# Why do doctors over prescribe drugs? **URL:** \ **Category:** Great Debates\ **Created:** [March 23, 2012, 3:22am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575 "2012-03-23T03:22:14Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![MonkeyMensch](https://avatars.discourse-cdn.com/v4/letter/m/82dd89/32.png) [@MonkeyMensch](https://boards.straightdope.com/u/MonkeyMensch)\ **Post date:** [March 26, 2012, 1:11pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/81 "2012-03-26T13:11:28Z")
> [@t-bonham@scc.net](#): > > **Why do doctors over prescribe drugs?** > > Because patients over-demand them. > > If someone goes to see a doctor with a cold, and the doctor tells them to “rest in bed, drink plenty of fluids, and take aspirin for headaches & fever”, their reaction is likely to be “I paid a $75 co-pay for that?”. Patients are unhappy with that, and want more. So doctors prescribe drugs: a prescription pain/fever reducer (to do what the aspirin would have done), a decongestant (to do what a vaporizer would have done), etc. > > You could argue that patients demand drugs because the drug company advertising & TV medical shows have brainwashed the into doing so. But doctors don’t want to argue with their patients, so they just write the prescriptions. My brother was an ER doc for years and it was this attitude that eventually drove him out of active practice, though he is still licensed. The facility’s attitude was, “Well, just write them a scrip.” He, I think, loved the money and the real work he did as a doc but didn’t want to deal with people who weren’t interested in their own health. His saying, “Yeah. You’re sick. Go home and rest,” didn’t cut it with management. ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [March 26, 2012, 1:52pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/82 "2012-03-26T13:52:17Z")
> [@MonkeyMensch](#): > > My brother was an ER doc for years and it was this attitude that eventually drove him out of active practice, though he is still licensed. The facility’s attitude was, “Well, just write them a scrip.” He, I think, loved the money and the real work he did as a doc but didn’t want to deal with people who weren’t interested in their own health. His saying, “Yeah. You’re sick. Go home and rest,” didn’t cut it with management. I think that part of the underlying problem is that we’ve gone from a doctor-patient relationship, where the patient finds a doctor he likes and sticks with that doctor until death or retirement do them part, to a provider-customer relationship that is driven by reimbursement and other financial considerations. If the doctor, who I started seeing three years ago when he joined my insurance company’s network, leaves the network, I get to find a new doctor because I can’t afford to pay for his services out of pocket. (FTR, I’ve seen the same doctor for five years, and even though I now get most of my routine and specialty care through the VA system, I choose to maintain a relationship with her because she’s a great doctor.) IME, the rest of the problem is making sure that customers feel that they are receiving value for their time and money, which is especially important when out-of-pocket expenses are higher than they used to be. People feel cheated when they don’t leave with a prescription because their problem is now a waste of time and money; it’s something they didn’t have to go to the doctor for. If they leave with a prescription in hand or the knowledge of tangible pills waiting at the pharmacy, that problem went from something trivial to something serious enough to require a prescription. It doesn’t matter if the prescription is for an over-the-counter painkiller or decongestant; the piece of paper or knowledge that there are tangible pills waiting at the pharmacy is what’s important here. Hospital and practice managers know this, and encourage that piece of paper. And, also IME, people who leave with a prescription are more likely to pay their bill because they feel they got value. When I did radiology billing, you wouldn’t believe the number of people who told me they weren’t going to pay their bill because the radiologist didn’t find anything wrong with them. Interestingly, the ones who at least had something unusual mentioned in the report – even if it wasn’t causing problems or was some otherwise-normal anatomic variation – tended to pay their bills. I don’t think anyone thought to do a controlled study, so it’s anecdotal evidence at best, but it illustrates my point here. ---
**Author:** ![Annie-Xmas](https://avatars.discourse-cdn.com/v4/letter/a/ecc23a/32.png) [@Annie-Xmas](https://boards.straightdope.com/u/Annie-Xmas)\ **Post date:** [March 26, 2012, 2:29pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/83 "2012-03-26T14:29:40Z")
> [@purplehorseshoe](#): > > Depressed (in the clinical, medical sense) does not mean “sad.” It means your brain isn’t functioning properly. Rich gorgeous folks can, and do, suffer from depression, the same way they can suffer from diabetes or tumors or pancreatic cancer or broken bones or anything else. And exactly HOW do doctors determine that a brain is not functioning properly and anti-depressants are called for? When I was imprisoned in the cuckoo’s nest, they forced me to take anti-depressants two hours and one blood test after I was admitted (it took me 14 hours to get food and 38 hours for basic toilettries). They knew I could only be held for 72 hours and that no anti-depressant could work in that short amount of time. Can ANYONE justify that? P.S. Obviously, making money for the drug company was worth risking my death from an allegic reaction to an unneeded drug (and I was told the flat out LIE "This isn’t drugs. It’s medicine.) ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [March 26, 2012, 2:52pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/84 "2012-03-26T14:52:15Z")
> [@Annie-Xmas](#): > > Can ANYONE justify that? I definitely cannot. But then, I think that doctors should not be the keepers of prescriptions, and that everything should be OTC. I guess anyone who feels that doctors should be the gatekeepers has no need to justify it, as they have already admitted that they are incapable of handling medication. ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [March 26, 2012, 3:09pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/85 "2012-03-26T15:09:29Z")
> [@Annie-Xmas](#): > > And exactly HOW do doctors determine that a brain is not functioning properly and anti-depressants are called for? When I was imprisoned in the cuckoo’s nest, they forced me to take anti-depressants two hours and one blood test after I was admitted (it took me 14 hours to get food and 38 hours for basic toilettries). They knew I could only be held for 72 hours and that no anti-depressant could work in that short amount of time. > > Can ANYONE justify that? > > P.S. Obviously, making money for the drug company was worth risking my death from an allegic reaction to an unneeded drug (and I was told the flat out LIE "This isn’t drugs. It’s medicine.) I can’t justify that at all, but something isn’t quite right to me. Anti-depressants generally aren’t something you necessarily start at full dose (too much risk of really, really nasty side effects), and they generally don’t work overnight. I’m wondering if you weren’t given something intended to calm you down, and the nurses told you a “little white lie” to get you to cooperate. (I’m thinking the blood test was probably a drug screen to see if you were on anything.) Also, lots of people react very negatively to the word “drug”, even though it’s synonymous with “medicine”. Psych nurses are very sensitive to stuff like this and will use lots of little tricks to make patients cooperate. They work more than they don’t. Again, I’m not justifying the treatment you got, and I’m not saying you don’t have the right to be angry. What I am saying is that what you’re told to your face is often not the same as what actually happened. I’m also not a doctor or a psych nurse, but I have firsthand experience with psychiatric medication, so I have a pretty good idea how they work, and I know a whole boatload of people who wound up in the loony bin for various reasons. ---
**Author:** ![CrazyCatLady](https://avatars.discourse-cdn.com/v4/letter/c/dfb087/32.png) [@CrazyCatLady](https://boards.straightdope.com/u/CrazyCatLady)\ **Post date:** [March 26, 2012, 3:14pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/86 "2012-03-26T15:14:17Z")
> [@jmiller15](#): > > What upsets me is all these new adds the drug companies come up for new ailments like the Shift Change disorder, seriously??? Seriously. People die from that shit. Their sleep cycle gets fucked all to hell, and one day they just fall asleep at the wheel coming home from work and drive right right into a utility pole or bridge abutment. It happened to my aunt’s fiance, and it happened to the father of one of my schoolmates. It’s been as issue as long as overnight shifts have been around, we just didn’t have a name for it or anything to really do about it. ---
**Author:** ![Annie-Xmas](https://avatars.discourse-cdn.com/v4/letter/a/ecc23a/32.png) [@Annie-Xmas](https://boards.straightdope.com/u/Annie-Xmas)\ **Post date:** [March 26, 2012, 3:14pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/87 "2012-03-26T15:14:24Z")
“That’s not drugs, that’s medicine” is the only thing I was told about the little pink pill (right to informed consent my ass). It was only after I experienced the ghastly side effects and got a perscription when I was released and googled it that I found out I was given an anti-depressant. Which, BTW, can give you “increased thoughts of suicide.” ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 26, 2012, 7:27pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/88 "2012-03-26T19:27:06Z")
> [@dataguy](#): > > I have to call attention to this statement because it attempts to frame a correlation as a cause. Studies in this area (reasons for increased life expectancy) have indicated that the major reasons for increased life expectancy are things like better sanitation (such as clean drinking water, modern septic systems) and refrigeration (eating less spoiled foods). They found that developments in medicine were not major contributors. The following list, ranked by order of importance, comes from [Answers.com](http://Answers.com), but I’ve seen similar information in other places: > > 1. Clean drinking water > 2. Universal sanitation > 3. Significantly improved nutrition, particularly during infancy and childhood > 4. Vaccination against most common epidemic diseases > 5. Access to high-quality trauma (accident and emergency) care > 6. Improved drugs (particularly, antibiotics) It is true that the first three are major contributing factors. You’ll note, of course, that the last three on your list are medical developments and are also contributing factors. My statement was unclear and should have stated that medical developments were contributing factors to increased longevity and not implied that they were causal factors. In addition, improved sanitation does not relate to the argument that cancer can be cured by the right diet and that the answer to all medical problems is fresh fruits and vegetables, as claimed by the OP. And again, no one has been able to provide a good answer to the original question of “if you claim that drugs are over-prescribed, then what’s the right prescription level?” ---
**Author:** ![jmiller15](https://avatars.discourse-cdn.com/v4/letter/j/f6c823/32.png) [@jmiller15](https://boards.straightdope.com/u/jmiller15)\ **Post date:** [March 27, 2012, 6:05am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/89 "2012-03-27T06:05:17Z")
Your right lets just all walk around on medication and be zombies… why is the answer from the medical community always a pill? Maybe it’s true that it’s the patient to blame, but I believe the doctor has some responsibility in saying no! A lot of ailements can be cured with exercise and a healthy diet! ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [March 27, 2012, 6:13am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/90 "2012-03-27T06:13:24Z")
> [@jmiller15](#): > > Your right lets just all walk around on medication and be zombies… why is the answer from the medical community always a pill? Maybe it’s true that it’s the patient to blame, but I believe the doctor has some responsibility in saying no! A lot of ailements can be cured with exercise and a healthy diet! And a lot of them can’t. It’s not an either or situation. Like I said, I can’t just change my diet to prevent seizures. An asthmatic can’t exercise away his need for an inhaler. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 27, 2012, 6:14am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/91 "2012-03-27T06:14:27Z")
> [@jmiller15](#): > > Your right lets just all walk around on medication and be zombies… So you’re not interested in an argument or facts or anything, right? Just your feelings? Like a sense of superiority over people who are taking medications? ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [March 27, 2012, 11:22am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/92 "2012-03-27T11:22:59Z")
I’m not a medical doctor, don’t play one…blah blah blah BUT! If I’m, say, a psychiatrist and someone comes to see me about some problems that I know are treatable with medication and have shown efficacy in many people, I would feel irresponsible if I didn’t offer these up as a solution. Because unless I do therapy, there isn’t anything else I can do for them. I assume that people who see me want to be treated with medication of some type. Otherwise, they are wasting my time as well as theirs. I imagine that other doctors feel the same way. I mean, if I’m a GP and someone comes to me with stomach pains, I will refer them to a specialist if I can’t figure out what’s wrong with them, but in the meantime I will prescribe something to stop the pain. If someone comes to me with acne, I will prescribe something to stop the acne. I will tell them about the benefits of exercise and diet. But why would I withhold them from the knowledge that there are drugs out there that can benefit them? It’s not like I’m forcing them to take the drugs. I’m just handing over a piece of paper. They can choose to get the prescription filled and follow my recommendations, or they can choose not to get it filled. Or they can choose to take the medication and take them as needed–hopefully informing me if this is what they choose to do. If a person doesn’t want to become a walking pharmacy, they do not have to be. But at least they are informed. Choices are a good thing. Like I said before, health strategies are not mutually exclusive. Personally, I’m doing just about everything short of going to shamanistic healers to optimize my health. Medication is also included in my regimen. I wasn’t prepared to admit this when I started on my journey, which hasn’t been an easy one, but some medication works. So does exercise and eating a balanced diet and talking to a professional. I don’t think any doctor wouldn’t advocate a holistic approach. I have never met a doctor who didn’t ask me about my diet and exercise. I can’t imagine any doctor I’ve seen telling me, “Hey, just take this pill and it will fix everything.” Patients may use pills as a crutch, but this is not the fault of the medical profession necessarily. ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [March 27, 2012, 11:45am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/93 "2012-03-27T11:45:03Z")
> [@jmiller15](#): > > Your right lets just all walk around on medication and be zombies… why is the answer from the medical community always a pill? Maybe it’s true that it’s the patient to blame, but I believe the doctor has some responsibility in saying no! A lot of ailements can be cured with exercise and a healthy diet! Just about all of my doctors have discussed my diet with me. Many have also discussed exercise plans. A lot of ailments can be IMPROVED with diet and exercise, IN CONJUNCTION WITH MEDICATION. I’m diabetic. I feel a heck of a lot better when I hop on my exercise machine every other day. However, no matter how much I exercise, and no matter what sort of diet I’m on, if I didn’t take my insulin I’d be dead very shortly. My body just doesn’t produce insulin, and without some source of insulin, my body can’t use the food that I eat as fuel. Even if I completely eliminated all sugar and other carbs from my diet, I’d die. What’s more, there are a lot of people who won’t follow a diet or exercise regime, but who will take medication. If a doctor has one of these patients, then s/he is going to prescribe medication, because taking a pill or a shot will do more good than not giving the patient medication. ---
**Author:** ![Anaamika](https://avatars.discourse-cdn.com/v4/letter/a/5f9b8f/32.png) [@Anaamika](https://boards.straightdope.com/u/Anaamika)\ **Post date:** [March 27, 2012, 2:29pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/94 "2012-03-27T14:29:59Z")
> [@ralph124c](#): > > An Indian friend once told me that Indian doctors are willing to prescribe antibiotics for colds-even though these drugs are useless to treat colds. Such overuse sounds like it would contribute to the antibiotic-resistant diseases-is this true? Absolutely. My dad just came back from India, and a doctor prescribed him antibiotics. Did he have a cold? No one knows. They didn’t really check him out, they just looked at him and gave him antibiotics -without even knowing what he had. ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [March 27, 2012, 2:59pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/95 "2012-03-27T14:59:57Z")
Maybe should read this article by Theodore Dalrymple, a British Psychiatrist. [http://www.newcriterion.com/articles.cfm/forced-smiles-2475](http://www.newcriterion.com/articles.cfm/forced-smiles-2475) > [@](#): > > I think something rather more banal has been at work: Most doctors would think that it is worse to withhold antidepressants from a single real case of depression than to give relatively minor side effects to ninety-nine people who do not need antidepressants. [http://www.telegraph.co.uk/health/children\_shealth/8036090/Its-not-ADHD-Sir-its-in-my-genes.-.-..html](http://www.telegraph.co.uk/health/children_shealth/8036090/Its-not-ADHD-Sir-its-in-my-genes.-.-..html) > [@](#): > > We have seen this clearly with the diagnosis of depression, which was once an uncommon but very serious condition. Now it is a diagnosis that has effectively banished the word “unhappiness” from the English language, at least as it is used in doctors’ surgeries and in hospitals. Depression – that is to say, all forms of human unhappiness – has become a technical problem, to be solved by medication or by some other technique. You also need to examine the trend to prescribe antidepressants by non-Psychiatrists and also prescribe them for off-label applications where there is little clinical data to prove that they are effective. ---
**Author:** ![Minnie\_Luna](https://avatars.discourse-cdn.com/v4/letter/m/4bbf92/32.png) [@Minnie\_Luna](https://boards.straightdope.com/u/Minnie_Luna)\ **Post date:** [March 27, 2012, 5:03pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/96 "2012-03-27T17:03:30Z")
> [@Marley23](#): > > So you’re not interested in an argument or facts or anything, right? Just your feelings? Like a sense of superiority over people who are taking medications? But **jmiller** is taking medications. Apparently the reasons they need the anti-depressant are justified, but the women around him/her taking the medications are taking them for unjustified reasons. I took Paxil for anxiety and depression. Without Paxil I would not have been a functional adult. Paxil allowed me to get rid of the major symptoms so I could attend therapy and make some progress towards dealing with the underlying causes of the disease and go off the medication successfully. ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 27, 2012, 5:52pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/97 "2012-03-27T17:52:22Z")
> [@Kolga](#): > > In addition, improved sanitation does not relate to the argument that cancer can be cured by the right diet and that the answer to all medical problems is fresh fruits and vegetables, as claimed by the OP. > > And again, no one has been able to provide a good answer to the original question of “if you claim that drugs are over-prescribed, then what’s the right prescription level?” I’m trying hard to follow your reasoning here. Why would improved sanitation have any relation to anything other than being a contributing factor to increased longevity, which was the context of my comment? Also, I re-read the original post, and I don’t see where the OP claims that “the answer to all medical problems is fresh fruits and vegetables.” ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 27, 2012, 6:04pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/98 "2012-03-27T18:04:48Z")
> [@jmiller15](#): > > Your right lets just all walk around on medication and be zombies… why is the answer from the medical community always a pill? Maybe it’s true that it’s the patient to blame, but I believe the doctor has some responsibility in saying no! A lot of ailements can be cured with exercise and a healthy diet! As has been said frequently in this thread - the answer from the medical community ISN’T always a pill. But clearly, you have no interest in actual debate, simply an interest in continuing your anti-medicine and anti-doctor posts. > [@dataguy](#): > > Also, I re-read the original post, and I don’t see where the OP claims that “the answer to all medical problems is fresh fruits and vegetables.” The OP referenced Gershon and his special raw food diet that “cures” cancer, and then in later posts continues to rant about fresh fruits and vegetables. I’m connecting the dots, based not only on the content of various posts by the OP but also the belief system of many people I know who rant in much the same way about the same things. ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 27, 2012, 6:07pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/99 "2012-03-27T18:07:16Z")
nm ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 27, 2012, 7:04pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/100 "2012-03-27T19:04:21Z")
> [@Kolga](#): > > And I am always amused by statements regarding the healthy lifestyles that increase longevity and health, given that the people who propose them forget that there was never a magical time where we were all eating organic, home-grown produce and locally butchered meats and not taking any medications and living as long as we are now. Average life expectancies have increased dramatically in the past hundred years, along with the improvements in medical technology such as medications. Again, I’m just trying to get a handle on your perspective. What is your stance–that good nutrition does not contribute significantly to good health? You just agreed with the data showing that this is one of the primary contributors to longevity (by the way, the first two items in that list (Clean drinking water, Universal sanitation) are estimated to account for 80% of the increase in longevity. Nutrition ranks next, above all the medically-related factors. Is it that you don’t think medicine is getting its fair share of credit? I’m really baffled at why you so strongly dismiss the notion that good nutrition is a major factor in good health. And it may not cure cancer, but neither does medicine. So what is your point, exactly? Also, you skipped over my request for clarification about why Universal Sanitation should be related to the cancer discussion. [Previous page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=4) [Next page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=6)