Less is more or Less

As we grow older and face our certain, inevitable mortality, it is understandable if we attempt to incorporate every identifiable intervention that might mitigate our chances of death. Or put another way, increase our chances of life.


The life-sustaining promise associated with ingesting drugs has become a huge part of being a senior citizen in America. Actually this is true for most of America, but particularly for the seniors. The mantra of “take your pills daily or risk dreadful consequences” has its positives and negatives. Keep in mind these are powerful drugs, not benign, cutely shaped candies. Each in its own right has a powerful affect on the body. Add drug upon drug, upon drug and you have a potentially lethal mix of conflicting agents. Too many of our Medicare Part-D eligible seniors have built up a laundry list of drugs that is robbing them of the precious vestiges of health.

It is easy to eventually progress to consuming up to 15-20 different drugs because it costs them “nothing” out of pocket. Their co-payments are close to zilch, nada, nothing. Since these drugs are ostensibly “free”, many Seniors end-up with a bag full of prescription drugs and maybe or maybe not take all or some of them. In any case, the need for a qualified drug screener is lacking at the point of delivery. The pharmacist is in an ethical and monetary quandary. Professionally, he is charged with making sure the drugs first and foremost do no physical or mental harm, secondarily the pharmacist is there to make sure a patients’ drug therapy is at its most efficient. In other words, the least amount of drugs to elicit the healthiest patient-state possible. This may at times call on the pharmacist not to fill one or several prescriptions as presented by the patient/customer. This of course means, s/he is in fact turning away money, since a filled prescription means money in the cash register (or at least a bill to the insurance company). The pharmacist in a position not unlike the physician/medical center owner who increases his profits by “churning” his patients/customers for more tests, procedures and follow-ups, whether they need them or not. The more “things” you do, the more money you get paid. For the pharmacists, the more prescriptions you fill, the more money you make. Currently, our drug delivery system is not set up to use the pharmacists’ expertise to professionally manage patient’s drug therapy. We simply sell the drugs behind the fasade of being the gatekeeper drug expert. We honestly would rather be concerned foremost with effectively managing your total drug consumption. The reality is far removed from theory. Our prevailing business environment simply does not permit such actions on a consistent basis. Sadly, the "drug expert" has been reduced to an overpaid cashier in one retail drug chain. I challenge all pharmacists to regain their professional calling; re-assert their use to the American people as a source of tremendous savings. Now is the time!! Take care of our grandmothers and grandfathers. Not simply as robotic technicians in a drug delivery system, rather as drug therapy managers and perveyors of healthy outcomes. But of course, the devil is in the details.