John Wesley, the founder of the Methodist church thought of himself as a physician. He practiced medicine from the time he was 19 until he died. His self-help health manual, “Primitive Physik,” was so successful on the American frontier that it out sold the Bible until the mid-nineteenth century.

In the 18th century, Wesley opposed the common practice of poly pharmacy that existed in his day. He was against leeching, bleeding and the use of quicksilver. He believed a physician should use one drug at a time.In its place, he advocated for clean air, fresh water and more exercise.

Should we as physicians today heed Wesley’s advice? Have we become too enamored with pharmaceuticals and less focused than we should be on true preventive measures? While I am not a medical nihilist, I have developed a great respect for the complications that pharmaceuticals can cause. We must always remember that almost all drugs are poisons. They are usually effective by blocking the body’s ability do what it is naturally trying to do. Thankfully, despite claims to the contrary on TV, most of the drugs we use do not work all that well.Their effect is limited both in their efficiency and their side effects. If that were not the case, there is no telling how much harm physicians might be doing by over prescribing medicine.

A day rarely goes by that I do not see a patient who is on more than 10 drugs. I admit that often, in an attempt to be helpful, I have put patients on an incredible array of agents, yet I truly have no idea how these drugs will interact with each other and what the cumulative effect will be. I am depending on the kidneys and the liver to filter out what is harmful. Such behavior can rightfully be regarded as foolish.

For 10 years, after he retired, Dr. Tom White worked 40 hours a week as a volunteer with me at the Church Health Center. After 40 years of practice Dr. White developed a healthy respect (maybe even a fear) of what drugs can do. For years he sought what he considered to be the perfect drug which is one that has no side effects and does nothing (He thinks he may have found it in quaffinorm).

What Dr. White has taught me is that the best health care a physician can offer is to spend the needed time to understand a patient’s symptoms. Help the patient come to realize that treatments other than pharmaceuticals are more often than not the best course of action. And in many situations, the right medicine is to simply let time heal the wound.

Since I am also a Methodist Minister, I know that John Wesley would be disappointed in my performance.Wesley believed in a disciplined way of living for his clergy and taking the easy way out was never okay with him.

There is no question that in the right situation pharmaceuticals can be life saving but they can also be dangerous. Which of the drugs we use today will be looked at in the future like we do bleeding and quicksilver?

Most days I hear Dr. White’s voice in the back of my head, “Is this prescription really necessary?” It is a good question to ask yourself every time you take out your pen.

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