Too Many Pills

BY MARK SCHOLZ, MD

It’s a painful reminder of failing health to be taking handfuls of pills every morning. Frustration mounts and the question often arises, “Are these pills really necessary?” Have I become the victim of a multibillion dollar medical establishment?

It’s logical to have questions. After all, what happens when your pills are stopped for a couple days—usually nothing! One can’t help but wonder, maybe some of these pills are necessary but all of them?  There must be some “extras” in there someplace. And what about interactions? Some patients intuitively suspect the human body has a maximum pill quota—they believe exceeding that maximum must be dangerous.

As a practicing physician, I have conversations about “too many pills” all the time. It makes me think of the movie Amadeus when the Emperor Joseph complained that Mozart’s music had, “Too many notes,” he said,” just cut a few and it will be fine.”

Patients often don’t understand the reason for their medications. Everyone agrees that the game of selecting medications is played by balancing benefits with risks. But this type of analysis requires homework beyond most people’s capability.

Yet when people unquestioningly defer to their doctor they feel powerless. They often have second thoughts.  Sometimes they feel resentment. Managing one’s health is a really high-stakes game. How can one attain greater peace of mind?

Bill Clinton famously stated, “Character doesn’t matter.”  But character is all we have to go on when we appoint a leader to make important decisions on our behalf. So actually, the opposite is true.  Character is very important.

While no human is perfect, physicians (and politicians) need to be held to a higher standard because in their position of power mistakes are much more damaging.  It may seem obvious to state, but the best way to find peace of mind is to look for a physician with exemplary character.

Making accurate character judgments is challenging, but for most of us, the alternative of running our own medical care is practically unattainable. I don’t mean to impugn doing some background medical research to take your conversation with the doctor to a higher level. But God forbid you discover in the course of your conversation that you know more about the subject than your doctor. Is there any revelation of character deficiency more devastating than that?

You can’t place all your trust in an Ivy-league degree or a Beverly Hills address. It’s the overall picture of the physician’s character that matters most. What type of people does the doctor hire for his office? What kind of doctors does he refer to?  Does his billing department behave in an ethical manner? Does he respect your time?   Does he listen to your questions? Realize that people can justify just about any kind of behavior if they consider themselves more important than you.

All of us practice character analysis in our daily life. Some of us are better judges than others. Ask friends or family members to come with you to the doctor visit and get their opinions as well. My co-author Ralph Blum who successfully dodged the prostate snatchers for twenty years has stated many times, “Patients must trust their instincts about their doctor and be willing to act on them.”