COVER STORY: Pill-popping folly

2009/12/01

ZUHAILA SEDEK

Feeling sick? ZUHAILA SEDEK tells you why self-medication is dangerous and
ill-advised. MANY people opt for self-medication in cases of headaches, stomach aches or the flu. But do they realise that common illnesses sometimes hide a more serious health problem? For example, a slight back pain could indicate fatigue, but it could also point towards a serious spine problem, which obviously cannot be addressed with a simple massage.

According to Malaysian Medical Association (MMA) president Dr David Quek, some symptoms can appear to be quite straight-forward but they must be taken in context where a trained mind (read: medical doctor) can make a reasonable and rational diagnosis.

“Medical practice is not as simple as many people think.

“It is too easy to make mistakes. With minor ailments, the adverse effects may be mild and not long-lasting because most times, our bodies are quite resilient and self-healing,” he said.

But for serious ailments, he added, a wrong self-diagnosis can lead to a delay or missed opportunity for treatment.

“It could endanger life or create serious complications,” he warned.

Having the convenience of the Internet at your fingertips is another reason why many people opt for self-diagnosis.

“We assume that our symptoms are exactly as described on some Internet sites. This is fraught with danger. There could be misrepresentation or mistaken identification.

“Training and specialised education help to develop and hone such clinical acumen and expertise among doctors.

“This is not possible by simply reading up on something without proper guidance and training." Another concern is the ease with which medication is bought at pharmacies, often without prescriptions.

This is probably another contributing factor why people opt for self-diagnosis.

“Of course, in the case of simpler ailments, fever medications, pain killers, cough medicines, external non-steroid creams and ointments can be bought over-the-counter (OTC).

“This OTC list usually comes with adequate public knowledge that such self-medication practices are proven safe and with very low potential for self-abuse or adverse side effects,” he stressed.

But Dr Quek said that all other medicines need the prescription of doctors who are trained to decide after a history of physical examination and tests.

“While pharmacists are professionally trained to know about medication effects, interactions and safety issues, they are not sufficiently trained to be diagnosticians.

“They are a critical part of the health care system but their role is not that of a physician," he emphasised.

“You should always get a doctor to give you a proper prescription,” he said.

Malaysians should not cite financial constraints as an excuse to justify self-diagnosis and self-medication.

“The cost of medical check-ups in Malaysia is very reasonable.

Health care is hugely subsidised but people don’t readily appreciate its value,” said Dr Quek.

He feels that many simply do not feel the need to budget for healthcare or place it as important as saving money for house renovations or buying a new car.

“Hopefully this attitude will change. It boggles the mind that some people will not spend on their health and are willing to take chances with it,” he said.

As for traditional or complementary health practices, his advice is that people should be wary of the evidence, “or lack of it”.

“Don’t be gullible in believing every suggestion that is poorly proven or based on the testimony of a few people. Be more critical and, above all, be more knowledgeable. Search for better and authoritative sources of information,” he added.

Why people do it WHY do people opt for self-diagnosis and self-medication? Saving time and money are two common reasons cited.

Hotel manager Annuar Zahary, 28, who recently married and is expecting his first baby, is convinced that self-medication works whenever he is unwell.

“I would not go and see the doctor whenever I am feeling slightly sick. Why should I spend unnecessarily when a strip of Panadol worth RM2.50 works just as well?,” he asked.

“Of course, I can also go to the general hospital but the long wait puts me off. It’s a big waste of time,” he said.

For Marco De Booij, 50, from Holland, who has been residing in Malaysia for nine years, the ease of buying medication at the pharmacies in Malaysia has always be a source of amazement to him.

“In Europe, no one can purchase any medication without a doctor’s prescription,” he said.

Anna Haycox, 36, meanwhile, opts for self-medication if she’s having a fever or cough. I buy my own medication as I’d get the same medication if I saw a doctor,” she said.

She depends a lot on the Internet when researching what medication is suitable.

“It’s very important that you check the source of the information,” she stressed.

Another individual, Yani Dulce Mamora, said that working at a healthcare centre has opened her eyes into the importance of consulting a specialist when she feels that there is something wrong with her body.

“It isn't quite right to do your own diagnosis. I think most of the time we take our health for granted. We often stock up on painkillers at home and make our own assumptions based on what we read or see.

“Worse, at times we choose to ignore the symptoms too. I used to assume that I knew everything. It is advisable to go see a doctor when you are sick,” she emphasised.