How important is it to take your medicine?

On June 22, 2011 the Medicine Today section of Medscape Today News posted an article entitled Consumer Medication Information: One Page Fits All, that discusses a report from the AMA Council on Science and Public Health. Sounds pretty impressive, doesn't it! Even more impressive, Dr. Sandra Fryhofer, a clinical associate professor of medicine at Emory University School of Medicine, Past President of the American College of Physicians, and who previously served on the AMA Council of Science and Public Health, reports that noncompliance, when it comes to taking pharmaceutical drugs, leads to more frequent hospitalizations, more deaths, and nearly twice the cost (some $100 billion annually) for health care than those patients who take their medications as directed by their physicians. What group of patients is she referring to? Could someone with all these prestigious accomplishments be taking a position that is misleading, intimidating, and only a partial truth?

I have no doubt that for many patients with advanced health care issues Dr. Fryhofer's position is often correct. After spending 35 years working in the ICU, CCU, emergency, and the general wards, I've seen what medications can do to save lives.

However, this one sided article fails to take into consideration that there are many patients who do take pharmaceutical drugs as directed who die (about 400,000 annually), are hospitalized for serious adverse drug events (2-3 million annually), and drive up health costs (to the tune of about $300 billion annually). Let's face it, MDs are seriously undertrained when it comes to the side effects of medications as well as when it is better to turn to lifestyle and other less invasive approaches rather than prescription drugs and technologies to deal with chronic diseases.

The American public is becoming increasingly gun shy when it comes to trusting what people like the distinguished Dr. Fryhofer have to say. Oh yeah, did I mention that she was awarded an honorarium from the people from WebMD who own Medicine Today? Are you wondering who the primary source of funding for WebMD might be? You got it, it is none other than Big Pharma!

Sadly, no study has been done that compares the benefits and risks of the overall practice of medicine from the point of lives saved and lives lost, morbidity, and cost, with placebo. It has been proclaimed unethical to even consider doing such a scientific study because "medical treatment is so obviously beneficial." Consequently, what has followed is a polarized discussion from both the medical profession and those outside the medical profession that is not much above name calling.

Wouldn't it be refreshing if mainstream and CAM practitioners formed a partnership for the purpose of combining their strengths? There are enough sick people to go around, but there obviously is no profession that has been successful in curing even one of them. What is to lose by pooling resources and increasing our options to manage chronic diseases?

What we all want is good medicine, a style of practice that is safe, keeps us healthy, and is affordable. We're in the midst of a transformation where service is becoming the objective and transparency the modus operandi. But we're not yet there, and that is why one sided articles like the one published by the AMA are still being written.

So long as money trumps service, we have some evolving to do before good medicine can become a reality.