Over medication versus medical need- A constant question

This week I need to get back on my soapbox about an issue that keeps coming up in my clinic. On Tuesday, a woman who has multiple issues, including diabetes, high cholesterol, high blood pressure, VERY obese, knee problems, back pain, and heart disease returned to my clinic. As we started talking about her cholesterol still being high and her medication needing to be increased, she said: “As long as you guys don’t Michael Jackson me.”{{more}}

First of all, I have never heard “Michael Jackson” used as a verb.

Second, I was quite taken aback that the possible situation with Michael Jackson could be used to justify NOT taking very necessary medication, including some that could save this woman’s life. Not the same scenarios at all. Please do not compare.

I have heard this story many times before with patients asking: “Do I REALLY need all this medication? Let me say a few things here:

Number 1-unless your doctor owns the pharmacy or stock in the drug company, NO doctor gets any additional money for prescribing you a new medication. So get that strange thought out of your mind.

Number 2-Many doctors, including me, do not like to add medications at all. I much prefer to keep things simple. I try to minimize medications, use combination pills, and stress the importance of lifestyle and dietary changes.

Number 3-There is simply too much research data to ignore about the necessary medications for people with diabetes. That is just a hard fact at this time in science and medicine. In fact, if your doctor does NOT recommend these medications, he/she is basically not keeping up to the accepted standard of care.

We know for a fact that bringing blood sugars down to a certain level (hemoglobin A1C of 7%) will decrease your chances of many diabetes-related complications. The way that is accomplished can vary, and this is why people take various medication regimens-you use what works and is safe for you. It may mean one type of insulin twice a day or it may mean three different tablets. Same with your cholesterol: you may need 1 pill a day or three different ones. The point is to reach that goal and make you healthier by whatever means are reasonable and safe for you. Treating diabetes successfully includes several prongs in the fork: blood sugars, cholesterol, and blood pressure are the biggies. Along with those are other important aspects of care like encouraging exercise and taking daily aspirin if you can.

You are like a flower planted in the garden. In order for the flower to grow and thrive, it needs sunshine and soil and water. But for some flowers they also need additional help, like fertilizer, pesticides, weeding. Do you stop and say “maybe we are overdoing it with this flower?” No, you keep tending to it; you give it what it needs to grow.

Number 4: Yes, it is possible to over medicate. So please speak to your doctor if you have these concerns. It is fine to ask: Do I really need this? How will it help me? Will it interfere with my other medications etc?

Don’t be paranoid, but be aware. Do not argue with or yell at our doctor but do ask questions.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227