PRESCRIPTIONS: Doctors' lack of drug training puts patients at risk

Most doctors agree that their role has been reduced from healer to that of drug peddler – and it seems they aren't very good at that, either.

Doctors' lack of knowledge of drugs and their use is so bad that the lives of patients is constantly put at risk, a group of leading pharmacologists has claimed.

Even the most conservative figures suggest that 1 in 16 hospital admissions is the result of an avoidable adverse reaction to a drug. Once there, up to 10 per cent of those will suffer another adverse drug reaction while in the care of a hospital doctor.

It's all the fault of the training hospitals, which are no longer teaching basic pharmacology and prescribing. "The competence of young doctors in prescribing is a very serious problem," says Prof Sir Michael Rawlins, chairman of the UK medical standards group, National Institute for Health and Clinical Excellence (NICE).

Ultimately, the blame lies with the General Medical Council, he says, which has changed the emphasis of doctor training to 'problem solving' rather than learning the basics.

The GMC issued its new teaching edict around 16 years ago, around the time when drug companies were coming up with more complex medications. The problem has been exacerbated more recently by the UK government's obsession with performance targets.

As a result, many clinical pharmacology departments had closed down, and there are just 68 specialists who practise clinical pharmacology and therapeutics in Britain , a fall of 24 per cent over the last 10 years. Of those that are left, half will retire in the next 10 years, and are unlikely to be replaced.

Prof David Webb, chairman of the Scottish Medicines Consortium, said medical students were privately expressing concerns at their lack of knowledge about drugs. "Patients are becoming ill and some are dying as a result of poor prescribing. There is no doubt about that. A substantial proportion of that is undoubtedly avoidable," he said.

This all bodes well for the drugs industry. With the last keeper of the gate removed, they can foist any new drug on the public without sufficient regard as to its safety. And they do.