Doctors Hand Out Pills, Pills and Still More Pills


Americans who visited a doctor's office in 1999 were far more likely to receive more than one drug than U.S. patients were in 1985, a new government survey of physicians shows. The increasing reliance on prescription medicines spanned all ages of patients and almost all classes of drugs, with the notable exception of antibiotics.

About 66% of visits to doctors in 1999 resulted in patients receiving a medicine or a vaccine, compared with 61% in 1985. And those given prescriptions, especially seniors, were much more likely to get multiple drugs, said Catharine W. Burt, chief of the ambulatory care statistics branch at the National Center for Health Statistics, which conducted the survey.

The increase in prescribing "is just a lot more than we would have expected just from the aging of the population," Burt said.

More and better medicines are on the market now than in 1985, experts said. New guidelines also have led doctors to treat many conditions more aggressively, often by using more than one drug.

But the survey's findings also suggest that drug advertising, including the promotion of drugs to the public, may be contributing to the trend.

"The ones that are heavily marketed are, in fact, heavily prescribed," Burt said.

"Modern medical science has made a huge amount of progress since 1985, particularly for chronic illnesses that older people suffer from," said Christine K. Cassel, chairwoman of geriatrics at Mount Sinai School of Medicine in New York. Because people are living longer, they "are taking more medications because they have chronic conditions."

On the other hand, she added, direct-to-consumer advertising "has made a huge impact on sales of medications which are not always the best medications for people to take."

The new information comes from a survey of a representative national sample of office-based physicians. It shows that medication (usually a prescription) was provided at 501 million of the more than 756 million visits to the doctor that Americans made during 1999.

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