LET me start off by saying I have the greatest respect for doctors. Well, perhaps not the greatest respect. I do have a healthy respect for some doctors — the ones who see their profession as a calling, not the ones who are in it for the prodigious amounts of money they make from helping sick people.
It costs a lot to become a doctor, so it’s reasonable enough for doctors to expect to recoup their investment, and make a profit thereafter. After all, they sell a vital service: the ability to heal the sick and save lives.
Doctors are entitled to be paid for their services, even handsomely, as many are. They are not entitled to charge the exorbitant fees many do today, especially specialists. They are certainly not entitled to act like omniscient, god-like creatures, and at times like snake oil salesmen, as many do.
One way of preventing them from doing that, is simply not to visit doctors. That way, you can avoid becoming a statistic in the sickeningly high incidence of iatrogenic (doctor-caused) disease. That alone is enough reason to avoid doctors, much like the plague, if at all possible.
Of course, if you break a limb, are about to have a heart attack, a stroke, or think you might have a serious illness, such as diabetes or cancer, you should hot foot it to your GP, or your closest ER.
Doctors do have their place, if only they would stick to it.
Years ago, a close friend, a newly qualified doctor, said he felt like a "drug pusher" because he was constantly doling out dangerous drugs to patients who didn’t need them.
"So why don’t you just stop doing it?" I asked — rhetorically, I thought — but he answered: "If I don’t, the patient will just go to another doctor and get a prescription."
Patients expect pills, he said, even for ailments that would get better on their own.
The problem also lies in the nature of pills doctors push — sorry, I meant to say prescribe. Drugs are the lucrative fruits of the pharmaceutical industry, but often do as much harm as they help. They are also often pretty rotten with side effects that require another visit to the doctor, and more money spent.
You don’t have to be a mathematical genius to work out that the more drugs patients are given, the more side effects they will suffer. That’s because pharmaceuticals are not sociable creatures. They don’t have team spirit. They don’t work well in combination with other drugs.
You wouldn’t know that from recent UK media reports extolling the virtues of a so-called polypill, which developers claim can prevent heart attack and stroke, and extend life by a decade or more.
Doctors in SA would doubtless be delighted with such a pill, given our high rates of cardiovascular disease. And this isn’t the first time doctors have suggested it might be a good idea to medicate the entire population. Some have been trying for years now to get everyone on to statins everyday. Ditto for aspirin.
The polypill’s ingredients look more than a little dodgy: not one, but three drugs to lower blood pressure, (amlodipine, hydrochlorothiazide and losartan), and one of the cholesterol-lowering class of drugs known as statins (simvastatin).
Each carries the risk of serious side effects. Again, it doesn’t take much to work out that the risk is magnified when the drugs are taken together.
Study results on the polypill look impressive enough: significant reductions in heart disease and stroke (72% and 64% respectively). But the study has serious flaws, as Dr John Briffa, a UK orthodox medical doctor with a special interest in natural medicine, points out on his blog.
But principally, Briffa says the study can’t — and shouldn’t — be used to judge whether the polypill can actually prevent cardiovascular disease and delay death, because it is just "speculation based on the idea that lowering blood pressure and cholesterol translates into significant benefits for health".
That idea is not supported by research, Briffa says. Blood pressure and statin medications are actually shown to be generally "ineffective for the purposes of disease prevention and preventing death", he says. And most people who take the drugs "just won’t benefit".
This is particularly the case, he says, for people at low risk of cardiovascular disease.
Briffa isn’t the only one concerned that the lead author of the study, UK interventional cardiologist Dr David Wald, is the son of Professor Sir Nicholas Wald, co-inventor of the polypill.
Not to take anything away from Prof Sir Nicholas and his impeccable medical pedigree, but he and a colleague, Prof Malcolm Law, hold a patent on the polypill, and are likely, says Briffa, to have "at least some desire to cash in on their invention".
There is no proof that their invention would be good for healthy people. And it would be better, as Briffa says, if they tested it in ways that do not lead to "wild speculation but cool hard facts".
Why don’t they do that? Because we would probably "get to see that, like so many drugs, the ‘expected’ benefits fail to materialise", says Briffa.
A nother British GP says "medicating entire populations sounds a great idea, but often causes unexpected harm". I agree with the latter sentiment, not the former.
The polypill panders to the desire for a quick fix, a panacea for all ills. The real magic bullet is taking responsibility for your own health, living a balanced life at work and at play, in harmony with nature and eating nutritious food, not popping pills.
- Marika Sboros is editor of Health News. Read her blog at blogs.businessday.co.za/marika.
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