banana prescriptions

photo: jetheriot

One great thing about medication prescriptions is that they're standardized. There's a blank where the doctor fills in the name of the patient, an empty space where he writes out how many pills to take and how many times a day to take them, and a blank where he signs his name. The symbols may seem strange, but they have precise meanings, and they communicate very specific instructions.

When you take the prescription to the pharmacy, the pharmacist dispenses scientifically measured doses he has carefully counted and re-counted. A medication prescription is a kind of currency that changes hands between a doctor, a pharmacist and a patient. It's the physical embodiment of a doctor's recommendations, loose enough to be tailored to the specific needs of the patient, tight enough to be precise and specific. Another great thing about the medication prescription is that, because it has a standardized format and uses a commonly agreed upon language, it can be easily reproduced. Doctors get them printed by the hundreds. 

But when doctors issue prescriptions for things other than medications, they don't use pre-printed prescription pads. Say a doctor prescribes you bananas for your low potassium. He tells you, “Your potassium is low, so I recommend adding bananas to your diet.” He doesn’t pull out his prescription pad when he prescribes you bananas. He doesn’t write “eat more bananas” on a piece of paper, tear it from a pad and slide it across his desk to you. He just tells you to eat more bananas.

If instead of prescribing bananas for your low potassium your doctor had decided to prescribe potassium pills, he would have taken out his prescription pad and written very specific instructions for you to take an exact amount of potassium a certain number of times each day. The pills would come in scientifically measured doses. The form of the medication prescription would have demanded such specificity. He couldnt have gotten away with writing "take some potassium" on the prescription. It would have been rejected by the pharmacist as too vague.

But when he prescribes you bananas by saying "eat more bananas", that's exactly what he's doing. Saying "eat more bananas" is a very vague prescription. There's no reason that prescriptions for things other than medications have to be vague. A doctor could write those prescriptions on pieces of paper too if they wanted. He could write down on a piece of paper a precise banana dose. "Eat one banana twice a day." That way everyone would agree on what the plan was.

If your doctor prescribes a lot of bananas to his patients, he could have hundreds of standardized banana prescriptions printed. There would be a blank for the patient's name, an empty space where he could write in clear language how many bananas to eat and how frequently to eat them. There might even be a checkbox scenario on the prescription, so that the doctor could just check one box next to the number of bananas recommended and one box next to the number of times a day they should be eaten. A blank for the doctor's signature would not be necessary on this pre-printed banana prescription, since a banana is not a controlled substance.

When you see the doctor again at your follow-up appointment, if he had given you a vague banana prescription, he may ask you something like, “Have you been eating more bananas since I last saw you?” And you might answer yes, because even though you’ve only eaten a few bananas here and there, the truth is, yes, you have been eating more bananas lately. If, on the other hand, he had given you a specific banana prescription, a pre-printed prescription with clear and specific instructions, he may ask you something like, “Have you eaten one banana twice a day since I last saw you?” And you would have to answer no.

Pre-printed medication prescriptions have some great qualities. They're standardized. They use precise language to give specific instructions. They're highly reproducible. If he wanted to, a doctor could take these desirable qualities and apply them to prescriptions for things other than medications, bananas for example.