There was nothing unique about that patient encounter except that it was my first appointment of 2017 and everyone at the office was buzzing about their New Year's resolutions.
It went like this:
Me: "Are you taking all of your medications?"
Patient: "Yes, of course."
Me: "Okay, let's review them. Do you remember what they are?"
Patient: "I am not sure, but they are all here." (Patient hands me a plastic bag brimming with orange pill bottles, boxes and over-the-counter containers.)
Me (in my head): Oh, brother!
That's when I made my resolution: In 2017, I will try to tip the balance: I will not only try to write fewer prescriptions, I will also try to get more of my patients off their drugs altogether.
The "why" was obvious to me: Too many patients are taking too many drugs, for too long, in too-high doses, suffering harmful effects.
The "how"? That was less obvious. Starting in the second year of medical school (course name: Pharmacology) and continuing through residency training and beyond, doctors are taught how to prescribe drugs.