A DOCTOR’S DILEMMA
I just finished seeing a patient, and he was very honest that he had already seen another physician about 2-3 weeks ago, as I was sick and unable to hold clinic. He also said that his condition had improved slightly, but that he refused to return to the other physician, because she prescribes expensive medications….so I looked at the prescription from the other physician, and true enough, an expensive medication was prescribed, but both the Brand Name and the Generic Name were given, and I know for a fact, that there are several brand names for the said medication….So I asked him, “Why did you not buy the more affordable generic equivalent of the medicine?” , the patient said, he was given strict orders by the other physician, to get only that particular brand, as the generic equivalents will not work. This particular brand happens to be the most expensive brand of said medication…..So I checked the prescription again, the name of the physician wasn’t there, but the clinic’s name and the address were there on the top of the prescription. I know the clinic, and I know the location…..it was at a site where most residents belong to the less fortunate members of our society….it was at a location where people eat less than 3 meals a day and would not go to a doctor, unless their condition had worsened…..So I could not understand why this physician would prescribe expensive medications knowing who her target patients were…..then the patient supplied me with the answer…..he said, the doctor had a mini-pharmacy within her clinic and you had to buy the medications from her, before you leave….so that was the answer! But I still had a bigger question that had to be answered!
What should be more important to a doctor…..the chance to earn so much more….or the chance to actually treat a patient, not just see him and prescribe a medication, but to actually treat him?
Where and when do we draw the line between earning more and living up to our promise and our oath? I am not talking about the Hippocratic Oath. I am talking about a much deeper and more meaningful promise every young child dreaming to be a doctor makes with himself or herself, and with God.
I am pretty certain that all of us who eventually became physicians dreamed of becoming one, not to be rich or affluent, but to treat and help people. Isn’t this the standard answer of every child when asked why he or she wants to be a doctor….”I want to cure sick people.” …or “I want to help people!” Then as we grow older, as we are awakened to the harsh realities of the world and of our poor country, we make an oath to ourselves, that when we become doctors, we will do our part in helping the less fortunate, if not, in bigger and more grandiose ways, then at least in making sure that they are treated in the same way as those who can afford.
This simple case with my patient….it was very telling on me…..That same medication that other physician prescribed… I took the generic equivalent of that drug a few months ago, and I was adequately cured of my condition…..I have given the same drug to my 2 older kids and they too have been cured by the generic equivalent….so this belief about generic drugs not being effective is pure rubbish, and when you dispense drugs or have a pharmacy…then it becomes a money making scheme, that borders on insensitivity and may even be deemed criminal.
If you prescribe a drug to a patient who earns less than 100 or even 200 per day, a drug worth more than a hundred pesos, and he has to take it twice a day, then how do you expect him to afford the medication and feed his family as well……and then, since you own a drug store, you know there’s another brand that he can purchase for 30 pesos each or even less….assuring him or at least giving your patient a good chance of finishing his treatment ….having these options before you and yet choosing to tell him to get the expensive brand from you….how can this not be insensitive?…and if the patient’s condition worsens and he dies and he is his family’s only chance…..how is this not criminal?
To all patients…..these multi-national drug companies will continue increasing the prices of their medications if we continue being foolish….”The Generic Law” not only to give us a more affordable alternative, but also to force these companies to lower down their astronomical prices….please don’t buy them to increase one’s social standing….branded drugs are not branded bags, and Generic drugs are not counterfeit bags….they are true, they are BFAD approved and they are effective.
After I saw the patient, he asked about the consultation fee, and he said, he had so little money left, so I said, what a lot of doctors have said before….”just pay what you can afford, while still being able to buy the medicine.” I may not become rich, in this profession, but I sleep well at night.
I refrain from writing something like this, as I would not like to hurt or even alienate my colleagues in this most noble of professions. I say most noble, because we have been awarded this most miraculous gift of being God’s instrument in healing the most precious of His creations. Let us use the gift well, let us use it as it was intended to be…..to help God’s people!
This Dilemma….it should not even exist…..there shouldn’t even be a choice….as physicians, we treat people, not just write prescriptions, we go the extra-mile, we make sure that at least they can finish our treatments…..and this should be regardless of their social status and our personal needs!
GOD BLESS ALL PHYSICIANS!
GOD BLESS OUR PATIENTS!
GOD BLESS EVERYONE!
I just finished seeing a patient, and he was very honest that he had already seen another physician about 2-3 weeks ago, as I was sick and unable to hold clinic. He also said that his condition had improved slightly, but that he refused to return to the other physician, because she prescribes expensive medications….so I looked at the prescription from the other physician, and true enough, an expensive medication was prescribed, but both the Brand Name and the Generic Name were given, and I know for a fact, that there are several brand names for the said medication….So I asked him, “Why did you not buy the more affordable generic equivalent of the medicine?” , the patient said, he was given strict orders by the other physician, to get only that particular brand, as the generic equivalents will not work. This particular brand happens to be the most expensive brand of said medication…..So I checked the prescription again, the name of the physician wasn’t there, but the clinic’s name and the address were there on the top of the prescription. I know the clinic, and I know the location…..it was at a site where most residents belong to the less fortunate members of our society….it was at a location where people eat less than 3 meals a day and would not go to a doctor, unless their condition had worsened…..So I could not understand why this physician would prescribe expensive medications knowing who her target patients were…..then the patient supplied me with the answer…..he said, the doctor had a mini-pharmacy within her clinic and you had to buy the medications from her, before you leave….so that was the answer! But I still had a bigger question that had to be answered!
What should be more important to a doctor…..the chance to earn so much more….or the chance to actually treat a patient, not just see him and prescribe a medication, but to actually treat him?
Where and when do we draw the line between earning more and living up to our promise and our oath? I am not talking about the Hippocratic Oath. I am talking about a much deeper and more meaningful promise every young child dreaming to be a doctor makes with himself or herself, and with God.
I am pretty certain that all of us who eventually became physicians dreamed of becoming one, not to be rich or affluent, but to treat and help people. Isn’t this the standard answer of every child when asked why he or she wants to be a doctor….”I want to cure sick people.” …or “I want to help people!” Then as we grow older, as we are awakened to the harsh realities of the world and of our poor country, we make an oath to ourselves, that when we become doctors, we will do our part in helping the less fortunate, if not, in bigger and more grandiose ways, then at least in making sure that they are treated in the same way as those who can afford.
This simple case with my patient….it was very telling on me…..That same medication that other physician prescribed… I took the generic equivalent of that drug a few months ago, and I was adequately cured of my condition…..I have given the same drug to my 2 older kids and they too have been cured by the generic equivalent….so this belief about generic drugs not being effective is pure rubbish, and when you dispense drugs or have a pharmacy…then it becomes a money making scheme, that borders on insensitivity and may even be deemed criminal.
If you prescribe a drug to a patient who earns less than 100 or even 200 per day, a drug worth more than a hundred pesos, and he has to take it twice a day, then how do you expect him to afford the medication and feed his family as well……and then, since you own a drug store, you know there’s another brand that he can purchase for 30 pesos each or even less….assuring him or at least giving your patient a good chance of finishing his treatment ….having these options before you and yet choosing to tell him to get the expensive brand from you….how can this not be insensitive?…and if the patient’s condition worsens and he dies and he is his family’s only chance…..how is this not criminal?
To all patients…..these multi-national drug companies will continue increasing the prices of their medications if we continue being foolish….”The Generic Law” not only to give us a more affordable alternative, but also to force these companies to lower down their astronomical prices….please don’t buy them to increase one’s social standing….branded drugs are not branded bags, and Generic drugs are not counterfeit bags….they are true, they are BFAD approved and they are effective.
After I saw the patient, he asked about the consultation fee, and he said, he had so little money left, so I said, what a lot of doctors have said before….”just pay what you can afford, while still being able to buy the medicine.” I may not become rich, in this profession, but I sleep well at night.
I refrain from writing something like this, as I would not like to hurt or even alienate my colleagues in this most noble of professions. I say most noble, because we have been awarded this most miraculous gift of being God’s instrument in healing the most precious of His creations. Let us use the gift well, let us use it as it was intended to be…..to help God’s people!
This Dilemma….it should not even exist…..there shouldn’t even be a choice….as physicians, we treat people, not just write prescriptions, we go the extra-mile, we make sure that at least they can finish our treatments…..and this should be regardless of their social status and our personal needs!
GOD BLESS ALL PHYSICIANS!
GOD BLESS OUR PATIENTS!
GOD BLESS EVERYONE!
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