Dependence on Prescription Medications: The ongoing debate over scope-of-practice between physician groups like the AMA and organizations like the AAPA has drawn attention to the roles of different health care providers. However, amid this battle, we risk ignoring a larger, more pressing issue: our medical system’s deep-rooted reliance on prescription medications as the primary solution for chronic conditions.
The Expanding Role of Prescription Medications
Consider the recent discussions surrounding GLP-1 receptor agonists (GLP-1 RAs) for obesity treatment. Physicians and specialists increasingly frame obesity as a chronic disease requiring lifelong pharmacological intervention. Statements such as, “We need to just really think about it as a chronic disease … to make sure that we try to keep that patient in [ongoing] treatment,” reveal how deeply ingrained this mindset has become. Similarly, when an obesity medicine specialist emphasized that GLP-1 RAs “are indicated by the FDA so that you could be on it for the rest of your life,” it reinforced a growing trend: long-term medication use as the default solution, rather than a temporary aid.
The numbers reflect this reality. According to the latest data from the AHRQ and CDC, men now spend an average of 40% of their lives on prescription drugs, while women spend 60%. Yet, rather than questioning why so many people require ongoing pharmacologic management, the response has been to expand access and ensure more people remain on long-term medication.
The Limits of Medication-Centric Health Care
Dependence on Prescription Medications: While the physician-APP (advanced practice provider) debate rages on, both sides overlook the deeper systemic problem. The focus remains on proving who can safely prescribe rather than questioning why prescriptions have become the primary intervention in the first place. Research repeatedly demonstrates that commonly prescribed medications often show impressive reductions in surrogate markers—such as LDL cholesterol, blood pressure, and A1C—while providing only marginal absolute risk reduction in major outcomes like heart attacks and strokes.
For example:
- Statins can lower LDL cholesterol by 30–50%, yet their absolute risk reduction for major cardiovascular events remains under 1%.
- Hypertension trials, such as SPRINT, ACCOMPLISH, and ACCORD, show significant blood pressure reductions but similarly modest absolute risk reductions.
- GLP-1 RAs reduce weight and metabolic markers but yield cardiovascular risk reductions of less than 1%.
Instead of addressing root causes like gut dysbiosis, glycocalyx dysfunction, hyperinsulinemia, and sleep deprivation, we mask symptoms with medication. Physicians and APPs alike find themselves bound by increasingly rigid clinical guidelines that emphasize medication adherence over comprehensive metabolic and lifestyle interventions.
Redefining Health Care Beyond Prescription Pads
As the health care system continues its assembly-line approach, patients receive a one-size-fits-all treatment plan that revolves around prescriptions. This model devalues both physician and PA education by reducing complex medical conditions to simple prescribing decisions. More concerningly, it diverts attention from holistic care, including lifestyle modifications, nutrition, sleep optimization, and stress management—interventions that could significantly improve long-term health outcomes without perpetual medication reliance.
Instead of pitting physicians and PAs against each other in a battle over prescribing authority, we should unite to rethink health care delivery altogether. A truly team-based model should emphasize:
- Comprehensive patient education
- Targeting root causes rather than symptoms
- Expanding metabolic and lifestyle medicine
- Encouraging collaboration between all health care providers
Time to Remove the Blindfold
Rather than arguing over who gets to write prescriptions, we must ask why medication has become our default answer. The current model of care prioritizes pharmacologic intervention over deeper patient engagement, metabolic understanding, and individualized treatment strategies. It’s time to shift our focus toward empowering patients with knowledge and sustainable health strategies.
At Stanford Physician Advocate, we believe that rethinking our approach to health care is essential. Join the conversation and explore ways to prioritize physician-led, patient-centered care that extends beyond prescription management. Visit StanfordPhysicianAdvocate.org to learn more and take an active role in shaping the future of health care.
Josh Moen is a physician assistant and public health researcher.