Bedside Medicine and Public Health: A controversy?

Article type: Research Article

Authors: van Boxtel, C.J.

Affiliations: Professor Emeritus of Clinical Pharmacology, University of Amsterdam, Amsterdam, The Netherlands

Note: [] Address for correspondence: Professor C.J. van Boxtel, Korte Velterslaan 10, 1393 PB Nigtevecht, The Netherlands. Tel.: + 31 294 251448; E-mail: cvboxtel@xs4all.nl.

Abstract: It has to be realized that rational drug use has become one of the most difficult, complicated and challenging medical responsibilities, for governments but certainly for practicing doctors and it therefore deserves considerable time and intellectual interest of all prescribers. Drug education, i.e. clinical pharmacology, has to be the cornerstone here. Probably because of the fact that the WHO approach has to be a public health approach, much of the material on drug subjects produced by WHO and intended for emerging countries makes the false impression of simplicity. However, it seems that the WHO strategies are not very effective. As an example, the 5th edition of the essential drug list of China shows a dramatic increase in the number of drugs in comparison with the WHO model list. It is certain that with public health advice alone you cannot amend the disturbing fact that at the moment drugs are among the 6 main causes of death. Approaching rational drug use from a public health perspective and then presenting it as an objective that can be achieved by rather simple means is very attractive for authorities who then can focus on the costs of drugs alone. It is also attractive for Medical Schools in order to reduce pharmacotherapy teaching in the medical curriculum. Therefore, in an era where we are experiencing an epidemic of drug induced morbidity and mortality and as long as pharmacotherapy teaching is so abominable in all medical curricula, WHO should have an active policy to stimulate the discipline of clinical pharmacology to help doctors in making responsible decisions for their patients.

Journal: International Journal of Risk and Safety in Medicine, vol. 18, no. 3, pp. 145-149, 2006