Casey Tuck - Lockwood | LinkedIn (original) (raw)
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- Michael Golub MD Doctors’ Emotional Connections…to Prescription Drug Brands? As residents of a brand-saturated culture, we all know how important brands are in our lives. For example, and to be extremely specific, the Pantone green shade (PMS 3425 C) of the Starbucks logo has a positive visceral effect on me. This reaction is triggered, no doubt, by the conditioning effects of their powerfully caffeinated beverages on dopamine release in my brain over the course of a lifetime. When it comes to patients, it is easy to understand how someone could come to love a medication, based on how quickly and reliably it relieves their distressing symptoms. Conversely, many people come to hate a medication, because of the burdensome nature of the dosing, the taste of the liquid, or the unpleasant side effects. But what about doctors? Are prescription drugs simply simply tools of their trade that they view in a neutral, dispassionate manner? I think not. I maintain that doctors can have strong emotional reactions to Rx medications. When I practiced emergency medicine, there were some medications in which I had great confidence and which I enjoyed administering because of how well, how quickly, and how consistently they worked. IV adenosine for supraventricular tachycardia comes to mind. Being able to control an SVT instantly with a simple injection made me feel wonderful, powerful, almost god-like. Other medications made me uncomfortable through repeated associations with negative situations. For example, ketorolac (an injectable NSAID) was introduced with great fanfare as a potent non-opioid pain reliever. But, as soon as we started using it, patients whom we suspected of drug-seeking behavior claimed to be allergic to it. This led to a series of stressful and contentious encounters in our emergency department. And consider the challenging matter of drug compliance. How often do doctors prescribe medications while suspecting, in the back of their minds, that their patient will not take the drug as recommended because its dosing schedule is unrealistic? How does that make doctors feel? Then there are the high-priced treatments that the doctor knows, even as they prescribe the medication through the EHR, will lead to pushback from the payor based on cost or prior authorization requirements, leading to additional paperwork and treatment delays. These are just a few examples of a curious, sometimes impactful, though rarely discussed, emotional aspect of being a prescriber.
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