The New York Times published a piece last week that I find incredibly troubling. While not directly impacting the workers' compensation system, the article sheds light on our cultural proclivity to rely on prescription medication for uses that were not intended and are not appropriate. Further, it highlights the role of well-meaning medical practitioners who, in reality, are creating more harm than good.
Dr. Michael Anderson, a pediatrician in Cherokee County, Georgia, noticed that some of his patients were performing poorly in school. Unable to determine that anything was medically wrong with these children, Dr. Andersen assumed that the school itself was inadequate. He may be right about that. But his solution to the problem is shocking.
He prescribes Adderall.
He admits, according to the NY Times, that the ADHD diagnosis that he makes is "made up" and "an excuse" to prescribe the drug for the express purpose of boosting academic performance (Adderall improves focus and impulse control). Dr. Anderson goes on to say, "We've decided as a society that it's too expensive to modify the kid's environment. So we have to modify the kid."
Wow.
Later in the article, we come to discover that one of the kids prescribed Adderall began hearing voices that were not there and admitting to suicidal thoughts. Dr. Anderson's solution? A week in a psych hospital and a switch from Adderall to Risperdal. Problem solved. For now.
Gradually over the last half century, we have become far too comfortable with the idea that there is a pill to solve every problem, even when legitimate medical diagnoses don't exist. Struggling in school? Take a pill. We see this every day in workers' comp. Pain? Take a pill. Still hurts? Take a stronger pill. And take more of them. We have to focus on non-pharmacological solutions to social, environmental, and even biological problems.
Dr. Anderson acknowledges that no one knows the long term effects of pharmacological solutions like Adderral for academically under performing kids. But, he says, "I am the doctor for the patient, not for society." In reality, he is doing a disservice to both.
Michael
On Twitter @PRIUM1
I was equally appalled by that article last week and the physician’s arrogance concerning his 'solution'... very troubling to say the least.
ReplyDeleteThe aspects of pediatric care in psyc medicine are very troubling. As is the belief that adult meds are useful and appropriate for developing brains by prescribers is. We all are aware of marketing efforts, and the desire to help, but the aspect of endangering a child for life is not to be condoned. There is the opportunity for some progressive legal minds to take that aspect of the FDA approval for age. Move this off label use of a drug becoming being experimental. This being the case, the exclusion from benefits is based on contract terms and very strong based on Medicare/Medicaid regulations stating non-payment. If the drug is then adjudicated then the “false claims act” could be instituted ,bringing sever financial and liberty consequences. Look at the litigation that was filed in Alaska under their department of Medicaid services. Although dismissed at this time, it has the ability to return and make the department of Medicaid, prescribers and manufactures liable.
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