"I was reminded of the incident last week when news reports emerged that Eli Lilly had reportedly urged primary care doctors to use the drug for elderly patients with symptoms of dementia. The company has denied promoting the drug for off-label uses.
The reports highlighted for me the crucial role that internists and other primary care doctors play in screening for psychiatric illnesses but also in knowing when to refer these patients for proper treatment. Although psychiatrists are not always available and not all patients are willing to see them, doctors must carve out our areas of expertise in keeping with our training and experience, and depression and psychosis are simply not my areas as an internist.
I tell [patients] that this cost-benefit decision [of prescribing medicines] should be made in conjunction with the patient's psychiatrist, not solely by an internist placed under pressure by a salesperson."
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