Prescribe-first-treat-later

Reading the featured article in today's Times, one thing in particular stood out to me -- the "prescribe-first" mindset and it's deleterious effects on unsuspecting patients and their families. Richard Fee was a young man who was obviously both physically and psychologically addicted to a manufactured substance --a "medicine", if you please. Richard's family seemed aware of their son's spiraling addiction, yet the doctors, clinical experts, and specialists who "treated" him seemed less conscious of this important fact.

Most troubling was the doctors' continued reliance on prescriptions to treat maladies that likely arose from another prescribed medication. For example, even when Richard's doctors were advised of his past abuse of drugs (like Adderall) used to calm his ADHD, on more than one occasion they proceeded to prescribe additional medications (often anti-depressants) to quote-unquote treat the negative side-effects of that prior drug. This mentality of "prescribe-first-treat-later" is alarming in the sense these doctors abdicated their Hippocratic responsibility to "first, do no harm."

One cannot help but think of the influence drug manufacturers and their associated actors had on Richard Fee's life. A more likely culprit for Richard's death was not the myriad doctors who prescribed his medications but the drug companies who created, manufactured, and packaged-for-sale the pills that ended up in his body. Are doctors to blame when they are on a weekly basis in contact with representatives from pharmaceutical companies? Or does this speak to an even larger issue --the way in which medical services are delivered in this country?

It seems unlikely that Richard's doctors were malicious in any way. Granted, some were obviously imprudent in their actions. Yet the real theme here seems to be the overwhelming influence of moneyed interests. As evidenced by Mr. Fee's case, several actors stood to gain financially -- drug manufacturers, insurance companies, retail outlets like CVS, and a motley crue of medical specialists. Fifteen-minute "med checks" sound awfully transactional. In the span of fifteen minutes, a sick patient becomes a customer in a check-out line. Most unfortunately, Richard Fee and his family learned this the hard way.