Although advancing health through the use of non-traditional methods is the centerpiece of my practice, prescription medications are and will continue to be a part of my practice as well, in part because of the limitations of alternative therapies and in part because many of you come to my practice taking medications, which will need managing until they can be reduced or eliminated. In this context, many of you have been and will continue to want periodic refills. In some doctors’ practices, and until now in mine as well, refills are often done semi-automatically, at your own initiative or that of the pharmacist.
Recently, it has come to my attention that many of my prescriptions have been written incorrectly, usually by accident. Thus far these have been caught by the pharmacist or yourselves before any harm has come to anyone, and most of them have been minor in nature. However, there is always the possibility of a more serious error, so I have thought it wise to make a slight change in my refill policies. This policy is primarily to protect you, but also to protect myself, insofar as I consider myself responsible for my own mistakes, even if they are inadvertent.
Therefore starting in September, 2014, I will be asking all of my patients who are seeking medication refills, whether the request comes from you yourself or from your pharmacy to contact me for an in person for or telephone medication review session. Alternatively, if you already have a session scheduled, you can use this time to review your medications. In the course of a medication review the following subjects will be reviewed, among others:
1. Is the medication and dosage you are actually taking the same as the one I have recorded in my records?
2. Are you having any known side effects to your medication?
3. Are there any changes or problems with your health that may be due to the medication?
4. Are you taking any new medications that may interact with your medication?
5. How well are your medications working?
6. Is it safe to continue taking the medication, given the risks to your health?
7. Should you be trying other solutions to your health problems instead of or in addition to your medication, for reasons of lack of efficacy or safety?
Millions of people worldwide take medications but few appreciate the risks inherent in taking medications. The risks vary from medication to medication, but in general, they are underestimated. Various studies since 1998 have estimated that 100’s of thousands of people die from medication errors annually! And this is just the errors! Many die or experience serious health problems from the correctly prescribed medications too. For those interested, I suggest reading Wall of Silence by Rosemary Gibson and Janardan Prasad. Reading this book will help you appreciate that refilling a medication is not just like filling up your car’s fuel tank with gas. It’s a possible risk to your health that requires regular review. The best way to prevent an error is to have a system where errors are less likely to occur. This is the reason for my new policy. I hope it will lead to fewer errors and better health for everyone.