| The problem in my mind, that the parent is intimating at, is that we confer far too much control to and assume far too much competence and beneficence on the part of physicians. I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it. The entire drug regulation system is predicated on the idea that you have certain providers, namely physicians, who are competent to make decisions, and shifting that decision-making power to those providers protects us from harm. The opioid crisis has demonstrated that whole paradigm is faulty. The problem is that no one profession should be entrusted with that level of power or command over decisions. Imagine, instead, a system where there was no drug regulation. Rather than assuming that physicians were making the best decisions about opioid use and sweeping the problem under the rug, such use would be constantly scrutinized. We need more competition, and fewer gatekeepers. Gatekeeping means there's only one thing that needs to be breached. |
Going outside recommended guidelines can be very very expensive for a physician.
The understanding of opioid use has clinically changed drastically in the last 40 years, similar to SSRIs in the last 70 years.
Not that I do not agree with your premise, but the issue seems to be much more institutional and related to human, research, and implementation error than a bunch of individual bad actors.
https://www.guideline.gov/