To Medicate or Not to Medicate

When doctors prescribe medicines for pretty much every ailment, some people protest. Is it really necessary? Don’t the medicines have side-effects? Are the doctors getting a kickback for prescribing certain medicines? How will the immune system ever develop? Won’t germs become more resistant if we over-use such medicines?

On the other hand, doctors who recommend that the patient let the illness run its course are taking a chance. Will the patient just go to another doc who’ll prescribe medication? Will such a patient give a bad rating (online or verbally) about the doc to the clinic/ hospital/ friends?

I realized how complicated this whole topic can be as I read Nassim Nicholas Taleb’s Antifragile. Taleb mentioned that centuries back, a doctor, Ignaz Semmelweis, noticed that more women seemed to die giving birth in hospitals than giving birth on the street. His findings were dismissed, partly because the news didn’t suit the medical community; but also because he had no theory to explain this (germs had not been discovered back then; and hence the need for doctors and nurses to sterilize or wash hands was not a practice back then). Others wondered if it was just random: was the sample size large enough to warrant such a conclusion?

You’d think that in the West where healthcare is insured, insurance companies would prefer that doctors avoid medication unless really needed and thereby act as a counter-weight to the pharma industry that would push for more medication. And yes, that does happen to some extent.

On the other hand, governments often make certain vaccinations mandatory for kids in all schools. But why? Doesn’t that violate every question asked in the first paragraph of this blog? Paresh Talwalkar explains. He points out that kids who are vaccinated are immune; but additionally, by definition, they can’t spread the disease either; both of which are good things for everyone around. Now consider a parent who has heard of side-effects of the vaccine and is not keen to get his kid vaccinated. Further, he reasons: if everyone else gets the vaccination and my kid doesn’t, he’ll still probably be OK. This train of reasoning leads to the question:

“Why put your child through a vaccine shot if you don’t have to?”

But if too many people didn’t vaccinate their kids, then the risk of the disease spreading increase. Worse:

“This has a further effect of making the vaccine less effective–because even people who are vaccinated have a lower risk, but they can still catch the disease.”

And so game theory dictates that governments make such vaccinations mandatory!

To medicate or not to medicate: it’s not a simple topic, is it?