Orly Avitzur, medical adviser to Consumer Reports, recently heard this story from an acquaintance, a snowbird who decided it was time to find a second primary-care doctor near her winter home in Florida. She scheduled her first appointment with the new doctor not long after getting a clean bill of health during her annual checkup with her regular physician back home in New York.
When the doctor completed the physical exam, he asked if she had trouble sleeping. Although she replied that insomnia was rarely a problem, he suggested a prescription sleep aid “just in case.” He then asked if she was anxious, and despite her denial offered antianxiety medication that would “help her out.”
Similar scenarios play out in exam rooms across the country, and too often patients end up getting unnecessary or even harmful medication. Here are five warning signs that your doctor might be an overprescriber:
You’re prescribed multiple drugs and aren’t sure why.
Ask your doctor to explain why you need to take each medication and whether there are ways that you can manage your symptoms or condition without drugs. For example, changing your diet and exercise habits might reduce your blood pressure or cholesterol; talk therapy might ease depression; and physical therapy might relieve muscle and joint pain. For medication that you’re already taking, ask whether you can stop taking it, when, and how to do it. (Some drugs, such as steroids and certain antidepressants, must be tapered gradually to avoid adverse effects.)
You’re given a prescription for every symptom.
New regulatory standards require doctors to ask all patients routine questions such as the ones our snowbird was asked about her emotional state and sleeping habits. The questions are appropriate, but if your answers usually result in a new prescription, think twice before filling it. The same goes for symptoms that you bring up on your own. Your doctor should take the time to thoroughly explore every new symptom you describe before she reaches for her prescription pad.
The office is full of pharmaceutical logos.
In the waiting room in Florida during the snowbird’s appointment, her husband noticed numerous pens, writing pads and sticky notes bearing drug logos. They are a sure sign that a doctor is receiving visits from pharmaceutical sales representatives pushing brand-name drugs. Some doctors might think that drug reps keep them up-to-date on the latest research developments, and some like to get “starter kits” of drugs to hand out to patients. But those free samples can cost you more in the long run when they run out and you have to continue costly prescriptions on your own.
You get antibiotics for the common cold.
Colds are caused by viruses, which don’t respond to antibiotics. Though doctors know that perfectly well, many of them feel more useful when they write a prescription — and many patients feel reassured when they get one. The practice not only is useless but also contributes to the growing problem of antibiotic resistance. Patients should understand that good medical care doesn’t always come with a prescription from a doctor.
Your doctor doesn’t ask about nonprescription drugs and supplements you take.
Drug-supplement interactions might decrease the effectiveness of a drug. That could lead to treatment failure or the enhanced potency of a drug, causing side effects. If a person on a blood thinner takes high doses of vitamin E, for example, he may develop dangerous bleeding; likewise, the supplement coenzyme Q10 could make the blood thinner ineffective.
What should you do if your doctor shows such signs of being an overprescriber? The best approach is the most direct: Bring up your concerns at your next visit. If she brushes them off, it might be time for you to think about finding a new doctor.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.