Wednesday, July 15, 2009

Regulate doctors, not propofol

Today we hear the DEA is considering making propofol a controlled substance, with the same level of scrutiny of distribution as narcs and benzos. Though Michael Jackson's toxicology reports have not been made public, everybody is concentrating on propofol as the culprit. I have a better idea. Why don't we regulate and punish these unethical doctors that led to this tragedy in the first place.

Propofol is a wondrous drug, revolutionizing the practice of surgery and anesthesia with its ease of administration, predictable efficacy, and rapid emergence. Many outpatient surgical procedures would not be possible, or would be more difficult, if it were not for propofol being widely available. Patients wake up quickly after propofol anesthesia, with very little side effects. This property of propofol allows the patients to recover quickly, letting them go home sooner. This lets surgery centers operate more efficiently and lower their costs. They can schedule more cases each day instead of waiting around for a recovery room full of patients to wake up.

If propofol becomes a controlled substance, the process of acquiring and using it becomes more cumbersome, slowing efficiency. Sure we would still have access to propofol, just like we can use morphine and versed now. But having to account for every drop of propofol that is used on a patient, like we do for morphine and versed, will inevitably slow down the operating room. When a vial of narcotics is not accounted for, the whole operating room practically shuts down until it is found. Yes propofol can have addictive properties. But deaths from propofol addiction are very rare. Alcohol kills thousands more people each year than propofol. Alcohol is also a mind altering substance but you don't see the government locking up all the beer in this country.

Instead we should be concentrating on getting rid of these doctors that are giving medicine a bad name. Where do celebrities find these "physicians"? MJ's personal doctor reportedly isn't even board certified in Internal Medicine or Cardiology. Was he the one who brought the propofol into the house? Who was the anesthesiologist that was reportedly travelling with MJ in the 1990's on his concert tour? MJ was supposedly getting propofol every night to help him sleep.Who referred Anna Nicole Smith to her doctors. What about Heath Ledger, or Elvis? Celebrities or their handlers always seem to be able to find these doctors that have no ethical fiber in their being. These so called doctors, if found to have contributed to the deaths of their patients by overprescribing or abusing medications, should be prosecuted to the maximum extent of the law. As a board certified anesthesiologist, I hate to say medicine needs more regulations. But we need to put the fear of God, or the DA's office, into all physicians to help prevent any more wasted lives.

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