Wednesday, April 8, 2020

Comments by GwynOlwyn

Showing 3 of 3 comments.

  • Just thank you. I hope that your article will be specifically useful to a patient I am trying to help at present. On the verge of undergoing electroconvulsive therapy because she has been on a medication treadmill for twenty years and the psychiatrists automatically step up intervention when the patient is “not responding” to medications rather than entertain the possibility that the progressive dysfunction is heavily iatrogenic in origin and not a sign of any kind of progressive mental illness at all.

    As a fellow Canadian I am so profoundly frustrated with the fact that clinically proven psychotherapeutic interventions for many facets of trauma, PTSD, entrenched grieving and/or depression (CBT, DBT, ERP, EMDR…), that can realize vastly improved quality of life and soul-reinforcing levels of independence, are unavailable to patients who cannot afford treatment — but we are more than happy to support, via MSP, drugging them to permanent disability.

    I am not suggesting that psychotherapeutic treatment modalities are any kind of panacea, nor that during acute phases of a mental health crisis the risk/benefits of applying psychoactive drugs (for short periods of time) might not be entirely necessary, but the default of getting patients on these drugs and then just adding drugs in succession is doing far more harm than good.

    I’m merely a patient advocate, and so have no traction within the system. And it is especially disheartening to try to help patients dealing with mental health crises because they are often indoctrinated to mistrust their own instincts.

    I will be printing out your piece because it shows that instincts are always relevant — especially for those who are told that their instincts are suspect.

  • I presume you meant nation-centric and not ethnocentric. I live in a ethnically diverse nation myself (Canada).

    Correct me if I am wrong, but in the emerging markets of which you speak such as India, my understanding is that the list of prescription-only drugs is not equivalent to that found in Canada or the US. Over the counter medication (that require prescription in established markets) is readily available and that would suggest that consumers get their information predominantly from pharmacists in those circumstances and not physicians.

    As for China, I am wondering whether numerous GSK scandals involving the bribery of Chinese physicians is well publicized within the PRC. In other words, how much could we reliably suggest that GSK manoeuvres that are highly publicized in the Western press to improve physician reputation have any traction whatsoever within the PRC?

    I think it is selling the Pharma consortium well short of its marketing goals to suggest that it has no intention of broadening the groups who will be prescribing medication in future. Will physicians still prescribe? Yes. But so too will a host of other health care practitioners in both emerging and established markets.

    I am not suggesting that physicians are not still a formidable lobbying group in all market areas around the globe, but I think it behooves those who might have patient interests at heart to recognize that Pharma can just as easily by-pass that power structure as bolster it.

  • I don’t believe any of the pharmaceutical companies are changing tack because lowered trust in physicians could threaten their revenue streams. I think they have discovered a far more potent and trustworthy avenues to ensure continued profitability: patient advocacy organizations and direct-to-consumer marketing.

    Basically, Pharma has identified that patients more readily treat their physicians as legalized street-level contacts who will get them what they need based on what the patients tell the doctors they need.

    Control the information that patients get, and you control their decision to prescribe and treat their condition(s) as they believe will be in their best interests.

    Basically, physicians are being passed over for all the perks and epaulettes that used to be slathered all over them by the drug companies because (and my apologies for the crassness of my subsequent analogy) they are aged-out sex trade workers as far as the drug company pimps are concerned.

    I think the change is tack is not about chamfering up a tarnished physician reputation, but rather a savvy recognition that it is far more likely physicians will not hold their prescribing monopoly for too much longer in any case.