Exactly. I said in another thread that no patient has the right to pressure me into an action I feel is unethical or bad medicine. But to explain why that request is not appropriate takes time. If you are only allowed 5 min per visit (not an uncommon schedule in some places) there just isn’t time and so they write and move on. Bad medicine, inappropriate and I have told folks that if their doc does this they need a new doc. Sadly, there is a sizable subset that seek out docs exactly for this. See the vaccine excuse mills in CA.
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This is another part of the problem, that you guys don’t generally get the time and space to get to know your patients as you would like/should.
Just another example of how the whole system is failing all of us…
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Technically, FDA approval is not a requirement. Doctors may prescribe any chemical compound. Getting it, or repercussions if they prescribe something stupid, are still factors. But FDA approval is the least of them.
Anecdote: I was once prescribed lemon drops. Ok, so the doctor didn’t bother to use his prescription pad. But he verbally prescribed lemon drops for blocked parotids. Best! Medicine! Ever! Not some palliative, like morphine, but an actual candy cure.
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Topical steroids can be a problem even with a prescription-- it’s so hard to get in to see a dermatologist in the US in a reasonable timeframe, but it’s not a good idea to rely on a primary care doctor for skin complaints. I had a rash my primary care thought was hives, they gave me steroid cream, which made it worse because it was a bacterial infection. I couldn’t get in to see a dermatologist for 8 weeks-- in the meantime I was accidentally cured by antibiotics prescribed by my dentist after a tooth extraction. It’s hard to blame the primary care doctor for not recognizing it, though I have made a point never to ask primary care about skin again and to never use steroids on an unknown rash.
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The vast, vast majority of doctors? No, they won’t. However, the US is a very big place and there are some percentage of unscrupulous doctors. We are not alone in this. Andrew Wakefield pretty much single-handedly created the antivax movement and he was a licensed physician in the UK at the time. I guarantee you there are sketchy doctors in Norway too. There’s also the internet. A huge part of the population is also within a few hours’ drive of Mexico, where all medications can be bought over the counter. The point being made by people in these comments is that if people want it, they’ll find a way.
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What would be really great is if the press would stop jumping on every preliminary study as though it means anything. One study never means anything except “we should or should not look into this further”. Appropriate medical action comes from the preponderance of evidence over large sample sizes in replicated research over long periods of time. The problem is that people have a “sudden breakthrough!” view of science given to them by movies and oversimplified junior high school science classes. This is then reinforced constantly by media overhyping every catchy paper headline, usually extrapolating so far past what the data supports that the article is completely fiction. This undermines faith in science, because it sets people up for endless disappointment when things aren’t really cured. Or they feel like “science changes the story all the time” on what is good for you or bad for you. The problem is the media reporting science at too high of a resolution and constantly overextrapolating.
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