The massive Physicians’ Desk Reference is distributed at no charge once a year to every practicing physician in the US. Weighing in at about five pounds, its 4,000-plus tissue thin pages are printed in painfully small type across three columns. With publishing costs underwritten by the pharmaceutical industry, the PDR is essentially one immense drug advertisement and as such has a built-in bias.
For example, older drugs that have been generic (and thus inexpensive) for years are simply ignored. Each entry in the PDR is composed of the full package insert for that drug. If you ask, your pharmacist will give you the package insert on anything you’re taking. You’ll be handed a tiny piece of paper that seems to unfold forever. That is a PDR entry.
Since 90% of a package insert consists of side effects, drug interactions, pregnancy and breastfeeding warnings, and so on, it’s safe to say that 90% of the 4,000 pages of the Physicians’ Desk Reference consists of the side effects of prescription drugs.
Side effects. That’s why doctors avoid prescription drugs. But let me expand on this. Another reason I and many other nutritionally oriented physicians avoid pharmaceuticals is that while patients often see symptoms as events that need medicine, we see symptoms as messages asking for a change of lifestyle. The vast majority of prescription drugs being taken are prescribed as a result of poor choices. A few examples:
• Lipitor for high cholesterol vs losing weight, eating nutritious food, and exercising regularly.
• Nexium for reflux esophagitis vs losing the belly and avoiding heavy meals after 6 pm.
• Celebrex for arthritis vs daily stretching exercises, pool workouts, and physical therapy.
• Over a dozen various prescription diabetes drugs to lower blood sugar vs regular vigorous exercise and working with a nutritionist to get the weight off.
• Two dozen medications for borderline high blood pressure vs biofeedback or yoga.
• Antibiotics to “knock out” a cold vs the knowledge that colds are caused by viruses and antibiotics kill only bacteria.
“Oh,” you may say, “I’d love to work with a trainer or meet with a nutritionist or learn stress reduction, but they’re not covered by my insurance. On the other hand, my prescriptions only cost $15 a month.”
With that perspective, what you’re getting is about $15 worth of health care. You’re swallowing pills that most doctors won’t touch themselves. And a key reason we prescribe so many medications (I’m sorry to say) is that the vast majority of the US patient population wants a quick fix without having to take much personal responsibility.
Good health requires lifestyle changes and a few dollars spent out of pocket. I wince whenever my suggestion to meet with a nutritionist or fitness trainer is rejected by patients because their health insurance won’t pay for it. To allow your health insurer to control your health, and ultimately your longevity, is to surrender your very life.
Despite the illusion of safety, most pharmaceuticals haven’t been around long enough for scientists to understand what the chemicals in the pills are actually doing inside you, not to mention their long term effects on your body. But really, most of these pills are simply masking symptoms. For example, we now know for certain that simply lowering your cholesterol numbers doesn’t prevent heart disease, and next time I’ll tell you why most of you don’t need to refill your Lipitor prescription.
David Edelberg, MD