November 12, 2009

Quackbusting the Quackbusters part 2

Or “Are medical doctors ignorant, to busy to think, or just poorly trained?”

Its time to get on my soap box again after hearing 2 stories this morning from a couple of patients.

So I’d like to share these anecdotes with you, and back it up with some science ( a study you can guarantee will not make it onto the so-called ‘quackwatch’ sites, and will be ignored by such people as Simon ‘keep libel laws out of science, so I don’t have to be objective’ Singh ).

First up, I’m treating a young guy for chronic back pain that has utterly failed to respond to normal medical care. After a few sessions of chiropractic, he’s had his best week ever, but then he gets the dreaded swine flu. His doctor tells him to stay in so as not to spread it (sensible advice if swine flu where A) a pandemic, and B) particularly virulent) to others. Also given tamiflu. Then, and this is the stupid bit, he gets an appointment with a back specialist to do a steroid injection – which the idiot doctor then goes ahead and does despite the fact that steroid compromise the immune system. The result – patient is worse and gets more aches and pains!

Then, another patient, on really heavy drugs for her severe pain, goes to doctor complaining of lack of energy, and forgetting things – such as how to drive whilst actually driving! Doctor says no its not side effects to drugs, so she goes home, looks up the drug effects and there it is – her symptoms ARE a known side effect.

Now at this point you may think it’s just a coincidence that I had 2 patients in one morning who had doctors unaware of how the drugs they used were working. But oh no… the truth is pretty awful…

The University of Arizona College of Pharmacy, mailed a questionnaire to 12,500 US prescribers. Recipients were asked to classify 14 drug pairs in to three categories:

* contraindicated (dangerous to use together)
* may be used together but with monitoring
* no interaction

Only 42.7% got it right! And worse – most only identified 25% of the dangerous interactions. The leader of the research, Dr. Malone, unsurprisingly, stated that the research indicates that health professional training programmes are not doing enough to teach students about potential drug-drug interactions.

It’s no wonder medicine in the US is the leading preventable cause of death.

Lucky for us though there is a website I have long been using – www.drugs.com – that lists all the drugs on the market, all their effects and interactions. All you have to do is type in the name and then choose what you want to read – the simple guide, the professional, the medical or the technical! Drugs.com also has an area you can save the list of all the medication you’re on, so if you get a new one and add it – it checks for all the interactions for you. Really sounds like something all doctors and hospitals should be using doesn’t it, and not just concerned chiropractors and their patients.

The link to the interactions checker –
http://www.drugs.com/drug_interactions.php

Dr Chris Pickard

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