Tuesday, January 29, 2008 Bautista: Doctors know best By Sam Bautista Tea Leaf Reader
THE bad thing about an issue, which hits the headlines, in the Philippine setting at least, is that a lot of side matters crop up to muddle everything.
Take for example the controversy surrounding the Cheap Medicines Bill now pending in Congress.
Don't make the mistake of thinking I am an expert in the matter of medication and healing. My only claim to medical knowledge is the mefenamic acid I take whenever my foot swells and throbs whenever I get a gout attack. (Mefenamic acid being the generic for a very effective painkiller. No, I don't take anything else because I believe I should suffer for my excesses, if and when it decides to strike.)
Anyway, expert or not, this is my five cents worth: Doctors should be given the right to choose the medicines which they feel would actually cure their patients, at the same time they should not close their minds to generics and in fact should push generics with all effort.
There I've said it. For better or for worse, whether someone out there will hate me for it or not, that is my take on it.
Doctors swore the Hippocratic Oath to save every patient who comes to them for assistance. The Oath does not make any distinction between rich or poor, male or female, white, black or all shades in between. It is encompassing and failure to do so could mean strict penalties, which include ejection from the Philippine Medical Association and removal of their license to practice.
And doctors, well most of them anyway, do know a lot more than ordinary persons in society when it come to their field of expertise. In my younger years as an editor it was hammered into my head to get only columnists who are experts in certain fields. So for example, you don't get a civil engineer to write a medical column. That is just plain stupidity.
So doctors know what their about and they should be believed. In fact a lot of my doctor friends will even go to the extent of not giving a diagnosis (no matter how I press them) unless they have run a full diagnostic analysis of the subject (which doesn't necessarily mean me). They are so careful that their medical opinion might lead to the wrong medication or dosage.
So, leave the medicine to the doctors.
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But on the other hand, government is also correct in forcing doctors to prescribe generics to their patients, whether they can afford the branded or not.
Probably, the authors, well those in the Lower House anyway, must have only wanted a reaction from the medical community on the tricky proposal of penalizing doctors who don't prescribe only the branded (which in most cases mean more expensive).
The politicians must have thought that the Generics Law is not being implemented properly so they think forcing the docs to do so would add teeth to the landmark law. Well they got the reaction and now the issue is getting out of hand.
One of the side issues, which further confuse the matter, is the claim that generics are not as good as the branded. Another is the assertion that there are a lot of false medications out in the market. Still one that really tickles my imagination is the argument that docs defend their prescription of branded drugs because they receive special treatment or favors from drug companies.
These matters have merit and should be looked into, but, not to the extent that the main intention for the Cheaper Medicine Act is forgotten. Or better yet, don't mix the side issues with the main. Treat them separately and probably all the issues will get some resolution.
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My doctor friends and friends who have doctors in their families agree: the Generics Law is very well thought out and practical. The only problem is that government is not implementing it properly.
I believe the doctors should also shoulder some of the blame. Like most Filipinos, doctors also place the blame solely on government for all the ills of this nation. A little thinking through will show how flawed this thought can be.
The problem was only government was promoting generics, which eats into its meager resources.
For the Generics Law we are all at fault, yes including patients who don't ask enough from their physicians about the drugs prescribed. And doctors should have taken the time to explain the properties of the branded over the generics they recommend -- especially for poor and little educated patients.
And the drug companies manufacturing generic drugs should have launched information campaigns on their products and the Generics Law.
We all took the time to understand the Generics Law before the huff and puff about the Cheaper Medicines Bill, the latter wouldn't have been needed. And government could have spent more of its resources to properly monitor the drug industry.
