By U. Seruk. Transylvania University.

In 2004 buy trazodone 100mg on-line treatment yeast infection home, researchers found a link on recall rather than daily symptom depression or adjustment disorder discount trazodone 100mg visa medications restless leg syndrome. Letters of violation Box 1 summarizes the types of disease- be burning the lining of her esophagus. Accessed 7 March link between morbidity and prescribing in the exaggerates prevalence rates. National Prescribing Service (2004) Sertraline for a treatment and (2) to insist on “Help-seeking” and other disease awareness (Zoloft), fluoxetine (Lovan, Prozac) for prescreening of adverts by a government communications by or on behalf of drug premenstrual dysphoric disorder. Accessed 7 Better definitions are needed of the prescriptions of terbinafine in primary care. Therapeutics Initiative (2003) Do statins have (2002) Prevalence, incidence and stability to ensure consistency with assessed a role in primary prevention? Moynihan R, Cassels A (2005) Selling sickness: of benefit should be based on clinical 14. Letter (2005) Warning letters and untitled is sufficient political will among to Anne Rochon Ford, June 16, 2004. European Commission (2003) Community References in healthy postmenopausal women: Principal code relating to medicinal products for human 1. Moynihan R, Heath I, Henry D (2002) Selling results from the Women’s Health Initiative use. Brown B, Standing Committee on Health Gynaecologists of Canada (2006) The criteria for medicinal drug promotion. Available: report on health aspects of prescription (Ontario): The Society of Obstetricians http:⁄⁄mednet2. Assessing current awareness could provide a basis for further research, leading to the Disease Mongering among Medical development of effective measures that will raise awareness levels and motivate students to participate in future and Pharmaceutical Students campaigns that seek to combat disease mongering. Jairaj Kumar, Abhizith Deoker, Ashwini Kumar, Most medical and pharmaceutical students in India are Arunachalam Kumar, B. Articles have been published warning the profession about disease mongering [5–7], but for the most part these warnings have not been heeded. One is reminded of Aristotle, who so rightly observed that “truth could influence only half a score of men in a century, while falsehood and mystery would drag millions by the nose. The questionnaires were distributed greater problem because the restrictions on drug dispensing among a random sample of 250 final-year medical and 250 are very limited—drugs often being dispensed without a final-year pharmaceutical students. Of the medical students, 30 out are poor and illiterate, and lack information on health care, of 199 (15%) were able to explain disease mongering with they often visit local pharmacists or quacks for medical relevant examples. Pharmacists routinely dispense drugs illegally over of 207 (55%) were able to do so, suggesting that awareness the counter. We visited 40 local pharmacy stores for medical of the problem was much greater among these students. Pharmaceutical promotional campaigns in India, unlike All the students, both medical and pharmaceutical, those in developed countries (where pharmacists have little said they had frequently seen drugs dispensed without influence on drug sales), are not only aimed at changing prescription. They had also often seen patients visit local the prescribing habits of physicians but also at pharmacists pharmacists for medical advice. However, both the medical and various schemes and incentives (including television sets, the pharmaceutical students were unaware of the incentives motorcycles, and the opportunity for higher profit margins) offered by drug companies to pharmacists for buying their to lure pharmacists into buying more drugs than they would drugs, which lead to unethical dispensing. As a result, the pharmacists make every effort We believe that our small project, despite its inherent to sell these drugs to patients visiting them for medical advice. They may also associate themselves with quacks or physicians Pharmaceutical students, who are exposed to the drug in their efforts to shift their stock of the drugs. We are written with the help of money that comes from drug believe that this situation demands proactive action on the companies [8]. We need to make a more concerted attempt part of the medical profession and also of the government. We do not wish India to be government should undertake major initiatives to ensure in the same position as the countries of the West, where that drugs are only dispensed with a prescription from adverse drug reactions are responsible for a significant a licensed physician. Medical associations and medical proportion of hospital admissions and require millions of college administrators should alert their members to outpatient visits and corrective measures.

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The Canadian Medical Association’s Policy on Physician Health Key references and Well-being emphasizes that physicians should be aware of Armstrong A cheap 100mg trazodone visa medications you can take when pregnant, Alvero R buy trazodone 100mg medicinebg, Dunlow S, Nace M, Baker V, Stewart the essential components of well-being, such as rest, exercise, E. They identifed four risk factors for a disrupted quences of work-home interference among medical residents. In addition, • describe some interventions that can improve the personal many doctors are embarrassed to fnd that they need relation- relationships of physicians. They are often “wounded healers” who have already faced stressors that make them vulnerable to mental illness, Case or who have undiagnosed mental health problems (e. Most of the residents in the such problems are likely to be compounded in spousal rela- program have intimate partners, and several have children. Although the One of the residents told the program director that this onset of relationship diffculties can be insidious, physicians resident had not had a chance to spend meaningful time should be alert to the warning signs, such as more frequent with their partner, with the exception of a yearly vacation. Useful strategies that develop and safeguard intimacy in a relationship include: protecting time to communicate with one’s partner; reading Introduction about the dynamics of relationships; attending a marital retreat; Certain traits that seem to go with the territory of medicine attending couples therapy; and taking time to manage one’s can have a detrimental effect on physicians’ personal lives. Refection for educators Warde and colleagues, reported increased marital and parental Get to know the spouses and signifcant others in the lives satisfaction have been closely associated with a decrease in of the residents in your program early on in residency confict between professional and familial roles. Educate residents’ spouses about the physician the confict between the demands training and home-life, and health resources available to their families (e. These individuals are often the frst to in both parental and marital satisfaction. Adequate vacation time, fexible Case resolution work hours and equitable part-time work are conditions of The program director organizes a day-long retreat for the employment that are conducive not only to improved family residents and their signifcant others. The program director life and mental well-being but also to greater job satisfaction brings in a well-known speaker to discuss issues surround- and productivity. Physicians are most satisfed as parents when ing physician health, including work-lifebalance, ways to they have a supportive spouse and when the work–home con- maintain healthy intimate relationships, and recognizing ficts of both partners are minimal. The resident body fnds the expe- medical practice can also affect physicians’ relationships with rience very useful and decide to make this an annual event their children. For instance, Armstrong’s group, found that to help prevent family stress related to residency training physicians who worked for a salary were more fulflled in their and to help recognize the roles that each of their families parental role than physicians who worked on fee-for-service play in their own residency program. Finally, the employment status of one’s spouse seems to play a role in parental satisfaction. It is also im- medical families, and portant to value the work and other pursuits of one’s partner, • explore challenges specifc to those relationships. Case As seductive as the practise of medicine can be, Michael Myers A resident requests a meeting with their supervisor over reminds us to “say yes to the relationship and practise say- coffee. The resident becomes distraught while disclosing ing no to other offers” (Myers 2001). Spend a minimum of that she miscarried her frst pregnancy three weeks ago twenty minutes alone with your spouse each day and plan a and that her partner, a more senior resident, is preoccu- date together every week. The resident acknowledges that her partner has tried Monica Hill and Nancy Love quote the novelist Henry James to be supportive, but feels that “he just doesn’t get it. Unbalanced criticism, defensiveness, Successful marriages and similar partnerships are built on ridicule, a posture of superiority, and “shutting off ” are poi- knowledge, friendship, fondness and admiration (Gottman sonous to this process (Hill and Love 2008). For physicians as for anyone else, this means having population, domestic violence and abuse occurs in medical time together to develop the essential advantage of such rela- families too. It includes affection, expressiveness, sexuality, cohesion, compatibility, autonomy Dual-physician relationships and confict resolution (Myers 2001). Confict between work and familial roles is inevitable at times, whether one or both partners are physicians. Classically, role Work and family life strain has been more frequently noted among female physi- The issue of deferring intimacy in favour of medical work has cians, but in reality male physicians experience it as well. Half been described in the literature on medical marriages (Myers of married women physicians are married to other physicians 2001 and Gabbard 1989). Dual-physician relationships bring sional advancement over the nurturing of intimate relation- certain challenges, such as complicated schedules and career ships, working long hours at the expense of their home lives. Careers postpone their investment in the “emotional bank account” of can be shaped, reshaped and salvaged more easily than rela- their families or in some cases, avoid admitting that they in fact tionships and families. Paradoxically, however, “the marital interests can be satisfying, which can lead to greater mutual relationship is the main source of coping with the stress of understanding, support and shared parenting (Schrager et al medical practice” (Gabbard 1989).

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