Communication Is Critical In The Physician-Patient Relationship

Tuesday, April 21, 2015

Striking one in every five adults and 300,000 children, arthritis is the leading cause of disability in the United States.  As an arthritis patient myself, and a patient advocate with the Arthritis Foundation, I am proud to advocate on behalf of millions of Americans diagnosed with arthritis – many right here in Tennessee. 

In 1982, when I was in kindergarten, I was diagnosed with juvenile rheumatoid arthritis.  I’ve been on every arthritis drug you can name in the last 31 years and have had multiple surgeries on my hips, knees, ankles, toes and jaw.  

Thanks to advances in medicine and science, arthritis patients can live out productive and fulfilling lives. It is important to note that these medications cannot repair prior damage – but they work wonders with inflammation and help keep me functioning going forward. 

These advances include biological medications that are treating many conditions, including rheumatologic diseases – but are also making a difference in oncology, neurology and dermatology.  This includes but is not limited to arthritis, cancer, Parkinson’s and certain skin issues. 

This year, the Food and Drug Administration approved the first biosimilar – complex versions of biological medications that are highly similar but not identical to their innovator counterparts.  More biosimilars are expected in the near future. 

I believe, as many others do too, that biosimilars hold great promise.  Biosimilars may provide less costly therapies and access to new and different medications.  However, at the end of the day – nothing is more important to me than the relationship I have with my physician, and the course of treatment that we decide on together as a team.  

I want my physician to be notified so that we both know if a substitution has occurred.  The substitution might be fine and perhaps a new biosimilar might even work better – but I still want to know what drug I’m on and I want my physician to have the same information – especially if there are any side effects, adverse reactions or other issues.  

At the end of the day – this is about patient safety and having up-to-date medical record information.  I want to be informed as a patient, and I always want my physician informed.  In order to ensure that physicians are receiving the most accurate information pharmacists need to communicate which biologic is actually dispensed whenever there is an interchangeable biosimilar that may be substituted. 

Thankfully, the Tennessee legislature is taking up this important issue in the form of House Bill 572 and Senate Bill 984 that seek to create a pathway for biological substitution.  This legislation enhances patients’ access to new and potentially less costly medication. But most importantly, it will ensure that pharmacists are communicating critical and up-to-date medical information to physicians. 

A failure to do this would leave an incomplete medical record. 

Advances in medicine and science are providing greater options for families, but this need not mean that it should be done at the expense of the physician-patient relationship. 

I commend the legislature for addressing this issue – particularly bill sponsors Senate Majority Leader Mark Norris and House Health Committee Chairman Cameron Sexton.  Thankfully the legislation has passed both the House and the Senate and heads to Governor Haslam for his signature.  I urge Governor Haslam to sign this legislation.  Hundreds of thousands of arthritis patients in the Volunteer State are counting on it. 

Kelly Rach


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