I went to pick up a prescription the other day. I dutifully signed and paid, then looked in the bag.
There was a little bottle of pills, and with it an encyclopedia.
A new phenomenon in our risk-averse world is so called “over-warning”
The Archives of Internal Medicine defines this as an “exhaustive list of every reported adverse event, no matter how infrequent or minor.”
We all know the story of “wolf wolf.” That’s over-warning - and look at the consequence.
The eight and a half pages of strident warnings; general information; questions you should ask your doctor; questions your doctor should ask you: adverse effects: potential interactions comprising this “encyclopedia” that came with my medicine could be expected to put any patient off ever taking anything.
Maybe not such a bad idea? (It reminds me of the patient for whom I prescribed Xanax for her anxiety. But when she read the list of potential adverse effects, she was too anxious to take it).
In their otherwise excellent book, Top Screwups Doctors Make – And How to Avoid Them, Joe and Teresa Graedon of NPR “Peoples Pharmacy” fame rather severely chastise doctors for overriding interaction and adverse-drug-reaction (ADR) warnings.
I can tell you from experience of using several different computerized medical records (EMR), that about every medicine you write comes up with multiple warnings – pretty much to the point that if you don’t ignore them, you could not prescribe anything.
I am in full agreement with the Graedon’s concern about ADRs and interactions. But if we want prescribers to take note of the really dangerous ADRs/interactions, we need to stop EMR companies, and paranoid pharmacies from over-warning.
