E-DRUG: Israel introduces generic drugs scheme (cont)
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Dear E-Druggers,
Oliver Hazemba <ohazemba@zamnet.zm> 09/04/99 05:03AM >>>
Some African societies have had confidence in their health providers
since immemorial and never bother much with the names of the drugs
dispensed.
What matters most is being given a drug to alleviate the health
problem.
This could be a cultural phenomenon where the traditional healers
never (usually) tell the name of the medicine but counsels the customer to
follow the instructions carefully to obtain the best results of the drug.
Oliver's comments on the introduction of the generic drugs scheme in
Israel seem interesting. They portray African traditional healers as
(usually) never telling the name of the medicine but counseling the
customer to follow the instructions carefully to obtain the best
results of the drug. The comments end with a statement that such a
"confidence is attainable in the modern society."
I can but agree with Oliver's comments regarding the amount of
confidence afforded African traditional healers. However, I am a
little skeptical about the effectiveness and attainability of that
level of confidence in our modern society. For the sake of this
inquiry, I would like to assume for just one minute the role of the
devil's advocate and challenge the view that our contemporary
pharmacists and other health care professionals, are exclusively
motivated by altruistic goals and that they will not abuse their
patients' trust.
We know too well that a segment of health care practitioners have a
tendency to abuse their privilege and take advantage of this trust to
induce demand and attain higher levels of income for their own
benefit. We also know well that a number of these health care
professionals have demonstrated a blatant inability to comply with
their professional role and keep the terms of the covenant they have
with society. Far from being the "pure" keepers of their fellow human
beings, a number of health professionals have engaged in "fertilizing
their female patients with their own semen", in "double-billing third
party payers", in "accepting bribes from pharmaceutical companies",
in "unduly prescribing some very expensive, unnecessary brand name
medicines", and in resorting to a host of uncalled for unethical
behaviors. Given this pattern of widespread abuse, one should wonder
whether it is really beneficial for society to let or encourage
"professionals" blindly taking care of the "non-professionals."
While I do not have a definite answer on these issues, I tend to
think that the era of total reliance on any given profession is
outmoded. Since consumers are increasingly better educated and
protected by extensive legislation, they deserve full disclosure about
what is done to them or what is undertaken on their behalf. Moreover,
they should be in a position to make their own decision.
I wonder if our friend Oliver or any other E-Drugger can provide any
empirical evidence to validly challenge this thinking. If so, please
be kind enough to support each of the implied assumptions in your
statement. For the sake of clarity, I have taken the freedom to
clearly articulate these assumptions in four propositions. As I
provide the four propositions below, I must admit that they are more
or less a product of my elaboration due to the stimulation brought
about by your own message. Therefore, please feel free to also tell me
wether or no these statements are a valid formulation of your thinking
on these issues.
- (1) a great deal of trust (or ignorance) on the patient's side is
the preferred way of doing business in the provision of pharmaceutical
care;
- (2) one can more or less freely manipulate the level of trust (and
ignorance) on the patient's side. Such a manipulation is feasible more
so now than it used to be in the past.
- (3) pharmaceutical care providers are less likely or less inclined
to abuse their patients, and
- (4) health outcomes are more likely to be improved by
pharmaceutical care providers when they operate under the veil of
blind trust from their clients.
kind regards
Ngoyi Bukonda
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