Saturday, May 3, 2008


Propagated by the pharmaceutical industry the term generic means common. Consumers have come to understand that a generic drug will be cheaper than the brand name medication. Patients have also come to understand that this generic prescription may not work as well as the branded alternative. Most let their pocket book make the choice accepting the fact that generic medications only have to provide 80% of the bioavaliability of the original product.

There are other ways that the practice of medicine opts for generics. In health care there is now generic care. Patients are frequently seen and treated by health care providers, not necessarily physicians, who care not for patients but for clients. The care itself is determined by algorithms, flow diagrams that have often been developed by insurance companies or governmental agencies based on research evidence. While evidence based medicine certainly has a role in patient care, it should not stand alone as the sole method of decision making in medicine.

Speaking with health care administrators (the business people who run hospitals, insurance companies, physician groups) one learns that the reason for these changes to physician surrogates and algorithms is to provide better health care and also to save money but not necessarily in that order.

Generic does mean common. Yet when people are ill, common in the last thing that they want. Most patients want uncommon care from uncommon caregivers that they know and trust. This trust is the hallmark of a good patient-physician relationship. This trust plays a vital role in healing. This trust is never generic.
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