Wednesday, April 9, 2014

A Terrible Year for Conjunctivitis

Where are all the eye infections? I’ve seen so few over the past year that I’ll discard half a dozen bottles of antibiotic eye drops when they reach their expiration date.

I carry thirty-two drugs. I don’t like to send guests searching for a pharmacy in a strange city, so I hand out whatever they need whether it’s a week of antibiotics or a tube of antifungal cream. I’m also generous with cough medicines, decongestants, expectorants, laxatives, and other over-the-counter remedies. I know that many patients including you don’t expect medicine whenever you see a doctor, but we in the profession get that impression.

When I restock, my order must be large to avoid a big handling fee. This becomes awkward when I run low on a critical drug such as prescription eye drops. I can’t allow myself to run out, and I can’t order other essentials such as antibiotics or antivomiting drugs until I need them because of the expiration date. I also can’t shrink my inventory by prescribing them when they’re not necessary.

This is where useless drugs come in handy (I’m stretching a point; it’s not certain that cough remedies, decongestants, expectorants et al don’t work, but researchers who conduct studies have trouble showing that they’re superior to placebos).

As I run low on important drugs, I become more generous with the others. This is easy because minor respiratory infections are every doctor’s most common ailment. For weeks, I’ve been loading up guests with sniffles, colds, “sinus,” “bronchitis,” flu, and similar bugs with every elixir, gargle, capsule, or lozenge in my possession. Soon I’ll run low on enough medication to eliminate the handling fee when I restock.    

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