One of the negative side effects of modern medicine is the negative side effect of modern medicines interacting with each other. This wasn’t always the problem it is today, for one simple reason ‒‒ patients never used to see so many different types of doctors on their own.
Dr. David Barile, medical director at Princeton Care Center and who is board certified in internal medicine, geriatric medicine, and hospice and palliative medicine, calls the problem “the prescribing cascade.”
It is a common pitfall in modern medicine that patients take it upon themselves to see specialists for ailments, without first speaking to their primary care physician, Barile says. For example, a patient will go to a cardiologist to look at his heart, then a gastroenterologist to look at his belly, and so forth.
But by bypassing the primary care physician, no one person is at the center of a patient’s medical treatments. Consequently, one specialist prescribes a medicine, another prescribes another, and so on. All these medicines, Barile says, create side effects that the patient thinks is a new illness. So he goes to a pulmonologist because now he’s having trouble breathing, and the pulmonologist gives him something that causes another side effect, and the cycle continues.
To help rein in the rampant over-prescribing and redundant medicines, Barile now runs the Comprehensive Geriatric Assessment (CGA) program on Tuesday, Wednesday, and Thursday mornings at Princeton Care Center on Bunn Drive. The program helps older patients by providing a holistic overview of the medicines and treatments they receive ‒‒ and which could be doing them a lot more harm than good.
The program examines all medicines and types of care and looks at the goals of the treatments elder patients receive. Exams are conducted in Dr. Barile’s office and include drug interaction screenings, cognitive and functional screening, advance care planning, and much more. The summary is sent to the primary care doctor and all of the physicians involved in the care of the patient.
This program, by the way, is covered by Medicare.
Dr. David Barile, Princeton Care Center, 728 Bunn Drive, Princeton. 609-924-9000. www.princetoncarecenter.com.