The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1896-09-27
SELF-PRESCRIBIN PATIENTS.
One Cause of the Decrease in the
Work of Physicians.
Medical Record.


To such as have studied the causes of the
present decline in professional work it be-
| comes serious question whether there are
not other elements than those attributable
to stringent business rela tons that explain
the condition. While the science of medicine
has made great progress in the methods of.
diagnosis and treatment the physician
finds, that his vocation, although more hon
orable and useful, is really less remuner-
ative. and his legitimate practice is proper
tlonately curtafled. There is no less sick
ness ne IN TN, rne morla ou1 the aumoef Oh
the sick ones are inclined to get the better
of the doctor and to act more or less indie
pendently of his direct ministrations. 1t is
not difficult to understand why this is so,
when consider the vast number of per-
So4s "ho WllIinSLy Sleiu " Tue sloM,hS
habit OF prescribing for themselves. This
tendency is fostered by the belief, in the
majority of cases. that such prescribing is
tacitly sanctioned by the profession itself
by the use of many of the legitimate rene
dies frequently ordered for the relief of
the more common ailments. There is a
very reasonable foundation for this convic-
ton, and its responsibility rests more
less on the prescriber himself At the bot
tom of the whole business Is the prevailing
practice of delivering private clinical lee
lures TO the patient on the nature, extent,
the indications for the use of special drugs
in the treatment of certain conditions.
While this may give evidence of remarkable
learning on the. part of the medical adviser
and may help for the time being to estab-
lish his methods in the confidence of his
client it too often educates the recipient
into the presumption of thinking and acting
for himself. The most superficial knowl-
edge is all that is necessary to this end
and. easily persuading himself that he has
a repetition of the malady of which he has
had such an authoritative opinion. he
either repeats the prescription at will or
purchases his former remedy in open mar
ket at the counter of the obliging phar-
macist. Quinine. phenacetin. saiol. NOR
phine. pepsin. the mineral laxatives and a
host OF other much-used medicines are
given the currency of indispensable house
hold articles To such persons a diagnosis
is a useless refinement. it being sufficient
for their special purpose that their physi-
clan has given explicit directions how to
use the supposed harmless remedies under
what the patient believes to be similar cir
cumstances. Not only this, but the remedy
is freely prescribed to all his friends who
are willing to trust to the blind chances
of having a like azifnent
With shame be it said that very many
of the pharmacists, far from discouraging
such practices, not only willingly abet
them but offer special inducements to pur-
chasers by peddiing the fayorite prescrip-
tions of well-known physicians. These
drug sellers, for they deserve no more Dig
nihed title. do not prescribe themselves,
but are willing to recommend the prescrip-
ton of another, charging a round price for
the trouble of dispensing it. When it is
understood that the physician knows of
this. it is not difficult to explain why so