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Prescription Writing: What it Means to the Dentist
P R E S C R IP T IO N W R I T I N G : W H A T IT M E A N S T O T H E D E N T IS T B y G E O R G E C . S C H IC K S , P h .G ., N e w a rk , N . J .
W ritin g a prescription has a professional significance. W hen a prescription is w ritten, any desired drug, and in the strength desired, may be employed. W hen the maximum and minimum doses ara known, the definite action that may be expected from the prescription is known. T h e use of an accepted proprietary dental preparation is not always satisfactory, as such a preparation comes always in the same concentration and combination. W ritin g one’s own prescriptions makes it possible to adapt the medication to the individual patient. Failure to w rite prescriptions has a very definite reaction, encouraging selfmedication. W h y ? Because the patient w ill seldom return when the same or a similar condition arises. H e w ill go to the drug store and buy another package of w hat he was told to get the last time he visited his dentist’s office, or he will get a full size container of the sample given him. T h e injustice to the patient becomes evident when he tries to clear up a self diagnosed and frequently entirely different mouth condition w ith the proprietary preparation he was told to buy previously. T oo often, in such situations, the patho logic condition gets beyond easy control before the patient returns to you or an other dentist. A patient w ill hesitate to get a refill of a prescription months later, as the original prescription is filed w ith the pharmacist, when the same patient would not hesitate to go to a drug store and call by trade name for a packaged product. T h e real injustice to the dentist arises when the patient attempts to alleviate one condition w ith a proprietary medication prescribed at a previous time and perhaps under different pathologic conditions. T h e patient may come to the conclusion that the dentist is incompetent and go elsewhere, or he may come to the dentist too late to be restored to his former condition. I should like to preface the following remarks with the statement that I am not waging a campaign against the honest m anufacturer of a nonsecret preparation with true claims as to its therapeutic action, but I find myself completely out of accord w ith the m anufacturer of a secret remedy or a medication w ith false claims. Advertising has become a tremendously powerful weapon to nostrum manufac turers. Seventy million dollars a year is spent by the makers and distributors of such medicines to promote their use by the public. Every conceivable method is used to popularize such products. If it were possible to determine w hat part of th at seventy million dollars is used to package and distribute free samples to mem bers of the medical and dental professions, the amount would undoubtedly be sur prising. Some products advertised under this seventy million dollar expenditure Jour. A.D.A., January, 1934
135
136
T h e Journal of the American D ental Association
do m erit the use by and the recommendation of the dental profession; but, from the maze of extravagant advertising, it is difficult to determine the true merits of a preparation. You are acquainted w ith the ways in which you are encouraged to take part in this intricate advertising scheme. I t has been said by men in your own profession that dentistry leads all other professions for exploitation by manufacturers of pro prietary or patented products. W hen the American M edical Association organized the Council on Pharmacy and Chemistry to investigate remedies peddled to men in its ranks, some of the quacks and fakers and makers of irrational remedies folded their tents and opened camp in your midst. Y our leaders saw the light and took steps to rid your ranks of cure-all venders, and your Council on D ental Therapeutics was organized to protect men in your profession. I t organized to determine the w orth of various drugs and products used in dentistry, of tooth pastes, tooth powders, mouth washes and gum medicaments. I t organized in order that dental practitioners might take the guesswork out of the use of medicaments and dentifrices. T h e Council is doing an excellent piece of work. If you wish to help make its w ork effective, if you wish to see dentistry freed of some of the cureall campaigners, there is at least one way to do it. Say “ N o !” to the next detailer who tries to give you free samples for distribution of a product not approved by your Council. Every wide-awake m anufacturer of a product which has scientific usefulness will do everything he can to comply w ith the requests of the Council. If his product does not meet the requirements of the Council and he w ill' not disclose its ingredi ents, beware! You should then know th at there is at least one respect in which his product does not meet the requirements of the Council. T h a t should be sufficient reason for you to refuse to make yourself an advertising medium for his product. T h ere may be a m anufacturer of a useful product who is representing it tru th fully and who may not have applied to the Council for approval. T here may also be some who have originally fashioned their product to meet the regulations of the Council and who do not seek acceptance. U nder such conditions, do not rely on the statements of the salesman. T h e Council is organized to provide scientific answers to such inquiries, and whether or not a proprietary product has been submitted by its maker for the approval of the Council, the latter w ill undoubtedly investigate such a product and send you a report. T h e demands it makes of manufacturers are fair and are aimed only to protect the interests of the dental profession. I t asks only that a product have some scientific or therapeutic reason for its existence, that the material does w hat its maker claims for it, th at its advertising is truthful and that it meets the other logical requirements of the Council as to composition, test and origin. T h ere is nothing unreasonable in such requests. It would seem then that any m anufacturer who could not or would not meet those demands should not find an outlet for his product among men in the dental profession. T h e distribution of free samples has an unprofessional aspect. I t not only makes the dentist an advertising medium for the m anufacturer, but each time the
Schicks— United States Pharmacopeia
137
form er gives a patient a sample, he indirectly places his stamp of approval on that product. T h e m atter does not rest there. T h e dentist not only approves the article, but also assumes responsibility for the effects of the preparation. These are very definite reasons that he should be thoroughly familiar w ith the merits of the product before he makes himself an advertiser of it. T h e day of the secret remedy is past. Every dental practitioner has a right to know— he must know— not only w hat medicaments he is prescribing, but also in w hat concentration and degree of purity they exist. Prescription w riting, then, should take on new significance. H ere is a practi cally untouched field. H ere lies a professional opportunity to intelligently adapt medicaments in the U .S.P. and N .F . to the individual needs of practice. Choose the pharmacist in the community who has always looked first to the scien tific aspects of his profession. I t is such a man who is prepared to do more than merely fill a prescription. Perm it him to w ork out special medicaments required for individual needs. H e will render such assistance as w ill most effectively aid the dentist in his work, and will advise him in the economics of prescribing. Pharmacy stands ready to serve professionally the members of the American Dental Association.
T H E U N IT E D ST A T E S P H A R M A C O P E IA : W H A T IT S H O U L D M E A N T O T H E D E N T IS T By GEORGE C. SCHICKS, Ph.G., Newark, N. J.
A t a time when travel was done by stage coach, and Indian arrows and tom a hawks made even a short journey precarious, D r. Lyman Spalding of New Y ork headed a small group of physicians in the first attem pt in this country to standardize drugs and preparations used in medicine. U n til this time, uniform ity in the use of therapeutic agents was seen only in the exchange of formulas and recipes among groups of physicians and apothecaries of the same locality. Different drugs and preparations were frequently designated by confusingly similar names, and not in frequently the same drug or preparation was markedly different in strength. I t is obvious that such a lack of system in nomenclature and standardization w rought even more havoc when drugs were called for on prescription. T hrough the influence of D r. Spalding and his co-workers, the United States was divided, for the purpose of carrying on this work of standardization, into four districts, N orthern, Southern, M iddle and W estern. Physicians in each district were asked to compile a list of drugs and therapeutic agents found by them to have thera peutic usefulness. T h e wisdom of such a standardization was readily apparent, but the perils of travel and the inadequate means of communication in those early days made it possible for only the N orthern district, comprising the N ew England states, and the M iddle district, made up of N ew York, N ew Jersey, Pennsylvania, D ela ware, M aryland and the D istrict of Columbia, to take part in the enterprise. Jour. A .D .A ., January , 1934-
W ritin g a prescription has a professional significance. W hen a prescription is w ritten, any desired drug, and in the strength desired, may be employed. W hen the maximum and minimum doses ara known, the definite action that may be expected from the prescription is known. T h e use of an accepted proprietary dental preparation is not always satisfactory, as such a preparation comes always in the same concentration and combination. W ritin g one’s own prescriptions makes it possible to adapt the medication to the individual patient. Failure to w rite prescriptions has a very definite reaction, encouraging selfmedication. W h y ? Because the patient w ill seldom return when the same or a similar condition arises. H e w ill go to the drug store and buy another package of w hat he was told to get the last time he visited his dentist’s office, or he will get a full size container of the sample given him. T h e injustice to the patient becomes evident when he tries to clear up a self diagnosed and frequently entirely different mouth condition w ith the proprietary preparation he was told to buy previously. T oo often, in such situations, the patho logic condition gets beyond easy control before the patient returns to you or an other dentist. A patient w ill hesitate to get a refill of a prescription months later, as the original prescription is filed w ith the pharmacist, when the same patient would not hesitate to go to a drug store and call by trade name for a packaged product. T h e real injustice to the dentist arises when the patient attempts to alleviate one condition w ith a proprietary medication prescribed at a previous time and perhaps under different pathologic conditions. T h e patient may come to the conclusion that the dentist is incompetent and go elsewhere, or he may come to the dentist too late to be restored to his former condition. I should like to preface the following remarks with the statement that I am not waging a campaign against the honest m anufacturer of a nonsecret preparation with true claims as to its therapeutic action, but I find myself completely out of accord w ith the m anufacturer of a secret remedy or a medication w ith false claims. Advertising has become a tremendously powerful weapon to nostrum manufac turers. Seventy million dollars a year is spent by the makers and distributors of such medicines to promote their use by the public. Every conceivable method is used to popularize such products. If it were possible to determine w hat part of th at seventy million dollars is used to package and distribute free samples to mem bers of the medical and dental professions, the amount would undoubtedly be sur prising. Some products advertised under this seventy million dollar expenditure Jour. A.D.A., January, 1934
135
136
T h e Journal of the American D ental Association
do m erit the use by and the recommendation of the dental profession; but, from the maze of extravagant advertising, it is difficult to determine the true merits of a preparation. You are acquainted w ith the ways in which you are encouraged to take part in this intricate advertising scheme. I t has been said by men in your own profession that dentistry leads all other professions for exploitation by manufacturers of pro prietary or patented products. W hen the American M edical Association organized the Council on Pharmacy and Chemistry to investigate remedies peddled to men in its ranks, some of the quacks and fakers and makers of irrational remedies folded their tents and opened camp in your midst. Y our leaders saw the light and took steps to rid your ranks of cure-all venders, and your Council on D ental Therapeutics was organized to protect men in your profession. I t organized to determine the w orth of various drugs and products used in dentistry, of tooth pastes, tooth powders, mouth washes and gum medicaments. I t organized in order that dental practitioners might take the guesswork out of the use of medicaments and dentifrices. T h e Council is doing an excellent piece of work. If you wish to help make its w ork effective, if you wish to see dentistry freed of some of the cureall campaigners, there is at least one way to do it. Say “ N o !” to the next detailer who tries to give you free samples for distribution of a product not approved by your Council. Every wide-awake m anufacturer of a product which has scientific usefulness will do everything he can to comply w ith the requests of the Council. If his product does not meet the requirements of the Council and he w ill' not disclose its ingredi ents, beware! You should then know th at there is at least one respect in which his product does not meet the requirements of the Council. T h a t should be sufficient reason for you to refuse to make yourself an advertising medium for his product. T h ere may be a m anufacturer of a useful product who is representing it tru th fully and who may not have applied to the Council for approval. T here may also be some who have originally fashioned their product to meet the regulations of the Council and who do not seek acceptance. U nder such conditions, do not rely on the statements of the salesman. T h e Council is organized to provide scientific answers to such inquiries, and whether or not a proprietary product has been submitted by its maker for the approval of the Council, the latter w ill undoubtedly investigate such a product and send you a report. T h e demands it makes of manufacturers are fair and are aimed only to protect the interests of the dental profession. I t asks only that a product have some scientific or therapeutic reason for its existence, that the material does w hat its maker claims for it, th at its advertising is truthful and that it meets the other logical requirements of the Council as to composition, test and origin. T h ere is nothing unreasonable in such requests. It would seem then that any m anufacturer who could not or would not meet those demands should not find an outlet for his product among men in the dental profession. T h e distribution of free samples has an unprofessional aspect. I t not only makes the dentist an advertising medium for the m anufacturer, but each time the
Schicks— United States Pharmacopeia
137
form er gives a patient a sample, he indirectly places his stamp of approval on that product. T h e m atter does not rest there. T h e dentist not only approves the article, but also assumes responsibility for the effects of the preparation. These are very definite reasons that he should be thoroughly familiar w ith the merits of the product before he makes himself an advertiser of it. T h e day of the secret remedy is past. Every dental practitioner has a right to know— he must know— not only w hat medicaments he is prescribing, but also in w hat concentration and degree of purity they exist. Prescription w riting, then, should take on new significance. H ere is a practi cally untouched field. H ere lies a professional opportunity to intelligently adapt medicaments in the U .S.P. and N .F . to the individual needs of practice. Choose the pharmacist in the community who has always looked first to the scien tific aspects of his profession. I t is such a man who is prepared to do more than merely fill a prescription. Perm it him to w ork out special medicaments required for individual needs. H e will render such assistance as w ill most effectively aid the dentist in his work, and will advise him in the economics of prescribing. Pharmacy stands ready to serve professionally the members of the American Dental Association.
T H E U N IT E D ST A T E S P H A R M A C O P E IA : W H A T IT S H O U L D M E A N T O T H E D E N T IS T By GEORGE C. SCHICKS, Ph.G., Newark, N. J.
A t a time when travel was done by stage coach, and Indian arrows and tom a hawks made even a short journey precarious, D r. Lyman Spalding of New Y ork headed a small group of physicians in the first attem pt in this country to standardize drugs and preparations used in medicine. U n til this time, uniform ity in the use of therapeutic agents was seen only in the exchange of formulas and recipes among groups of physicians and apothecaries of the same locality. Different drugs and preparations were frequently designated by confusingly similar names, and not in frequently the same drug or preparation was markedly different in strength. I t is obvious that such a lack of system in nomenclature and standardization w rought even more havoc when drugs were called for on prescription. T hrough the influence of D r. Spalding and his co-workers, the United States was divided, for the purpose of carrying on this work of standardization, into four districts, N orthern, Southern, M iddle and W estern. Physicians in each district were asked to compile a list of drugs and therapeutic agents found by them to have thera peutic usefulness. T h e wisdom of such a standardization was readily apparent, but the perils of travel and the inadequate means of communication in those early days made it possible for only the N orthern district, comprising the N ew England states, and the M iddle district, made up of N ew York, N ew Jersey, Pennsylvania, D ela ware, M aryland and the D istrict of Columbia, to take part in the enterprise. Jour. A .D .A ., January , 1934-