Thursday, May 17, 2012
Doctors are the ones who should decide what medicine you need

By Dr. Anthony Policastro When I took pediatric night call in the past, I would get many phone calls. I was usually covering for another doctor so I did not know the patients that were calling in. Some of the calls were just questions. Some were requests. Occasionally I would get calls that were more like telling me what to do. In those instances, it was usually a call from a mother. She would tell me she knew what was wrong with her child. She knew what medication her child needed and she wanted me to call it in to the pharmacy. My usual response was that I would see the child and the mother would tell me it was not necessary. The mother knew the diagnosis and the needed treatment. I usually would leave it that if they wanted to come see me they could do so. However, I was not willing to prescribe medication for a patient that I did not know. I recently received two complaints about other physicians to review for the Board of Medical Licensing and Discipline. The complaints were both the same. A patient wanted a specific medication and the doctor would not prescribe it so the patient filed a complaint. There are several aspects of this to address. The first has to do with complaints to the board. The board reviews complaints to make sure that a physician does not violate the Medical Practices Act of the State of Delaware. Nowhere in that act does it say that a physician has to prescribe medication that the patient desires. For that reason, a physician will never be in violation of the act by choosing not to prescribe a requested medication. These complaints imply that there is a problem. A patient can choose which physician they want to see. They can be evaluated by that physician. They might have medication prescribed. If they do not want that particular medication, they can have that discussion with the physician. However, if the physician decides not to choose the medication they desire, patients have the option to choose another physician. What is not an option is to complain that a physician did something wrong. I have a chart of the different ADHD medications in my office. I will often take it out to discuss it with patients. If they have a preference, I will discuss it with them. I will tell them the pros and cons of the various medications. Together, we will make a decision on the best medication for their child. The second aspect of prescribing medication is related to the first. There is no question that patients know their bodies better than a physician does. There is no question that patients frequently know which medications work best for them. However, that is only a small part of what treatment involves. Physicians spend four years in medical school to learn about disease processes. They learn about medications and what works best for a particular diagnosis. They then spend an additional three to seven years in a residency program. That helps them to hone and focus on all the things they learn. The result is that there is anywhere from 7 to 11 years of information and experience that go into making a decision about what medication to prescribe. A patient who tells a physician that he or she knows better about what medication to use is basically saying that their experience of dealing with one patient means more than all the experience of the physician. They might have some insight that the physician does not have. However, they do not have all the necessary information. They do not realize that the physician is the one responsible for the medication that is prescribed. The physician will be held liable if he/she agrees to do what the patient wants and the patient is wrong. There is currently a move at the federal level to increase the number of medications that can be purchased over the counter. If that happens, patients can have more latitude in treating themselves. However, right now many drugs can only be obtained with a prescription. The reasons for that are multiple. Physicians spend a lot of time both in the classroom and in treating patients over a number of years. A patient might indeed have some good ideas about what works for them. However, if they want a physician to write a prescription, they need to have some respect for the physician's abilities. They should agree to an examination if that is requested. They are also free to choose a physician who is willing to work with them to address their particular issues.

Alzheimer's Association soiree The Alzheimer's Association Delaware Valley Chapter will host An Affair to Remember: Sparkling Memories, Sunday, May 20, from 11:30 a.m. to 2:30 p.m. at Harry's Savoy Grill and Ballroom in Wilmington. This sophisticated soiree will feature brunch items, chilled champagne drinks, a Champagne and Diamonds raffle, live music from the Philadelphia String Quartet, and a silent auction. The Philadelphia String Quartet is one of the most sought after live musical acts in the Delaware Valley, and they are sure to impress all attendees with their generation-spanning musical collection. Another exciting feature of the event is the Champagne and Diamonds Raffle, featuring a certified diamond, donated by Carl Doubet Jewelers, which will be awarded to one guest at the conclusion of the event. John DiEleuterio, the state director for former Senator Ted Kaufman will serve as emcee. To register for this fundraising event, contact Katie Macklin at 800-272-3900 or Tickets are also available online at Community CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child, or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements.

Cost is $40. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Free dental clinic Maryland's Eastern Shore Mission of Mercy (MOM) clinic will offer a two day free dental clinic the weekend of March 13-17, 2013, at the Wicomico Youth & Civic Center in Salisbury. The focus of this mission is to provide treatment of immediate dental needs to the under served populations on the Delmarva Peninsula. Anyone 19 years of age or older is eligible to receive services including extractions, restoration (fillings) or cleanings. All of the treatment will be provided by volunteer board registered dental and medical professionals at no cost to those receiving care. For more information and to sign up to volunteer, call 443-365-5776 or visit Stewards of Children presentation Nanticoke Memorial Hospital is hosting a Stewards of Children Presentation on ÒHow to Protect Your Children from Sexual Abuse. This training session will take place on Wednesday, May 23, from 5:30 to 8:30 p.m. at Nanticoke Memorial Hospital. Cost of the session is $10 per person to cover the cost of course materials. Stewards of Children is a primary prevention, sexual abuse prevention training program that educates adults to prevent, recognize and react responsibly to child sexual abuse. Provided is a three hour training, the program is presented by an authorized facilitator. An interactive workbook and accompanying video are utilized to share the message that adults are accountable for the safety of children. To register or for more information, contact Kathy at 629-6611, ext. 3910. Rommel's ACE supports WSW For the third year in a row, representatives from Women Supporting Women will be at six Rommel's ACE stores (Ocean City, Salisbury, Selbyville, Seaford, Cambridge and Exmore, Va.) accepting donations and sharing information about their mission Ð to provide awareness, education and support for those affected by breast cancer. From 10 a.m. to 2 p.m. every Saturday in May, shoppers can make a difference in the lives of women with breast cancer. Over the past two years, customers have contributed nearly $12,000 to Women Supporting Women. For more information about Women Supporting Women, visit For more information about Rommel's ACE, visit

First aid classes Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid on Tuesday, May 15 from 6:30 to 9:30 p.m., at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants ages 13 and up. The course covers cognitive learning, role-playing, and skill practice. Cost is $30. Payment and registration is required by no later than five business days prior to the class. Late registrations (if seating is available) will be an additional $5 fee. To register, or for more information, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Milford Memorial Hospital Fair The Bayhealth Milford Memorial Auxiliary sponsors the 55th Annual Milford Memorial Hospital Fair on Saturday, May 19, from 10 a.m. to 4 p.m., on the grounds of Milford Middle School. The entire family will enjoy a Civil War re-enactment, the 4th Annual Tricycle Race, children's games, stock car track, strolling entertainer, rides and inflatables, a petting zoo, great food, crafts, and vendors' booths, as well as a full schedule of entertainment throughout the day that includes the Milford's Got Talent Show. There will also be a special tent offering free health screenings and the Planetree Carnival showcasing Bayhealth's Planetree model of patient-centered care. The kick-off to the 55th Annual Milford Memorial Hospital Fair will be a pulled pork or chicken dinner plus flower and book sales on Friday evening, May 18 from 5:30 to 7. To purchase tickets for the dinner, call George Caccamise at 302-422-6815. Raffle tickets are $2 each or six tickets for $10 and may be purchased in the Reflections Gift Shop at Milford Memorial, Retail Shop at Kent General, EcoChic Boutique and Dolce in downtown Milford or by calling 302-233-8448. Winning tickets will be drawn at the end of the fair. Net proceeds from this year's fair will be used to purchase equipment for the surgical units. Visit for more information. For questions about the fair, call Kim Wilkins at 302-430-5719.

New Parkinson's Support Group A new Parkinson's Support Group has started in Seaford. The group's first meeting was held on April 16, at the Nanticoke Senior Center. There were 24 people in attendance, half with Parkinson's, and half caregivers. The May meeting and all future meetings will be held on the third Monday of each month from 10 to 11:30 a.m. at the Senior Center. The agenda for the May meeting will be a discussion of the National Parkinson Foundation's (NPF) ÔHospitalization' Initiative. All members will be given a NPF Hospitalization Kit. Lunch and a social period will immediately follow the meeting. The group will focus on educating members about Parkinson's through guest speakers and small group discussions. Persons with other movements disorders are welcome to join the group as much of what is discussed is not limited to Parkinson's. The value of exercise will be continually stressed and an exercise class for the group will be started in the near future. New members are encouraged to attend. Reservations or advance notification is not required. For more information, call Dennis Leebel at 302-644-3465.