Chasing Rainbows? Part I
Chasing rainbows or pursuing dreams�.what's the difference? During my growing up years, I was fortunate to have very practical, hard-working parents that instilled a desire to do well and pursue my dreams. They wished for my brother and I many things they were not able to experience, including an opportunity for higher education. In fact, from both my patents' sides of the family, I was the first college graduate and my brother was the second. They had a dream for us and we all pursued it.
Pursuing a dream means that you have a goal and you plan and work towards reaching that goal. Chasing rainbows is "pie in the sky" or wanting something that either is not realistic or when one does not want to "pay the piper" or put in the effort that is required to become educated and/or qualified to be able to reach that goal. That goal is either unrealistic, unachievable, or just not attainable. As an example, in junior and senior high school, I wanted to go to college, get a degree in engineering and become a navy fighter pilot. It became unrealistic, unachievable and not attainable due to my poor eyesight in one eye. I was extremely disappointed but realized I had other opportunities. My mother worked in a small local chain of drug stores where I spent a lot of time and enjoyed what pharmacists were doing. My dream, then, changed to become a pharmacist, which was realistic, achievable, attainable and ultimately realized.
It's easy to come up with grandiose ideas that we think we want to do. Have you ever had any of those? Actually, these ideas keep coming, but with age, comes a good dose of reality and the realization that we "can't do it all". We must find what we can do, what we are educated to do, what we are qualified to do, what we have the facilities/wherewithal to do, what we have the circumstances to do and what we are willing to give up to achieve that dream.
Yes, there is a difference between idealism (chasing rainbows) and realism (pursuing dreams). What is possible or real in pharmacy practice? First of all, we must always keep the "pharmaceutical" (manufactured or compounded) within the profession. Many other health professionals would love to take over the "product" but it is our lifeblood and the basis for our profession.
Second, we must always be "realistic" about our activities and what we can do. Notice I did not say what we would "like to do" but what we "can do". We do not practice in a vacuum but within a social, political, professional, regulatory, legal, ethical structure where we have some limitations on our activities. The bottom line here is that if it is possible to go after a new activity, we must be able to get reimbursed for it or we cannot sustain it��.each activity must be financially sustainable. Even though we would like to give our services to everybody at little or no charge, it is not realistic. The activities need to be such that we are pursuing a dream, not chasing rainbows.
I'm afraid that many are going to be chasing rainbows with Medicare Part D because it may not be economically sustainable. Also, large corporations (General Motors in Oklahoma City, for example) are realizing that they cannot provide full health insurance coverage for their employees and are looking at cutting back or eliminating coverage and I understand that this is happening across the nation with other corporations.
Let's consider the question, "Is full health care coverage for all citizens realistic?" Obviously, I think we are finding that it is "chasing rainbows" and not "pursuing a dream". This is not meant to be a negative uncaring statement, but a statement of reality. It's easy to get caught up in new programs (governmental or otherwise) to later find out that they are not workable. In fact, we may get to the era where we only can afford "catastrophic health coverage" and all routine minor and even major coverage is covered by the individual. We may also get to the time where health insurance covers only "life-threatening" situations (medical care and pharmaceuticals) and does not cover "life-style" situations (medical care and pharmaceuticals) brought on by an individuals lack of self-discipline where society pays for their poor decisions. I'm not sure we can continue to afford to pay for the poor judgment of others. Obviously, we would love to do so but we would only be chasing rainbows; our current path may result in a collapse of our healthcare system that is already being predicted by some.
We need to be realistic and pursue a dream of what is real and attainable.
More on "Chasing Rainbows" next week
Loyd V. Allen, Jr., Ph.D., R.Ph
Editor-in-Chief |
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More than 60 article citations with links to abstracts and publishers were added to the CompoundingToday.com Literature Search Tool. See them all at CompoundingToday.com's article search page. The breakdown of articles and topics are:
- Sumatriptan and naproxen in migraine (3)
- NADH in cognitive disorders, especially Alzheimer's disease (3)
- Magnesium in the prevention of migraine (6)
- Bevacizumab in macular degeneration/edema (3)
- Arnica in surgical bruising/wound healing (18)
- Aminopyridines (especially 3,4 diaminopyridine) in neuromuscular disorders (especially multiple sclerosis) (34)
Here is a sampling of these articles:
- Demarin V, Podobnik SS, Storga-Tomic D et al. Treatment of Alzheimer's disease with stabilized oral nicotinamide adenine dinucleotide: A randomized, double-blind study. Drugs Exp Clin Res 2004; 30(1): 27-33.
- Michels S, Rosenfeld PJ, Puliafito CA et al. Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clinical study. Ophthalmology 2005; 112(6): 1035-1047.
- Peikert A, Wilimzig C, Kohne-Volland R. Prophylaxis of migraine with oral magnesium: Results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia 1996; 16(4): 257-263.
- Smith TR, Sunshine A, Stark SR et al. Sumatriptan and naproxen sodium for the acute treatment of migraine. Headache 2005; 45(8): 983-991.
- Solari A, Uitdehaag B, Giuliani G et al. Aminopyridines for symptomatic treatment in multiple sclerosis. Cochrane Database Syst Rev 2003; 2: CD001330.
- Stevinson C, Devaraj VS, Fountain-Barber A et al. Homeopathic arnica for prevention of pain and bruising: Randomized placebo-controlled trial in hand surgery. J R Soc Med 2003; 96(2): 60-65.
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