Do cardiologists prescribe too many drugs?

One of the most common reasons people require medical care is their medical care. This is a distinctly modern problem. In times past, doctors treated disease. Patients saw their doctor when they were sick. They had a problem; doctors offered help. The doctor of today often improves health by removing healthcare. It’s one of my favorite tricks—stopping nonsense. Excess healthcare happens for many reasons. Three big ones are the conflating of risk factors with disease, overdiagnosis and the one-disease-one-treatment mindset. A high cholesterol level is not a disease but it is treated with a pill. When women acquire the diagnosis of ductal carcinoma in-situ (DCIS), you can bet they, too, accept treatment. Worse, medical education, guidelines, and electronic health records conspire to favor the view of patients not as people but as lists of diseases. Indeed, the problem list is a big problem. One way excess healthcare manifests itself is polypharmacy–too many pills. I chose to write about this topic in my last column over at theheart.org | Medscape Cardiology. It’s relevant for cardiologists because we prescribe lots of medications. In fact, it’s almost a mandate for us to prescribe at least four medications for patients with established heart disease. I call these the big-four—aspirin, statins, beta-blockers and ACE-inhibitors. They are the untouchables. The big-four drugs are mandated because they are “evidence-based.” Clinical trials “proved” th...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs