By Genevieve Yates
Warning: The following article contains brand names which may be
offensive to some readers.
Recently I attended a weekend CPD event sponsored by a pharmaceutical company. Naturally suspicious of such funded meetings, I was somewhat reassured when told that the sponsors had no input whatsoever into the meeting’s content and that there would be neither brand promotion nor brand names mentioned. “As it should be”, I thought.
The almost ubiquitous use of brand names by GPs has always irked me. I recall being a 5th year med student, my mind brim full of generic drug names together with their indications, adverse effects and contraindications. Despite my pharmacological prowess, I floundered in my student GP rotation that year, adrift in a sea of unfamiliar names. “What the hell is Endep? Oh, amitriptyline. I know it’s harder to spell, but there’s a principle involved!” Having been lectured on the evils of drug companies by ivory towered academics, I was horrified by what I saw as widespread corruption in GP land.
I spent much of my residency perched loftily on my high horse. My black and white stance seemed to be justified by the hospital’s policy regarding use of brand names in medication charts: it was a death-by-firing-squad offence. Still largely unfamiliar with any of the brand names, I had many an opportunity to shake my head and “tsk tsk” as I flipped through MIMS and ‘translated’ the medication lists in letters from GPs. Fuel was added to my fire when I saw a confused, bradycardic, hypertensive elderly woman who had been self administering Noten, Tenormin, Atahexal and Tensig, believing they were different medications. My letter back to the woman’s GP was a little condescending and preachy, I’m ashamed to admit.
Fast forward a decade or so, and I here I was at this conference, staring at a PowerPoint slide trying in vain to remember which sulphonylureas were which. Glimepiride, Glibenclamide, Glicazide, Glipizide… they all sounded so damn similar. The relative merits and risks of the different sulphonylureas were being outlined but the teaching points were lost on the predominantly baby-boomer-GP audience who knew the drugs only by their brand names.
“Which one is Amaryl?” a 50-something-year-old GP seated next to me whispered.
“I’m not sure,” I confessed. “I wish they would just tell us the brand names.”
I horrified myself. What had happened to old me: the paragon of virtue in a grubby corporate world? When I had gone over to the dark side? I’d thought myself incorruptible.
Overall, the weekend was excellent; I came home informed, enthused, and determined to re-ignite my generic flame.
The first patient I saw post-conference requested repeat scripts for Zanidip and Coversyl Plus. I spent several minutes changing his list of five hundred or so medications to their correct generic names and gave him his requested prescriptions.
“What are these Doc? You gave me the wrong ones!”
I patiently explained drug naming conventions and the rationale behind my rediscovered crusade.
“Bloody political correctness strikes again. It’s all bullshit!”
“It has nothing to do with political correctness. It is about good medicine and… Oh, never mind.”
“Can you just change the computer back and write the scripts like you usually do so that I know what the hell they are?”
I won’t give up though. I refuse to completely surrender my youthful ideals but perhaps I will temper them somewhat. With my first few grey hairs has come an increased tolerance to life’s shades of grey.
Written August 2010.