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PHYSICIANS DISCUSS
IMPROVING USE OF DRUG THERAPY
M
ORE effective teaching of drug therapy is equally obnoxious methods. Time after time urged by Dr. Austin Smith, secretary of the opportunity has arisen to point out the necessity A. M. A.'s Council on Pharmacy and Chemistry, of insisting that hospital formularies contain only in a paper which offers constructive criticism useful agents offered undcr fully descriptive and specific suggestions to improve the physi- name~ ." cian's prescription writing. Because of the rapid advallces in dru g therThere has been much discussion, Dr. Smith re- apy, the study of rational drug therapy mu st also ports, since the former president of the American be pursued actively by the licensed practitioner. Medical Association, Dr. H. L. Kretschmer, Some indication of the need for this contin'uatioll pointed out deficien<;ies in the prescribing habits of education can be gained simply by examininR of many physicians. Comments from one well- items available in the average pharmacy, Dr. known educator carry an implication that the Smith observed. pharmacist may be in a position to help improve "The shelves of almost all drugstores contain the situation. The young medical practitioner packages of substances which have little or no dreads the writing of prescriptions, the educator therapeutic value. A colleaguc of minc, Dr. stated, because he lacks confidence that he may E. P. Jordan, inquircd of a prcscription pharmaexpress his desires correctly, because he is in cist in a Chicago loop drugstorc and learn cd that doubt concerning the best combinations and this 'dead stock' is an important item t o be commixtures, and because he fears criticism from puted in the annual store report and th at probthose who might observe his errors. He urged ably it would be considerably higher in the ordithat four groups teach prescription writing: nary drugstore than in a pharmacy devoted to pathologists, clinicians, pharmacists, and physi- prescriptions. cians who have graduated in pharmacy. "Inquiry then was made of a pharmacist in a In answering the argument that there is less suburban neighborhood and the inquirer learned need to teach prescription writing and pharma- that in this suburban store there was about $3000 cology since drug manufacturers now "provide worth of dead stock which soon would have to be little ampuls which can be broken for injection thrown away. Most of the items reached the and tablets which can be given by mouth, all of store through a physician'S prescription and from them being accompanied by profusely descrip- 70 to 80% of this material probably came from tive literature," Dr. Smith said: smaller a nd less well-known manufacturers. " ... No manufacturer has yet been able to offer These preparations were ordered because a physianything which will serve as a substitute for cian prescribed new or unusual drugs, ointments clinical judgment. The manufacturers have or the like but failed to use them more than once done much to advance our knowledge concerning or twice. the use of drugs. They have made funds avail"Obviously medical or direct mail advertising able for research. They have conducted original or the local activities of detail men were the fac research and they have sought better relations tors largely responsible for the prescribers using with those who are best qualified to evaluate these preparations before consulting such groups clinically new drugs. However, it should never as the Council on Pharmacy and Chemistry or be forgotten that the medical school is the place former teachers who are in a position to supply a to lay a foundation for a knowledge of drugs .... " scientific evaluation of claimed therapeutic merit. "This situation results in criticism from the After commenting on various methods of improving the teaching of drug therapy i:q. medical pharmacist, unnecessary financi.al expenditure colleges, the secretary of the Council pointed out by the consumer, financial loss by the druggist that a progressive attitude in formal education and frequent loss of patient confidence by the must be continued during the hospital training. physician. It is no credit to the medical profes"So far as the use of drugs is concerned," said sion," physicians were told, "when pharmacists Dr. Smith, "the intern ought to be shown an ex- state that they can tell what detail man is calling ample by the experienced men on the staff and on doctors in their neighborhood by the type of sho~ld see only the best of drug therapy. prescriptions that begin to fl ow into the phar"He should not be forced to use hospital form- macy." ularies which list remedies by number or other - J. Am. Med. Assoc., 130: 559 (Mar . 2), 1946. 256
IMPROVING USE OF DRUG THERAPY
M
ORE effective teaching of drug therapy is equally obnoxious methods. Time after time urged by Dr. Austin Smith, secretary of the opportunity has arisen to point out the necessity A. M. A.'s Council on Pharmacy and Chemistry, of insisting that hospital formularies contain only in a paper which offers constructive criticism useful agents offered undcr fully descriptive and specific suggestions to improve the physi- name~ ." cian's prescription writing. Because of the rapid advallces in dru g therThere has been much discussion, Dr. Smith re- apy, the study of rational drug therapy mu st also ports, since the former president of the American be pursued actively by the licensed practitioner. Medical Association, Dr. H. L. Kretschmer, Some indication of the need for this contin'uatioll pointed out deficien<;ies in the prescribing habits of education can be gained simply by examininR of many physicians. Comments from one well- items available in the average pharmacy, Dr. known educator carry an implication that the Smith observed. pharmacist may be in a position to help improve "The shelves of almost all drugstores contain the situation. The young medical practitioner packages of substances which have little or no dreads the writing of prescriptions, the educator therapeutic value. A colleaguc of minc, Dr. stated, because he lacks confidence that he may E. P. Jordan, inquircd of a prcscription pharmaexpress his desires correctly, because he is in cist in a Chicago loop drugstorc and learn cd that doubt concerning the best combinations and this 'dead stock' is an important item t o be commixtures, and because he fears criticism from puted in the annual store report and th at probthose who might observe his errors. He urged ably it would be considerably higher in the ordithat four groups teach prescription writing: nary drugstore than in a pharmacy devoted to pathologists, clinicians, pharmacists, and physi- prescriptions. cians who have graduated in pharmacy. "Inquiry then was made of a pharmacist in a In answering the argument that there is less suburban neighborhood and the inquirer learned need to teach prescription writing and pharma- that in this suburban store there was about $3000 cology since drug manufacturers now "provide worth of dead stock which soon would have to be little ampuls which can be broken for injection thrown away. Most of the items reached the and tablets which can be given by mouth, all of store through a physician'S prescription and from them being accompanied by profusely descrip- 70 to 80% of this material probably came from tive literature," Dr. Smith said: smaller a nd less well-known manufacturers. " ... No manufacturer has yet been able to offer These preparations were ordered because a physianything which will serve as a substitute for cian prescribed new or unusual drugs, ointments clinical judgment. The manufacturers have or the like but failed to use them more than once done much to advance our knowledge concerning or twice. the use of drugs. They have made funds avail"Obviously medical or direct mail advertising able for research. They have conducted original or the local activities of detail men were the fac research and they have sought better relations tors largely responsible for the prescribers using with those who are best qualified to evaluate these preparations before consulting such groups clinically new drugs. However, it should never as the Council on Pharmacy and Chemistry or be forgotten that the medical school is the place former teachers who are in a position to supply a to lay a foundation for a knowledge of drugs .... " scientific evaluation of claimed therapeutic merit. "This situation results in criticism from the After commenting on various methods of improving the teaching of drug therapy i:q. medical pharmacist, unnecessary financi.al expenditure colleges, the secretary of the Council pointed out by the consumer, financial loss by the druggist that a progressive attitude in formal education and frequent loss of patient confidence by the must be continued during the hospital training. physician. It is no credit to the medical profes"So far as the use of drugs is concerned," said sion," physicians were told, "when pharmacists Dr. Smith, "the intern ought to be shown an ex- state that they can tell what detail man is calling ample by the experienced men on the staff and on doctors in their neighborhood by the type of sho~ld see only the best of drug therapy. prescriptions that begin to fl ow into the phar"He should not be forced to use hospital form- macy." ularies which list remedies by number or other - J. Am. Med. Assoc., 130: 559 (Mar . 2), 1946. 256