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Wednesday, January 7, 2009

Let them eat drugs!

I understand that retail stores are under pressure to entice customers amid a faltering economy. But I'm not sure Wegman's and Giant are sending a great public health message by offering free generic antibiotics to patients for the next few months (source: Baltimore Sun). Might this encourage doctors to prescribe them more freely, or patients to pressure doctors for prescriptions, at a time when they are already overused?

Maybe the grocery store chains should have picked a different drug. Statins, perhaps?

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6 Comments:

Anonymous Anonymous said...

Outstanding point I did not think of. Local Depts of Health absolutely need to follow trends and utilization to see the effects of these offers. You are right, the temptation to ask/prescribe for rx could bump use by ??? 5-10%.

January 7, 2009 12:37 PM  
Blogger Jessica Berthold said...

Thanks. That's a good idea about the Depts of Health...You can bet the grocery stores will be tracking the rise in filled prescriptions, right down to the pill!

January 7, 2009 3:17 PM  
Anonymous Mark S. Erlebacher, MD FACP said...

I noted this in our local (Syracuse, NY) paper too. Physicians are having enough trouble talking patients out of using antibiotics inappropriately for colds and now this adds to the problem!

Wegmans should restrict their marketing to bring in customers to food products without encouraging an already abused area of patient directed medical mismanagement. The vast majority of patients with colds still think an antibiotic will help resolve their cold symptoms sooner. Getting antibiotics for nothing facilitates this. When will government, businesses, and insurers understand that patients need CME to contain health care costs?

The antibiotic may be free but the path to getting them isn't. The costs of treating C. Diff. and MRSA is higher yet. I agree with the other bloggers that if they want to give away something free, how about free generics that patients don't take regularly due to costs, like antihypertensives, lipid lowering agents and the like?

January 13, 2009 6:20 AM  
Blogger marta meyers md said...

If physicians are competent and practice good medicine they know most URI infections are viral and do not require antibiotics. The fact that grocery stores are using marketing ploys to get patients into their stores should have no effect whatsoever on the precsribing habits of doctors. The huge problem of resistant bacteria that has resulted from their indiscriminate use is not the fault of the place that dispenses them.

January 13, 2009 10:26 AM  
Blogger matransplant said...

As a RPh, I am concerned about people pharmacy-shopping, and resulting drug interactions not being caught. If a person on warfarin gets a script for, say Bactrim ds, filled at another pharmacy for free, the interaction is not going to be flagged by the pharmacy since the warfarin wasn't filled there. The increased INR may necessitate an ER visit, increasing the cost of healthcare.
MS RPh, CGP

January 14, 2009 5:14 PM  
Blogger Jessica Berthold said...

Excellent point, matransplant. One would hope the pharmacist would ask about other drugs the person is taking, but I'm sure that doesn't always happen.

January 15, 2009 9:35 AM  

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Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

CasesBlog
Ves Dimov, MD, ACP Member, is an allergist/immunologist and Assistant Professor of Medicine and Pediatrics at the University of Chicago, where he evaluates and treats both pediatric and adult patients.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Musing of an Internist
Justin Penn, MD, ACP Associate Member, attended medical school at the University of Washington School of Medicine and trained in internal medicine at the University of Rochester, where he is serving as Chief Resident.

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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