Doctors, Patients, Pharmacists and Prescribing

November 28, 2023 by Vernon Coleman

The following essay is taken from `The Medicine Men’ by Vernon Coleman, first published in 1975 (and now available again via the bookshop on www.vernoncoleman.com). Little has changed since it was published 48 years ago.

We still know very little about doctors' prescribing habits. We don't know what really makes them prescribe certain drugs and ignore others and we do not know much about regional and geographical variations.

However, although we do know something about the way in which drugs are taken (or not taken) we still do not know anywhere near enough about what makes people take medicines, or, stop taking them.

Once we have some definite facts then we must do something to control prescribing habits, and to influence the ways in which patients take their drugs. It is no longer good enough to allow prescribers and patients complete freedom, for there are too many people with a vested interest in the prescribing of certain drugs, and too many people ready to take drugs for no very good reason.

The annual consumption of drugs is growing at an alarming rate and we must control this excessive consumption by education and legislation.

One survey has already shown that when 463 doctors were asked what drugs they used for various simple complaints 40 separate remedies were suggested as possible treatment for bronchitis; 38 different remedies were said to be the answer to diarrhoea; and 45 the best for peptic ulcers. There was much variation in cost and chemical content. We need to find out why doctors prescribe so many different drugs and whether or not they are really right to do so.

And we need to look at the role of the pharmacist.

For several decades the pharmacist has been little more than a retailer of drugs. He is allowed to sell certain mild preparations (mostly quite useless) for minor conditions and he is allowed to hand out the pills prescribed by physicians.

This seems to be a tremendous waste of skill and education, for pharmacists are the people who should be capable of training patients and re-educating doctors. Members of the public often consult pharmacists first; they often obtain advice from the assistant in a chemist's shop. Unfortunately, I doubt whether the advice they obtain at present is of very much value. The qualified community chemists should be encouraged to stop selling camera equipment or household goods and concentrate on selling pharmaceutical products; and the chemists' stores which sell records, books and so on should not be allowed to sell or to dispense powerful drugs. If we had chemists who were independent and not linked to drug-producing companies we might be able to give them more responsibility.

Pharmacists could, in addition, help in the continuing education of doctors who, as I have mentioned, are desperately ignorant about the drugs they prescribe. It would be far better for general practitioners to learn about new drugs from the local chemist than from the drug company representative.’

Taken from `The Medicine Men’ by Vernon Coleman, which was first published in 1975 and which is now available again as a paperback. You can purchase a copy via the bookshop on www.vernoncoleman.com or from your local version of Amazon.