Sunday, March 29, 2009

Over Prescribed, Record Broken

I have a running record that you don't want to break. Previous record was a person on 26 different daily medications, which I thought was outrageous. Then it happened at the Diabetes Expo in Portland, Oregon. A woman sat down and pulled out her list of medications. 33. She is on 33 medications a day. I looked at her, looked at the list, looked at her symptoms she had checked off a list of stress survey, and wanted to scream. Modern medicine is failing her. This can't be what we are hoping Americans have access to. I am hoping patients can explore their options and try Chinese medicine, acupuncture, and naturopathic medicine as they might be able to help at the very least reduce the amount of medication they are on, at best help them correct the underlying imbalance and thrive.

An analysis of 2.4 million insured adults over 65 years old in 2004 showed the average senior seeing two or more doctors filled 27 prescriptions a year and were at risk for 10 potential drug errors. Both of these numbers increased with the number of doctors a person saw. Add to this the 106,000 + adverse drug reactions per year (1966-1996 study) that lead to death (which puts iatrogenic/ doctor caused deaths the fourth-sixth leading cause of death) and we have a problem. This is not healthcare. This is disease management. I find it curious in the current debate there is no definition of health and wellness. There is only talk of the system, insurance, and access. We have a unique opportunity to address the system. I'd like to advocate for more wellness and alternatives to the current drug madness, access for all Americans to true person centered healthcare, where they could access a variety of providers if they choose.

Tuesday, March 17, 2009

Big Pharma's unspoken influence on health care and other musings

In a recent NY Times article students at Harvard medical school were surprised at the extent big pharma had on their education.  In recent grades Harvard received an F for failure to disclose the conflicts of interest of their lecturers among other things.  We have discussed this topic in our podcast 'Nemesis of Medicine'.  This marriage of the pharma industry and medical education institutions is sadly absent from the current discussion of health care reform.    

Journal of American Medical Association Dr. Catherine DeAngelis said, "The influence that the pharmaceutical companies, the for-profits, are having on every aspect of so blatant now you'd have to be deaf, blind, and dumb not to see it."  When seniors argue for prescription rights as if this is true medical reform we are in trouble.  The marketing machine of big pharma masked as health care is the big elephant in the room.  What we have currently in the U.S. is a disease management, symptom based model of care and it's very expensive.

While access is one component of the discussion, we need to question access to what?  The discussion should include a change to talking about health and wellness.  A system that addresses the root causes of dis-ease, not just disease management.  All too often I see patients that are left coping with the dictate their doctors gave them, "get used to it, this is as good as it's going to get for you."  All too often patients are left with this statement and don't realize the options they have.   Naturopathic and Chinese medicine practitioners have options for patients that get results. People are voting with their dollars and have been spending more out of pocket on complimentary and alternative medicine than with their allopathic medical expenses.

One would expect an increase in research dollars to study these alternative therapies  since more and more Americans are using the therapies.  As a practitioner I am constantly scouring the reserach to help my patients.  Instead what we hear are attacks on complimentary and alternative medicine as psuedoscience in the Washington Post.   A doctor from Yale university, which received a C grade in policing big pharma on it's campus, was calling for defunding NCCAM (National Center for Complimentary and Alternative medicine ), the branch of the NIH (National Institutes of Health) which studies complementary and Alternative medicine.  His suggestion was that he doesn't like the government funding pseudoscience.   Instead, this physician, like many in his field, appear to collude with rigorous "pharma" standards and hence "pharma" results and "pharma" interests.  

At Nature Cures Clinic we are embarking on our own research as there is a clear need for it, however the model of research that earns institutional recognition does not reflect current practice.  The current trend of reductionistic single intervention research can not capture the essence of what makes naturopathic medicine thrive -- addressing root causes rather than symptom management.

We have a unique opportunity in time where the strangle hold big pharma has on medicine is loosening.   Patients are looking for alternatives to help the with their health conditions, dis-ease, and illness.  And we are ready.