Is the Prescription Right?

American doctors write about 900 million prescriptions every year, and the vast majority of physicians are supremely confident that what they write is right. But is it? Last week an expert task force told the Secretary of Health, Education and Welfare that too many doctors know far too little about drugs. While few of the doctors "seem inclined to voice any question of their competency in this field," the study group concluded, "lack of knowledge and sophistication in the proper use of drugs is perhaps the greatest deficiency of the average physician today."

Headed by Dr. Philip R. Lee, who was an expert practitioner and careful prescriber in Palo Alto before he joined HEW, the group declared that "appropriate prescribing" means "the right drug for the right patient at the right time, in the right amounts, and with due consideration of relative costs." The failure of many doctors to achieve this ideal, said the group, traces back to medical schools, most of which give only one course in drugs and their use. Later, in practice, the physician gets most of his information on drugs from manufacturers' promotional material.

To help doctors raise their prescription skills, the Lee committee recommended federal financial support for expanded teaching about drugs in medical schools. It also proposed publication of a national drug compendium in which all lawfully available drugs would be listed, along with their effects, both good and bad. And it advocated compilation of "objective guidelines" to help doctors tailor their prescriptions to the patient's needs.

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