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Doc sounds the alarm on risk of over-medication for seniors

Dr Raman Ashta

Dr. Raman Ashta is hardly the first person to move south to Vero Beach in order to spend her time doing what she loves. Retirees have been doing it for a century.

That said, Ashta didn’t move all that far south and she’s still very much working full time.

A family practice physician who has an office in Vero Beach but works for Sebastian River Medical Center, her southward trek only took her from Melbay Healthcare in Melbourne to a fountain-facing office on 11th Circle, off 37th Street.

The move has not changed the fact that Ashta is, as she says, “passionate about health maintenance and the prevention of lifestyle-related diseases such as obesity, hypertension and diabetes.

“I want to do primary care,” she says. “I’ve experimented a little bit with different styles of practice and this is what I started with, this is what I’m good at, and this is what I’m going to stick to.”

Ashta says she has no intention of “running around seeing 100 patients a day,” in her new location. Instead she prefers to focus intently on each patient, getting to really know what makes them tick.

And that’s not always easy.

“I look at what cultural backgrounds patients are from; what is going on psychologically around them; what medications they’re on because medication – a lot of time – can also cause problems. Then I make my recommendations that are individualized to that patient, instead of one size fits all.”

Medications, by the way, are one of Ashta’s chief concerns. And for good reason.

Saying she regularly meets patients who are taking 20 or more different drugs, she points out that most of them “are sick of that.”

And sometimes even sick because of that.

Many patients, according to Ashta, tell her “I don’t want to be taking these pills for breakfast, lunch and dinner. I want less pills.”

The excessive use of prescription drugs – especially among seniors – is as hot a topic with the National Institutes of Health as it is with Ashta.

According to NIH, “older patients are particularly susceptible to medication-related problems associated with polypharmacy and multiple prescribing physicians.”

In fact, NIH insists that – at a minimum – seniors should have an annual review of the medications they’re taking. And that should also include drugs prescribed by dentists, dermatologists and any other healthcare provider as well as any over-the-counter drugs or supplements.

Failure to do so can be catastrophic, even fatal. Ashta says she undertakes just that kind of review of her patients’ medications to see what’s really necessary, what can be used on an “as needed basis,” and what can be gotten rid of altogether.

Finding a primary care physician – especially one with a dedication to getting to know the patient as a person as well as regularly reviewing that patient’s prescriptions – is getting harder all the time.

Just last year the Association of American Medical Colleges projected a shortage of almost 36,000 primary care physicians in this country over the next five to seven years, noting that, “as the U.S. population ages, so too does the physician workforce.”

Still, Ashta is not a “seniors only” doctor. As she puts it, “I see everybody, from ages 5 and up, and every age has its own charm. When I’m here in the room with kids, it just reminds me of my own kids and it’s mostly a fun encounter.

“I guess I can relate to people at all ages. A lot of the patient population here is 50 and older and they have rich experiences and fun stories.”

“I want to do what I love to do, and I’m excited to be here,” Ashta says.

 

Dr. Raman Ashta is with Steward Healthcare’s Sebastian River Medical Center. Her offices are directly across the street from the Indian River Medical Center’s campus at 3745 11th Circle. The phone number is 772-564-2485.

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