Sit back for six minutes or so and enjoy every line of Bohemian Polypharmacy – a parody of Queen’s classic, Bohemian Rhapsody. This time around, it’s a song all about polypharmacy – which is what we call it when we are taking more medicines than we need to. This is yet another brilliant gem from Canadian pharmacist and professor Dr. James McCormack, with lyric help from David Scotten and creative input from Pete McCormack. Great vocals are by local Victoria band Aivia members Liam Styles Chang (lead) and Shae Scotten (background).
Dr. James McCormack is half of the brains behind Therapeutics Education Collaboration (TEC), home of the highly entertaining (and educational) BS Medicine podcast (the BS stands for, of course, Best Science). His partner in crime is family physician Dr. Michael Allan. Here’s how they describe TEC:
“The best way to describe us is that we are the ‘mythbusters’ of drug therapy.”
“Put simply, our goal is to provide physicians, pharmacists, nurses, nurse practitioners, physician assistants, other health professionals and the public with current, evidence-based, practical and relevant information on rational drug therapy.
“Thanks to our listeners, we have become one of the most popular medical podcasts on the web. We try to keep the information provided in our podcasts practical and relevant so clinicians can incorporate this information into their day-to-day practice. Humour, because evidence can be really dull, plays an important role in all our presentations.”
Dr. McCormack adds this ‘Coles Notes’ approach to skeptical thinking for health care providers when considering prescription drugs:
UNTIL PROVEN OTHERWISE, I ASSUME THAT . . .
1) When I read a clinical trial, the conclusion is wrong;
2) When I review a patient’s medication history, the drugs and the dose they are taking is wrong;
3) When considering ordering a clinical test, the test is not needed;
4) When reviewing clinical practice guidelines, most recommendations are opinion-based, not based on data from well-designed randomized controlled trials, and do not apply to my patient’s values;
5) Finally, when a new drug comes out, it provides no advantages over what is already out there.
See also:
- When drugs that help turn into drugs that harm
- The New Therapeutics: 10 Commandments
- Take statin drugs “when diet and exercise are not enough”
- How to deal drugs: Big Pharma’s dirty little tricks
- Six not-so-simple steps toward protecting us from dangerous drugs
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The Ethical Nag 
What do I think? I think you’ve written yet another important article. Thank you.
Specifically:
5) Finally, when a new drug comes out, it provides no advantages over what is already out there.
So true. A new drug is often fast-tracked to get on the market too soon ($$) and hasn’t been proven by years of use in patients. A new drug is often a means to gain $$ when a previous one is ‘going generic’, not because it’s better.
Thanks for this, Cave. In many ways, the patients who end up using the new drug in real life represent the (unregulated) final stage of drug development.
James and Mike are voices that inspire and educate MANY doctors…at least they’ve done that for me for 10 years. And I am grateful. Check out James’ “Choosing Wisely” YouTube video!
Hi again Dr. Mark – love that video! (Readers, check Dr. Mark’s views on the new AHA cholesterol guidelines here and his preferred Absolute Cardiovascular Disease Risk/Benefit Calculator developed by Dr. James McCormack.
This is great.
I’m not anti-meds one bit, but they need to be worthwhile. Now I happily take meds for 2 endocrine conditions, but those make a huge difference in my life. Twice I simply stopped taking statins (got my arm twisted because of family history) and now refuse to resume them. That decision dismayed some PCPs and cardiologists, but that really seems to have been “cookie-cutter” medicine. These same people dismissed my suggestion of the cardiac condition that I actually do have, just as they refused to recognize and treat the endocrine condition that I do have (and had diagnosed myself.)
My husband’s doc put him on blood pressure meds because he was “PRE-hypertensive.” He was only even that after they drastically lowered the threshold. He felt terrible and kept cutting his dose until finally he quit. In the last couple years he has reduced his blood pressure by integrating more exercise into his life.
And that’s working just fine, thanks.
Hi Kathleen and thanks for sharing your perspective here. You bring up an interesting dilemma with the sudden growth in “PRE” diagnoses. We’re now diagnosed with PRE-diabetes or PRE-hypertension or even osteopenia which is kind of like PRE-osteoporosis – all of which is very good news indeed for the drug industry. I feel a new blog post coming on . . . 😉
” I feel a new blog post coming on . . . ;-)”
Please do! I’ll be waiting. The meds for osteopenia thing is a big shuck.
I agree. See also: We Never Imagined People Would Think of Osteopenia as a Disease from February 2010.
Not even so much the conclusion is wrong (number 1) but it was spun to be the best conclusion money can buy. Or the data was massaged so as to get exactly the conclusion sought.
Hi Dr. Joe – nice to hear from you again.