I know I’m going to get into trouble for this but we have a saying in our house, “Life is for people who can’t cope with drugs.” It’s a joke, OK? But it means that my children have grown up not afraid of, or unduly fascinated by, drugs.
Doctors are often accused of being in the pocket of Big Pharma, induced and seduced to promote medication over other remedies, and inherently hostile to alternatives. But, I tell you what, we can hardly extract a free pen out of a pharmaceutical rep these days. The largesse of yesteryear, when doctors could enjoy a luxury weekend away with a token medical lecture thrown in, is well and truly gone. There are such strict rules about these things that all the fun has gone out of it. Medical meetings these days are very focussed and austere. In addition, Pharmac’s aggressive bargaining has screwed down drug prices so much that, in New Zealand anyway, there is not much fat in the industry.
Still I encounter a lot of people who tell me they don’t want “drugs”. I think part of the problem is the terminology. If I said this product (Digoxin) is extracted from a plant, purified, put into pills and sold in a shop as “supporting heart health” then it would probably be a big seller. If I could say it was organic, the price would go up again. To my mind, if a chemical is used with therapeutic intent, it’s a drug. The question then is whether it is a safe and effective one, and this is where conventional medicine parts company with Big Natura, the huge multinational companies that dominate the supplement and vitamin industry. They can continue to promote products of unknown efficacy just be trading on buzz words like “natural”, “pure”and “potentised”. This is marketing not science.
Don’t get me wrong. As I’ve said in this column before, I’ll recommend complementary medicines where there is good evidence to support them. Doctors are big promotors of exercise, dietary changes, counselling, and supplements when appropriate. And I acknowledge there has been some dodgy science over the years which has lead us down the wrong path. But evidence-base medicine from objective sources tends to be self-correcting, and governments have a vested interest in advocating non-drug remedies on the basis of cost alone. So, while it might seem that we in the medical profession reach for the prescription pad at the drop of a symptom, good doctors don’t.