I started this entry with a link to one of the online pharmacies, but I've now erased the link.
Longtime readers of Docnotes will know that I added Google sponsored advertisements in September or so. the ads appear only in the archives of the weblog. So if you're reading this in an RSS reader or you logged in to the home page at www.docnotes.net or www.docnotes.com, you never see them. But people arriving here from web searches will see them, and while I won't say how much I make on these ads, I will say that they earn me far more than it costs to run host the weblog every month.
Since google chooses the ads on every page based on the topics that I discuss, theya re hoping that the ads are relevant to what the user is interested in. The ads can't influence my writing - since the writing happens before the ads do.
But I just looked at an archved page where I discussed a certain medication (and how bad it was) .. and there at the top of the page are three ads for how to buy that medication over the Internet without a prescription.
Hmmm. I don't like this. I don't like it that one can buy prescription medications over the Internet. Yes .. I'm gonna use the same argument you'll hear from most physicians .. I don't think it's safe. Sure, it may be safe to sell some things (I don't dare name them here!) that have recently become OTC .. or will soo become so.
But if my role as your physician is to be a resource - to help you make decisions about your health - then I'm hoping that you will let me do my job. A few months ago I saw a patient in the office who was buying an antidepressant on the Internet. He had tried another - didn't feel much better in 2 weeks, and tried a second one. He wasn't dosing either one properly. It was a tricky situation, and I was oddly reminded of it a month ago when Ray blogged about how he was over his head trying to replace a wood floor:
Sunday was "Install the Wood Floor" day, which quickly turned into "What in the hell was I thinking" day. So, today I'm on the phone with a few companies to find someone else to come in and finish the job. I have to remember - people pay me to do what I consider to be very easy stuff... so I shouldn't feel bad paying other folks to do things that are probably easy for them. ;)
Ray is a great programmer, but he's never coming over to my house to install my wood floor. Dosing antidepressants isn't very hard for me to do ... and it may seem so easy that an intelligent person like my patient ccould do it too. But he can't. This doesn't mean he's dumb and I'm smart. Indeed - he's likely much smarter than I am. I just have a different skill.
In this era of the Internet - with medical information everywhere - I don't doubt that the opportunities to bypass the physician are ample - and sometimes appropriate. Finding the line between appropriate and inappropriate medical "self-service" is going to be the hard part.
So .. back to the office ... this was tricky because I don't want to chastise him or be insulting (as I can expect Ray feared when he called the wood floor guys: "hey bob .. this guy onthe phone wants us to come fix his botched floor. yuk yuk yuk") ... I want to understand why he did it, and make it safe for him to ask for my help .. now and in the future.