An essay by Richard P. Holm, MD
Every physician and care provider who has been practicing for a while can tell you stories of people who were hospitalized with an unknown illness and cured by simply reducing the number of medicines they were taking. A daughter once brought her increasingly confused and failing elderly father into the clinic to see me. He had been living in a Minneapolis nursing home and was taking a “shoebox” of medicines prescribed by multiple different VA providers. The daughter asked if there were any changes that might help. She was elated when I dropped the pill count down from twenty to six.
In two weeks, he returned to the clinic remarkably improved. Following a move to Brookings, he enjoyed something like three good years of life in an assisted living center, his daughter’s family nearby, until a quick death came following an infection. The daughter told me that after stopping all those pills, her father went from a zombie to rejoining the living world again—reading newspapers, hanging with new friends, playing pinochle, attending church, and going out to dinner with his family.
Medications are overprescribed in this country, and there are many reasons for this culture of pills. Care providers are being pressured to follow health care protocols which are basically recipes for care. These recipes are an attempt to improve quality but often do the opposite and encourage adding unnecessary pills. Other causes include excessive prescribing by the specialists that are also seeing the patient, the time limits that care providers are allowed with patients and their overzealous wish to satisfy their patient, the pharmaceutical industry’s excessive promotional efforts including their direct-to-public advertising (which is not allowed in most other countries), and the patient’s desire for an easy pill rather than a tougher lifestyle change. Health care protocols, physicians, the pharmaceutical industry, and patients are all to blame for the burden of polypharmacy that has taken hold of our country.
Medications intended to be helpful can sometimes be harmful. It should be a careful, well trained, and considerate care provider—not a protocol or an advertising campaign—that determines when a new medicine should be started. Please DO NOT stop any medicine you are presently taking. However, every time you see your care provider, start with the statement that you are not seeking another medicine unless it is necessary, and ask if there are any medicines that can be stopped.