Our Sore Expectations

By Almas Shamim

“Ye to haalat hai G.B.Pant ke doctor log ka!” my friend fumed, seemingly exasperated by the unsatisfactory prescription for her runny nose. One does not go to a doctor only to be told to take paracetamol and cetirizine! Obviously, a doctor is supposed to do much more- or should I say- ‘prescribe much more’?

Indeed, there are many instances when requisite medicines are missed, but the example quoted above is nothing more than a beacon of danger, to put it in the mildest way. Let me remind you that my friend had presented herself only with a ‘runny nose’. She had no other symptoms or signs, whatsoever. So her expectation, which she so eloquently spelled, of being prescribed some more medicines, was unfounded. These expectations form a major factor in forcing many doctors to adopt the unethical practice of prescribing unnecessary medicines. And one of the most abused categories of medicines is that of antibiotics. It is not uncommon to see patients diagnosed with a ‘viral fever’ prescribed some or the other antibiotic, even though the doctors know well enough that the antibiotic cannot treat the ‘viral fever’ in itself, but only help cure the accompanying bacterial infections, if any. Many doctors prescribe these medicines only to avoid the situation mentioned above as an example- of the patient complaining about NOT been given more medicines. A private sector doctor may be scared that an unsatisfied patient might not come back to his/her clinic the next time (meaning a lost chance of earning money!) and so the doctor prescribes a list of vitamin and mineral tablets, syrups for indigestion, a randomly thrown in antibiotic and maybe a few more- so that when the patient leaves the clinic, s/he not only has a lighter pocket (having spent at the pharmacy which is so often attached to private clinics) but also a feeling of gratitude and satisfaction towards the doctor. A government sector doctor might not be bound by the money factor in his prescriptions- probably that is why govt. sector prescriptions have been found, through research, to be less irrelevant than prescriptions by private doctors- but s/he still depends on patients for building up trust of the public on the health system of the state. In short, all doctors are influenced, in some way, by the NEED for more medicines among their patients.

Such unnecessarily prescribed medicines have a lot of serious outcomes on the patient and the state. For one, we might be consuming a tablet that will NOT improve our health any further, simply because our body never needed it in the first place; but these medicines will continue to bring about their side effects on our bodies. Secondly, sometimes these medicines might not be available at the government pharmacy and could burn a hole in our pockets when we try to buy them from ‘outside’. Thirdly, and this is quite an irony, the unnecessary use of some medicines among some patients may translate to the unavailability of the same medicines for other patients who might ACTUALLY need them. And lastly, the unnecessary use of antibiotics may lead to resistance to these antibiotics and they may NOT be effective on us in the future (while continuing to cause their side effects).

So, while it is undoubtedly true that no doctor should prescribe medicines unreasonably, it should be interesting to see how, sometimes at least, WE and our sore expectations shape our doctors’ prescriptions. It will be a good practice to try and ask our doctors the purpose of each of the drugs on our list and also confirm from our doctors if all the pills are really necessary. While the doctor may not go back and change the prescription instantly, and you may also not be able to judge if the medicines are really necessary or not, it DOES help to bring to your doctors’ knowledge that the patients are AWARE and unnecessary prescriptions are NO LONGER NEEDED and WILL NOT BE ACCEPTED anymore. 

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi and can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it.