Harry Mozeley Stevens, an Englishman whose life spanned half the 19th and a third of the 20th centuries, was a sporting event concessionaire who sold scorecards to attendees of sporting events. (He was also the alleged inventor of the hot dog, but that’s another story.) He coined the famous phrase: “You can’t tell the players without a scorecard!” The scorecards, and the hot dogs, made him a wealthy man.
In many ways, nowadays your doctor “can’t tell his patient without a scorecard of medications.” A study reported a few years back by researchers at Mayo Clinic and Olmsted Medical Center explained that 70% of Americans take at least one prescription medicine and many take more than one, with a whopping 20% taking five or more! When you add all the vitamins and supplements people are taking, you’d be hard-pressed to find any adult American who isn’t being medicated with something. What’s so telling about this disturbing trend is that oftentimes doctors don’t even need to examine you or ask you questions. They can merely look at your medical record and see what medications you are on to understand (most) of your problems and issues!
I’ve discussed the reasons why Americans have to take SO many medications in prior blogs, so suffice it to say here that our terrible diets and sedentary lifestyles, coupled with constant social, financial and other stresses of modern life, along with substance abuse, have inflamed this already serious situation.
While we attack our bodies with cortisol (built up from chronic stress) and ruin our vascular, orthopedic, gastro-intestinal and endocrine systems with inactivity and bad diets, it is small wonder that the majority of prescriptions people take are related to those conditions. Indeed, the top medicines people take for their ills relate to:
- High blood pressure
- Anxiety and depression and other mental illnesses
- Stomach and other GI ailments
- Arthritis and other musculoskeletal problems
- Coronary artery disease and high blood cholesterol and lipids
- Management of stroke prevention with blood thinners
- Neurologic diseases such as MS and Parkinson’s
- Bacterial and viral infections
- Asthma, COPD and other lung diseases
- Autoimmune disorders
- Chronic pain
That is only a partial list of conditions that often require medical therapy. The costs of these diseases and drugs are staggering. Nearly 2.7 trillion dollars was spent on healthcare in 2012, but 213 billion dollars could be saved by using prescription medicine in better ways, according to a report from the IMS Institute for Heath and Informatics.
IMS arrived at the $213 billion figure based on six categories in which doctors, patients or both could be making better use of medication, from getting a prompt diagnosis when new symptoms arise to taking medicines as directed by the doctor. Across the six categories, the researchers generally focused on spending on a handful of very common or very expensive diseases—from high cholesterol and blood pressure to HIV and diabetes—for which costs of care and complications are well documented.
“There’s even larger avoidable costs if we were to look at all disease areas” where patients aren’t getting optimal care, Murray Aitken, the institute’s executive director, told The Associated Press in an exclusive interview. “There’s a big opportunity for improvement.” And Aitken said more-appropriate use of medication—taking it exactly as prescribed, not taking antibiotics for viral illnesses, preventing medication errors and the like—could prevent six million hospitalizations, four million trips to the emergency room and 78 million visits to doctors and other outpatient care providers each year.
The report, titled “Avoidable Costs in Healthcare,” found the biggest area of waste is patients not taking medicines prescribed by their doctor, either at all or as directed. IMS estimates the cost of such “non-adherence” at about $105 billion a year. Reasons for the longstanding problem include patients fearing drug side effects, not understanding complications that can occur without treatment, having mental health issues and not being able to afford their medicines.
So whether you are taking statins for cholesterol and lipids…beta blockers, calcium channel blockers, ACE inhibitors, ARBs for high blood pressure…PPIs or antacids for your GERD and stomach…SSRIs or SNRIs for depression and anxiety…or acetaminophen, NSAIDS or steroids for your joint pains, it’s good for both you and your doctor to “tell the players” in your medication line-up, review them during each visit, go over any side effects or interactions you need to look out for AND, most importantly, figure out health behaviors to enable you to GET OFF of as many medications as possible.
If you must be on medicine, do as the studies suggest: take them exactly as prescribed.
Who knows? Maybe you can shorten the line-up and prolong your good years in the process by changing your habits!
For more with Dr. Sherer, click here for his podcast and video interviews, or purchase his memoir, The House of Black and White: My Life with and Search for Louise Johnson Morris.