Prescription As a Part of Medical Practice - Essay Example

1. Introduction Prescription is important part of medical practice that is widely influenced by various intrinsic and extrinsic factors. While clinical needs of the patients remain the key element of prescribing behaviour of General Practitioners, other factors like new drugs, perceived needs by the patient or peer network and drug manufacturers etc. significantly impact prescribing decisions of the GPs. In the contemporary times, the social perspectives to health have undergone dramatic changes and medical prescriptions have also become necessary appendages to the body beautification rather than as clinic requirements of the patients. Botox is one such medical drug that has gained cosmetic values and its injections have increasing become popular amongst the public. 2. Psychology behind prescription The most common reason for prescribing is to ensure that disease is managed and controlled and patients get well (Checkland et al., 2008; Audit commission, 1994). Most importantly, prescription is seen as palliative care that helps to improve quality of life. Medical prescriptions are hugely important to legitimize line of treatment and cede to patients’ demands in a legal way. While GPs have moral obligations to reduce cost and prescribe effective medication, often various compulsions influence prescribing behaviour of GPs. 3. Major factors that influence prescribing behaviour 3.1 Patient/ client demand The familiarity with patients often influences prescribing. The medical practitioners is inclined to support patients’ line of treatment if he/she believes that it would help or atleast would not have adverse health ramifications. Very often, negative perception of patients, force clinicians to prescribe drugs which the patient may not require. Patients with psychological problems often get satisfaction only when prescribed medications by physicians. Also GPs tend to accede to patients’ demand when there are chances of getting the required drugs from the open market, especially prescription of antibiotics and cosmetic value drug treatment like Botox. 3.2 Preference Vs patient needs Preference for particular drug against the needs of the patient become necessary sometimes when expected benefits outweighs risks. When patients have multiple health problems, the regular treatment needs to be intervened with different drug to increase the efficacy of treatment. Bradley (1992) says that GP needs to communicate effectively when imposing his/her preference and emphasize patients’ priorities vis-à-vis treatment. Cosmetic related treatments have increasingly become important choices for patients. The availability of drugs like Botox in the open market poses serious threat to the health of the patients. Hence, physicians and surgeons often comply with patients’ demands and help lower danger by proactively supporting their decisions to enhance their personal assets through cosmetic treatments. 3.3 Influence of friends and acquaintance Medical practitioners have very close networking that also influences their prescribing behaviour. The strong communication amongst their peer group helps to evaluate drugs and treatment for particular disease. In similar medical cases, replication of treatment and prescription of patients of medical fraternity members, who are also friends, is often found to be similar. 3.4 Repeat prescription This is major threat to the overall well being of patients as patients who have chronic illnesses tend to get repeat prescriptions. Over a period of time, the condition of patients as well as his disease could change. Harris and Dajda, (1996) assert that 80% of drug prescription of GPs in UK is repeat prescription! They are printed in large batches and therefore GPs often ignore the need for review, thus endangering the health of patients. Repeat prescription also promotes buying medicines without the advice of GPs and getting it from unreliable sources like internet. 3.5 Cultural and ethnic needs Socio-environmental approach to healthcare delivery has increasingly become common across the globe. It is predominantly applicable for diseases and health hazards caused by environmental causes. Stress, smoking, drugs, fast food etc are external factors which contribute towards diseases like obesity, hypertension, cancer, stroke, cardiac diseases etc. Most pertinent is the fact that compulsions of contemporary society encompass unique cultural approach towards diseases and health. For example, HIV/AIDS was seen as God’s wrath in African community till few years back. Hence, for improved health, creating awareness and changing perception to diseases becomes critical to the fitness and health of the society at large. As such, the prescribing decisions of GPs and clinicians need to incorporate the cultural paradigm and encourage effective communication to empower their patients for collective action plan. 3.6 New drugs Introduction of new drug in the market is important aspect as it could significantly influence prescribing decisions of GPs. The pharmaceutical companies tend to target GPs to prescribe their drugs. GPs therefore can be influenced by the vested interests of the drug manufacturers or may genuinely find the composition of drugs to be effective in the treatment. Scholars believe that GPs often rely on advertisements or medical representatives to learn about new drugs that could adversely impact patients help as the knowledge about drugs could be insufficient, incomplete or even wrong (Prosser et al., 2003, Jones et al., 2001). Hence, new drugs and influence of medical representatives encourage GPs to disregard the interests of patients. 3.7 Shared understanding and negotiated plan of action In the present times, patients have a right to be proactive in their treatment (Stevenson et al., 2000). It is important that patients be made aware about the line of treatment and the importance of drugs that would be prescribed. The understanding equips the patients with necessary knowledge that he/she can utilized to optimize his treatment. The informed consent therefore hugely helps to negotiate effective plan of action. In the prescribing decisions regarding cosmetic treatment like Botox treatment, shared understanding and negotiated treatment becomes major compulsions. 3.8 Concordance as opposed to compliance Concordance as opposed to compliance has increasingly being preferred by patients as it enhances patients right to know and equips him/her with information (Marinker, 1997). The patients are therefore able to make better decisions regarding medication and treatment. Compliance, on the other hand, undermines the rights of patients and prescriptions tend to ignore his/ her competencies as empowered individual. 4. Conclusion Prescription is fundamental to treatment of diseases and relies mainly on the expertise of GPs and medical practitioners, both in terms of treating the diseases and in depth knowledge about drugs. The influence of external factors on prescribing behaviour demonstrate changing dynamics of ethics and moral obligations of GPs, drug manufacturers and media which tend to influence or get influenced. One can therefore, conclude that prescribing behaviour and decisions of GPs need to keep patients’ welfare at the top priority and evaluate other factors against the perceived risks and benefits to the patients. (words: 1085) Reference Audit Commission. (1994) A prescription for improvement: towards rational prescribing in general practice. London: HMSO. Bradley, C. P. (1992). ‘Factors which influence the decision whether or not to prescribe: The dilemma facing general practitioners’, British Journal of General Practice, vol. 42, pp. 454-458. Checkland, K., Marshall, M. & Harrison, S. (2004) ‘Re-thinking accountability: trust versus confidence in medical practice’, Quality Safety in Health Care, vol. 13, pp. 130-135. Harris, C. M., & Dajda, R. (1996) ‘The scale of repeat prescribing’, British Journal of General Practice, vol. 46, pp. 49-53. Jones, M. I., Greenfield, S. M. & Bradley, C. P. (2001) ‘Prescribing new drugs: Qualitative study of influences on consultants and general practitioners’, British Medical Journal, vol. 323, pp. 378-381 Marinker, M and Shaw, J. (2003) ‘Not to be taken as directed’, British Medical Journal, vol. 326: pp. 348-50 Prosser, H. & Walley, T. (2003) ‘New drug uptake: Qualitative comparison of high and low prescribing GPs attitudes and approach’, Family Practice, vol. 20, pp. 583-591. Stevenson, F. A., Barry, C. A., Britten, N., Barber, N. & Bradley, C. P. (2000). ‘Doctor-patient communication about drugs: The evidence for shared decision making’. Social Science & Medicine, vol. 50, pp. 829-840. Read More