Physician, Hear Thyself

By Dan Gordon

Copyright © Michelle Thompson

Taking the right medicine in the proper dosage is vital. Knowing its side effects is just as critical. But too often, physicians don't tell their patients enough about the drugs they prescribe — and sometimes they don't say anything at all.

"If I'm writing antibiotics, are you allergic to penicillin?"

"No, I'm not allergic to anything."

"Okey-dokey."

That interaction, captured on audiotape, constitutes the entire dialogue between a doctor and his patient about a drug being prescribed. No instructions on how long or how often to take the medication. Nothing on potential side effects. Not even a mention of the drug's name.

The findings of a new UCLA study indicate that such sparse communication between doctors and their patients when a new medication is being recommended is all too common. And the potential public-health implications are considerable.

Studies have found low rates of adherence (whether patients take the proper doses at the right frequency for the right length of time — or whether they take their meds at all), putting millions at risk for adverse drug events, unnecessary hospitalizations and worse.

We're talking about a lot of pills. Nearly half of all Americans are on at least one prescription medication at any given time, and half of older patients take three or more. It's estimated that every person in the U.S. is prescribed about five drugs a year.

During her medical training, Derjung Mimi Tarn Ph.D. '06 was struck by the number of patients who were coming back for repeat visits without an understanding that the medication they had been given for chronic conditions such as hypertension was supposed to be taken continuously. "I would see people who, three to four months after being prescribed the drug, had already stopped taking it," she says. "It seemed as if either we weren't telling them certain things or there was a lack of understanding of what we were saying."

Published Jan 1, 2007 8:00 AM