Money and fame talk—and sometimes, even those who have taken an oath to “do no harm” listen, and let their financial and personal interests supersede their better judgment.
An unfortunate example is Dr. Conrad Murray, Michael Jackson’s personal physician who, last week, was charged with involuntary manslaughter in the King of Pop’s death. Giving Jackson propofol, a medication designed to induce anesthesia, as a sleep aid, the cardiologist went outside the proper use of the drug as well as his own level of expertise. While it’s unclear whether Jackson had an addiction problem, he was reportedly using a variety of heavy meds, including daily injections of the narcotic pain reliever Demerol. A responsible physician would have looked at Jackson’s drug-seeking behavior and evaluated the possibility of substance abuse. But instead, Murray appears to have let celebrity and maybe a handsome sum of cash cloud his medical reasoning.
Few doctors are fortunate—or in Murray’s case, unfortunate—enough to treat one of the most famous recording artists of all time. But celebrities aren’t the only ones willing to pay physicians top dollar to feed their prescription drug dependence. In a disturbing CNN segment that aired last Wednesday, reporters investigated the prevalence of pain management clinics in South Florida that essentially sell prescriptions to substance abusers and dealers. Once again, the temptation of easy money leads to a reckless misuse of medicine.
As a doctor of internal medicine who has been practicing for 17 years, I believe that Murray and the docs on the CNN program are anomalies in what is still a caring field. However, even docs with great integrity may be unknowingly over-prescribing medications and contributing to a patient’s substance abuse. Because I treat men and women who are recovering from addiction, I closely monitor my patients’ medications and curtail the dosage if I feel it’s no longer appropriate.
For doctors in private practice, I recognize that monitoring is more difficult and the risk of abuse may not always be forefront in their minds. But physicians in any setting must be hyper-vigilant. This means looking at patterns and examining whether complaints match actual symptoms. It means scaling back if a patient’s dose and length of use seem to exceed their medical needs. Although the perception of pain varies, we must use our best judgment to prevent misuse—before it’s too late. While few of us would go to Dr. Murray’s extremes to satisfy a patient, his reckless behavior should serve as a wake-up call to all of us.Christopher Randolph, M.D. Medical Director, Phoenix House
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