Drugs That Are Requisite

SINCE the outbreak of war we have had much valuable instruction and advice on the exercise of economy and the avoidance of extravagance and waste. It is our duty to apply this teaching in our professional as well as in our privat.e life, and to practise the strictest economy in the use of dressings and in prescribing medicines. This does not mean that a drug which is considered necessary in treatment should be withheld simply on grounds of expense; it does mean, however, that before ordering a costly drug a practitioner should satisfy himself that the same therapeutic effect cannot be obtained with a less costly drug. Over forty per cent. of the population of the United Kingdom are entitled to the services of panel doctors, whose duty it is to order at the expense of the Drug Fund such drugs as are requisite for treatment, and whose responsibility it is to ensure that unnecessary charges are not imposed on the Drug Fund. It follows that a practitioner should never request his panel patients to buy medicine. On the other hand, if a panel patient should be bold enough to ask his doctor to prescribe a particular medicament, such as malt and cod-liver oil, tincture of iodine, olive oil, etc.-and I am told that in some practices this is fairly common-the (loctor should, of course, make the patient understand clearly that he must prescribe what in his judgment is necessary, but that he cannot at the cost of public funds pander to a patient's desire by prescribing what in his judgment is unnecessary. It may be that the patient's uninformed faith in such substances and in much advertised drugs will be so strong as to lead him to purchase them himself-and the British public spends some £30,000,000 a year in this way-but the doctor shoul(d not make himself a party to such action. It would appear that in private practice there is no rational method of pricing prescriptions either by chemists or (iispensing doctors. Even if. the ingredients of a mixture cost but a shilling, the price charged for a bottle of medicine is usually from half a crown to three shillings; and the same charge may be made by the doctor for a bottle of medicine as for a consultation andl a bottle of medicine, from which the patient readily deduces that a consultation costs nothing and that what …