Thomas A. M. Kramer, MD


Medscape General Medicine. 2003;5(4) 

In This Article


More and more, the television and other media tell our patients to talk to us. "Ask your doctor," they say. Millions and millions of dollars are being spent just to tell our patients to talk to us. The reason that so much money is being spent to foster communication is because marketing is being done to people who cannot, of their own volition, buy the product. They have to come to us to ask permission.

We are the gatekeepers of most pharmaceuticals. Some medications are available over the counter, and we can only assume that this is because the US Food and Drug Administration (FDA) and other organizations have determined that they are safe enough to be dispensed solely on the basis of patient demand. It is interesting to note that many of these used to only be available by prescription. Recently, omeprazole (Prilosec) became available over the counter after years of "prescription-only" use. Many things that we now take for granted as over-the-counter medications, such as ibuprofen, started out as prescription-only medications. Although certainly a major part of this was a marketing transition secondary to loss of patent protection, the implication is that only now are they safe enough to be used without a prescription.