keep our weight down, drink responsibly, and don’t smoke. We live in an unrealistic bubble that ill health happens to other people and so what, there is always a cure! It’s on a shelf in the pharmacy or can easily be prescribed. We are indestructible!!! So when we have a health problem we turn up at the doctors and expect to come away with some pills. Problem solved. If the doctor was to suggest that we need to exercise, lose weight, stop smoking, eat healthily and definitely,” don’t smoke” we already know this so what happens? We may get annoyed and become difficult. Once we have got what we want we ignore all the good advise and carry on as before.
Consequences
We already know in another article in May that anti-biotics are having a reduced effect. A £2 billion fund has been suggested to be created because the main pharmaceutical companies know there is little ROI on new drugs so they are not investing. So the problem is global! Individually we know that paracetamol may not work for “that” headache and want different, more powerful ones. We may form an opinion that the doctor does not know their job that well so we pressure on him or her to give us different pills (whilst keeping taking the ones we have already got, just in case). We become needy patients and doctors are now locked in a cycle of being an outlet for the pharmaceutical companies. And all that means is more pressure on limited NHS funds – when it’s gone, it’s gone! 
“Is it any wonder – A&E – Accident and Emergency has become Anything and Everything ?”
Solution
So what is a better way, which could reduce the cocktail of pills we take, some of which can have side-effects that are worse than the original problem? We need to take responsibility for our own health. Unless we do we may succumb to a life of over-indulgence leading to a pill solution that ultimately can lead to a poor quality of life and a state of helplessness where we are totally dependent on pills or worse. How do you do that? Take control? Well, it’s simple. Next time you go to see you doctor, take the lead and ask a simple question
“My dear Doctor, what non-pill options are available?”
Once the doctor has recovered from you asking the question you may be surprised at the options that are available to you that can ultimately lead to a healthier and better quality of life where pills are only prescribed when there is no alternative. So the choice is yours. Or does your unrealistic attitude make you a victim of your own inactions.
