It is not surprising to find perennial common misunderstandings among consumers of health services about the health industry, the medical practice in particular. Nelson is right in pointing out some of these confusions, which to me, is mainly brought about by simple ignorance (this is not meant to be a put-down, or revilement of laypeople---because the same situation can hold true in other fields).
Yes, there are lapses committed by the FDA from time to time in their task of monitoring drugs that are in use or in scrutinizing those that the pharmaceutical industry wants to bring into market. It has been assailed in the past for approving drugs that turned out, after their long-term use, to do more harm than benefit to users (such as the hypnotic thalidomide---in the 50's---as mentioned before by a poster). The FDA's task can seem to be so difficult, indeed. It can be upbraided for not bringing a very promising drug fast enough to market at one time or for approving a drug too quickly at another.
In fact, in certain instances, further proof (by more empirical studies) for the efficacy and safety of a new drug is cut short because of its potential to save many lives. However, some of them may prove to have no "staying power", so to speak, because their harmful effects may not be evident in the short term but would only unravel after a long-term use! In general, the usefullness of a new drug might be judged on the basis of its cost-benefit ratio and on balancing its adverse effects vs. its health benefit.
On the package insert of a drug, the manufacturer is required to list down all its potential adverse effects, so much so that virtually no one drug is totally free ofpotential side effects. In fact, such listing, very often scares the hell out of my own patients when they read the package insert followed by a demurral in using it. Some of them misinterpret the potential adverse reactions to the drug as inevitable upon taking it.
I invariably try to assuage their fears by asking them to see things in their proper perspective. I would say that one can be struck by a lightning bolt from the sky or be run over by a vehicle when crossing a street. But it hasn't prevented most people from ever crossing the street. One can get food poisoning from eating out in a restaurant, or worse by getting hepatitis or salmonellosis, or even typhoid fever. But they haven't prevented people from going out to dine in restaurants.
There are drugs to cure diseases and others to control incurable diseases to manageable level so as to prevent or minimize their complications from emerging or are used simply for the relief of the symptoms of the disease. Drugs that are useful at certain dosages can be poisonous at another. To my mind, the use and abuse of antibiotics that lead to bacterial resistance are mainly driven by patient demands for antibiotics.
Patients often become quarrelsome when they are refused antibiotics, especially in upper respiratory infections (URI) where the vast majority are due to self-limiting viral infections. Besides, they may even harbor the feeling that one is not up to par when one fails to prescribe an antibiotic. One of my pet peeves in medical practice is a patient who whines that another doctor he had consulted had given him an antibiotic (that I had refused to prescribe a few days earlier) for an URI which had promptly "cured" him. I was the villain, the other was a hero, even though such infections are known to resolve days later (symptoms could persist for a week or so at times.)
From small beginnings come great things.
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