Clipping Board » Medical Myths ─ The truth about healthcare is often different from what you intuitively think.
Director of Dacun Health Center / Dr. Huang Jiancheng
Mentioning IV drips inevitably brings to mind a deeply memorable experience from over eight years ago. It enabled me to reflect and ponder on various unreasonable medical practices related to IV drips, which is also the main reason why I have since been reluctant to administer IV drips casually. At that time, I was serving at the Keelung Naval Third Shipyard Clinic and also working part-time at a general hospital near the train station. The hospital offered on-duty doctors a fixed salary, plus an additional fifty yuan for each IV drip administered and two hundred yuan for each patient admitted. To earn more, I always encouraged patients to be hospitalized and receive IV drips during my shifts. One night, after seeing a little girl with a fever, it was already past three in the morning! Lying in bed, I counted my earnings—it was another fruitful night, with 850 yuan just from IV drips! The income from two nights of part-time work was more than a month's salary in the military, and I couldn't help but feel proud.
I wondered if the little girl had been settled yet. When I walked back to the duty room, her parents were holding her down while the nurse administered the IV drip. Children of that age are the most troublesome! Even after the drip is started, both hands must be tightly secured; otherwise, they might pull out the needle or move too much, causing leakage. I reluctantly got up to clarify with the nurse, lest I be woken up again. The little girl had already fallen asleep, her eyelashes glistening with tears under the fluorescent light, looking very uneasy. Her parents were slumped on either side of the bed, keeping watch.
I lay down heavily, the scene replaying in my mind: she just had a cold and fever. I could have given her a suppository or a fever-reducing shot, and they could have gone home to rest! Why did I prescribe an IV drip? Tormenting three people at once! Moreover, the dozen or so IV drips administered tonight were completely unnecessary! Could I really be earning such heartless money? I couldn't help but feel a wave of panic, tears wetting the pillowcase.
Why not administer IV drips?
Unnecessary IV drips are a 'waste of resources and effort.' As healthcare workers, we should educate the public to avoid them! At Dacun Health Center, I see an average of over a hundred patients daily, and in four years, I have administered IV drips to fewer than ten patients. This is a stark contrast to the common practice in general hospitals and clinics! This might seem like overcorrection, but I believe the only thing lacking is the 'psychological comfort' for the patients, not the maintenance of their physiological or physical health.
Are IV drips nutritious or energizing?
Most people who request IV drips believe they are nutritious or energizing, helping the body recover faster. In reality, this is not the case! If one can drink and absorb, 'the most nutritious IV drip cannot compare to a glass of milk.' Common IV drips are usually glucose water, saline, amino acid solutions, or albumin solutions. Their nutritional value cannot compare to my favorite sports drink or papaya milk! Some might think that injection is more effective? That's also wrong! 'Drinking is healthier than injecting.'
When encountering IV drip enthusiasts who are hard to dissuade, I occasionally prescribe one or two bottles for them to take home and drink, because drinking is healthier! Some people have also mentioned that others' IV drips are yellow. Fine, just add some multivitamin liquid or a vitamin drink.Once, a medical colleague told me that he liked to add some vitamin B12 solution to his IV drip, making it look red and seemingly more valuable!
Does getting an IV drip make you feel much better?
Many people have told me that after getting an IV drip, they feel much better when they have a high fever, severe cold, dizziness, or various discomforts! They obviously attribute the efficacy to the IV drip, which is quite absurd! What's the difference between getting an IV drip and drinking a bottle of sports drink? Why does drinking a sports drink have no effect while getting an IV drip has a miraculous effect? It must be that the nurse added antipyretic analgesics or steroids (or both, which is becoming more popular) into the IV drip! In fact, the injections can be given directly without the need for an IV drip, and the effect would be the same. But would the medical fees be as high then?
Why do doctors like to give IV drips?
I have a young female patient who started experiencing palpitations after getting an IV drip half a year ago. At that time, she sought medical attention for stomach pain, and the doctor suggested an IV drip. She thought she wouldn't have enough time to go to work within half an hour! The doctor assured her she would have enough time. So, an IV drip was completed in just over twenty minutes! Since then, she often feels palpitations because she thinks her heart must have been overburdened by the fast drip.
If the IV drip you received costs a few hundred dollars or a few hundred dollars plus insurance, I can assure you that you received glucose water or saline solution. The current cost of these IV drips at clinics is around thirty dollars. In theory, with a labor or farmer insurance card costing two hundred and twenty dollars, giving three or four bottles would still be profitable! So, some young doctors, to compete in the market, have started a trend—giving IV drips without additional charges, aiming for small profits but quick turnover. And they have succeeded! A standout in this regard is a certain health center director and doctor in Pingtung County, who has an unusually high number of patients, administering about sixty IV drips for every hundred patients. He has now opened his own practice and is said to monopolize the local IV drip market.
Some doctors give IV drips not to make money but as a routine or with the mindset that 'patients won't wander off after getting an IV drip,' usually targeting hospitalized patients. More than three years ago, my mother coughed up a little blood, and an X-ray showed an abnormality in her left lung, so I arranged for her to be admitted to Changhua Christian Hospital for further examination. Unexpectedly, when I returned after going out, she had already been given an IV drip and was lying helplessly in bed. I was furious and immediately asked the nurse to remove the IV drip. My mother has always been healthy and was hospitalized only for examination. Why give her an IV drip? Getting an IV drip immediately restricted her movements, even making it difficult to go to the bathroom. Especially since she had never had an IV drip before, seeing her arm stretched out straight was heartbreaking!
There are also a few cases where, although there is no medical condition requiring an IV drip, giving one might be necessary. For example, some high-profile individuals recently fainted due to excessive fatigue. We noticed that when they were lying in bed being interviewed by the media, they always had an IV drip. Actually, since the diagnosis was excessive fatigue and they had already regained consciousness, just resting more and drinking a beverage would suffice. Why the need for an IV drip? But then again, for such important figures, if they didn't have an IV drip, they wouldn't have a specific illness to report, just resting in bed. Would that be acceptable for their media image? Although this situation is understandable, it inadvertently encourages the public to demand IV drips when they feel tired.
Aren't all hospitalized patients given IV drips?
People who think they are seriously ill often request IV drips at outpatient clinics, always saying, 'Doctor, give me a big bottle! It doesn't matter how much extra it costs.'I wonder if these people are somewhat influenced by the inpatients receiving IV drips. If so, that's really confusing! The vast majority of inpatients receive IV drips not because the drips provide them with nutrition or some medicinal effect. IV drips are usually used to maintain an IV line, meaning they are administered for the convenience of adding medication. A critically ill patient may have a condition that requires immediate IV injection to save time. If we wait until then to find a vein, whether we can find one or not, if we miss the opportunity, wouldn't it be a waste of hospitalization? Many inpatients are prescribed IV injections three or four times a day or even more. Isn't that unbearable? Moreover, not every nurse has top-notch skills. So, by administering an IV drip, slowly dripping, as long as the vein remains unobstructed, the injection can be administered through the rubber tube. Of course, there are pros and cons to this; once an IV drip is started, the freedom of movement is restricted! But doctors always prefer it this way. Firstly, inpatients should rest well and not wander around to avoid being unavailable when tests or information are needed. Secondly, doesn't it feel like you're not really hospitalized if you're not on an IV drip?
I know some people who are hospitalized purely for the purpose of receiving IV drips. When they go to the hospital for outpatient treatment and request an IV drip, the doctor says, 'A large injection will cost extra! Otherwise, you'll have to be hospitalized.' As a result, they get hospitalized! And they stay for several days, which is really baffling! I believe this situation wouldn't occur in teaching hospitals (hospitals with resident doctors) or hospitals where beds are often hard to come by.
Under what circumstances should an IV drip be administered?
Common conditions that require IV drips include the following:
1. Temporary inability to eat or when the doctor advises against eating, such as in cases of coma, myocardial infarction, gastrointestinal bleeding, post-surgery, shock, etc.
2. When the gastrointestinal tract cannot absorb food after eating, such as in cholera, gastrointestinal obstruction, etc.
3. When IV injections may be needed at any time, such as in various critically ill patients.
4. When IV injections are needed several times a day, such as in bacterial pneumonia, cholecystitis, and other severe infections.
5. When medication must be administered via IV drip, such as in meningitis therapy, chemotherapy, etc.
The above conditions have already reached the level where hospitalization is necessary. As for general outpatient cases, I can't think of any necessary situations for IV drips at the moment. I mentioned earlier that I have also administered a few IV drips at the Dacun Health Center. I remember the first one was for a welfare recipient who came to see me for the first time and requested an IV drip. I was worried he might misunderstand that welfare insurance is worthless, so I administered it for him. There were also two IV drips for an elementary school girl who had asthma since childhood. Every time she had an attack, she was sent to a major hospital for hospitalization, which was quite costly (the last time was over nineteen thousand yuan for one night). When she was sent to the health center that day, it was almost closing time, and I decided to provide her with special service, allowing her to be hospitalized at the health center. I administered two IV drips for her, and her symptoms were relieved. The next morning, when she was discharged, the total fee was two hundred yuan (though her family treated me to fried rice noodles and fish ball soup for dinner). After that, I recommended she use inhaler therapy (inhaling medication is more convenient and can reduce side effects), and she hasn't had an attack in one or two years. Until one day when she had another attack, and since there was no medication at home, I prescribed two inhalers for her, and she was fine after using them!
Other IV drips were either because I couldn't refuse due to the person's status or because I was in the mood to satisfy their request at the time.
Conclusion
Medical care is a highly professional job, dealing with people of various levels, so doctors have a lot of room to maneuver. In the same health center outpatient clinic, one could administer one IV drip for every ten thousand patients or six thousand IV drips.Gouty arthritis can often be resolved with just two or three days of medication (with few exceptions), but it's also common to hear about patients being hospitalized for several days and receiving dozens of IV drips. There are too many similar cases! Who is right and who is wrong? Where is the reasonable standard? By the time you finish reading this article, your knowledge about IV drips will have greatly improved! But if you are a doctor and a patient tells you, "Just give me a big shot! It doesn't matter how much it costs," would you refuse?
I firmly believe that, with the exception of teaching hospitals, at least 90% of the IV drips administered in general primary care hospitals (including inpatient care) and clinics are completely unnecessary. If we consider only outpatient care, a conservative estimate would be that over 99% of IV drips are unnecessary. In other words, when you visit an outpatient clinic, not requesting an IV drip and firmly refusing one is appropriate in over 99% of cases.
Ideal medical care should involve multifaceted concern, taking into account not only the patient's physical condition but also their convenience, financial situation, dignity, and acceptance. On July 4, 1994, it was reported in the news that National Taiwan University Hospital pioneered a "feigning illness" training course for new resident physicians. Seventeen new resident physicians at NTU experienced what it's like to be hospitalized, with the hope that they would treat patients more kindly in the future! During an interview, one physician said, "I never realized how painful an IV drip can be!" and "Being a patient is really restrictive—when the phone rings, you can't reach for it because your hand is hooked up to an IV."
For the doctor, the entire process of administering an IV drip is just a matter of writing a few words on a prescription. However, the patient often endures ignorance, pain, and wasted time and money. Perhaps every hospital and clinic faces operational pressures, but is this a sufficient justification?
Writing this, I suddenly recall the recent toxic grape incident. A few fruit farmers used the banned carcinogenic pesticide tetrachlorodinitrobenzene, which was exposed by the media, leading to a severe drop in grape sales and prices. Consequently, the farmers protested and petitioned everywhere. By so blatantly writing about the misuse of IV drips, might I cause a drop in IV drip sales, leading to dissatisfaction, protests, or even harm from manufacturers? I think not! Didn't I mention earlier? "Drinking an IV solution is healthier than receiving it intravenously." So, when you're sick, drink more IV solutions! But by the way, while glucose water is sweet, remember to dilute saline solution, or it will be too salty!
Myths about IV Drips
Mentioning IV drips inevitably brings to mind a deeply memorable experience from over eight years ago. It enabled me to reflect and ponder on various unreasonable medical practices related to IV drips, which is also the main reason why I have since been reluctant to administer IV drips casually. At that time, I was serving at the Keelung Naval Third Shipyard Clinic and also working part-time at a general hospital near the train station. The hospital offered on-duty doctors a fixed salary, plus an additional fifty yuan for each IV drip administered and two hundred yuan for each patient admitted. To earn more, I always encouraged patients to be hospitalized and receive IV drips during my shifts. One night, after seeing a little girl with a fever, it was already past three in the morning! Lying in bed, I counted my earnings—it was another fruitful night, with 850 yuan just from IV drips! The income from two nights of part-time work was more than a month's salary in the military, and I couldn't help but feel proud.
I wondered if the little girl had been settled yet. When I walked back to the duty room, her parents were holding her down while the nurse administered the IV drip. Children of that age are the most troublesome! Even after the drip is started, both hands must be tightly secured; otherwise, they might pull out the needle or move too much, causing leakage. I reluctantly got up to clarify with the nurse, lest I be woken up again. The little girl had already fallen asleep, her eyelashes glistening with tears under the fluorescent light, looking very uneasy. Her parents were slumped on either side of the bed, keeping watch.
I lay down heavily, the scene replaying in my mind: she just had a cold and fever. I could have given her a suppository or a fever-reducing shot, and they could have gone home to rest! Why did I prescribe an IV drip? Tormenting three people at once! Moreover, the dozen or so IV drips administered tonight were completely unnecessary! Could I really be earning such heartless money? I couldn't help but feel a wave of panic, tears wetting the pillowcase.
Why not administer IV drips?
Unnecessary IV drips are a 'waste of resources and effort.' As healthcare workers, we should educate the public to avoid them! At Dacun Health Center, I see an average of over a hundred patients daily, and in four years, I have administered IV drips to fewer than ten patients. This is a stark contrast to the common practice in general hospitals and clinics! This might seem like overcorrection, but I believe the only thing lacking is the 'psychological comfort' for the patients, not the maintenance of their physiological or physical health.
Are IV drips nutritious or energizing?
Most people who request IV drips believe they are nutritious or energizing, helping the body recover faster. In reality, this is not the case! If one can drink and absorb, 'the most nutritious IV drip cannot compare to a glass of milk.' Common IV drips are usually glucose water, saline, amino acid solutions, or albumin solutions. Their nutritional value cannot compare to my favorite sports drink or papaya milk! Some might think that injection is more effective? That's also wrong! 'Drinking is healthier than injecting.'
When encountering IV drip enthusiasts who are hard to dissuade, I occasionally prescribe one or two bottles for them to take home and drink, because drinking is healthier! Some people have also mentioned that others' IV drips are yellow. Fine, just add some multivitamin liquid or a vitamin drink.Once, a medical colleague told me that he liked to add some vitamin B12 solution to his IV drip, making it look red and seemingly more valuable!
Does getting an IV drip make you feel much better?
Many people have told me that after getting an IV drip, they feel much better when they have a high fever, severe cold, dizziness, or various discomforts! They obviously attribute the efficacy to the IV drip, which is quite absurd! What's the difference between getting an IV drip and drinking a bottle of sports drink? Why does drinking a sports drink have no effect while getting an IV drip has a miraculous effect? It must be that the nurse added antipyretic analgesics or steroids (or both, which is becoming more popular) into the IV drip! In fact, the injections can be given directly without the need for an IV drip, and the effect would be the same. But would the medical fees be as high then?
Why do doctors like to give IV drips?
I have a young female patient who started experiencing palpitations after getting an IV drip half a year ago. At that time, she sought medical attention for stomach pain, and the doctor suggested an IV drip. She thought she wouldn't have enough time to go to work within half an hour! The doctor assured her she would have enough time. So, an IV drip was completed in just over twenty minutes! Since then, she often feels palpitations because she thinks her heart must have been overburdened by the fast drip.
If the IV drip you received costs a few hundred dollars or a few hundred dollars plus insurance, I can assure you that you received glucose water or saline solution. The current cost of these IV drips at clinics is around thirty dollars. In theory, with a labor or farmer insurance card costing two hundred and twenty dollars, giving three or four bottles would still be profitable! So, some young doctors, to compete in the market, have started a trend—giving IV drips without additional charges, aiming for small profits but quick turnover. And they have succeeded! A standout in this regard is a certain health center director and doctor in Pingtung County, who has an unusually high number of patients, administering about sixty IV drips for every hundred patients. He has now opened his own practice and is said to monopolize the local IV drip market.
Some doctors give IV drips not to make money but as a routine or with the mindset that 'patients won't wander off after getting an IV drip,' usually targeting hospitalized patients. More than three years ago, my mother coughed up a little blood, and an X-ray showed an abnormality in her left lung, so I arranged for her to be admitted to Changhua Christian Hospital for further examination. Unexpectedly, when I returned after going out, she had already been given an IV drip and was lying helplessly in bed. I was furious and immediately asked the nurse to remove the IV drip. My mother has always been healthy and was hospitalized only for examination. Why give her an IV drip? Getting an IV drip immediately restricted her movements, even making it difficult to go to the bathroom. Especially since she had never had an IV drip before, seeing her arm stretched out straight was heartbreaking!
There are also a few cases where, although there is no medical condition requiring an IV drip, giving one might be necessary. For example, some high-profile individuals recently fainted due to excessive fatigue. We noticed that when they were lying in bed being interviewed by the media, they always had an IV drip. Actually, since the diagnosis was excessive fatigue and they had already regained consciousness, just resting more and drinking a beverage would suffice. Why the need for an IV drip? But then again, for such important figures, if they didn't have an IV drip, they wouldn't have a specific illness to report, just resting in bed. Would that be acceptable for their media image? Although this situation is understandable, it inadvertently encourages the public to demand IV drips when they feel tired.
Aren't all hospitalized patients given IV drips?
People who think they are seriously ill often request IV drips at outpatient clinics, always saying, 'Doctor, give me a big bottle! It doesn't matter how much extra it costs.'I wonder if these people are somewhat influenced by the inpatients receiving IV drips. If so, that's really confusing! The vast majority of inpatients receive IV drips not because the drips provide them with nutrition or some medicinal effect. IV drips are usually used to maintain an IV line, meaning they are administered for the convenience of adding medication. A critically ill patient may have a condition that requires immediate IV injection to save time. If we wait until then to find a vein, whether we can find one or not, if we miss the opportunity, wouldn't it be a waste of hospitalization? Many inpatients are prescribed IV injections three or four times a day or even more. Isn't that unbearable? Moreover, not every nurse has top-notch skills. So, by administering an IV drip, slowly dripping, as long as the vein remains unobstructed, the injection can be administered through the rubber tube. Of course, there are pros and cons to this; once an IV drip is started, the freedom of movement is restricted! But doctors always prefer it this way. Firstly, inpatients should rest well and not wander around to avoid being unavailable when tests or information are needed. Secondly, doesn't it feel like you're not really hospitalized if you're not on an IV drip?
I know some people who are hospitalized purely for the purpose of receiving IV drips. When they go to the hospital for outpatient treatment and request an IV drip, the doctor says, 'A large injection will cost extra! Otherwise, you'll have to be hospitalized.' As a result, they get hospitalized! And they stay for several days, which is really baffling! I believe this situation wouldn't occur in teaching hospitals (hospitals with resident doctors) or hospitals where beds are often hard to come by.
Under what circumstances should an IV drip be administered?
Common conditions that require IV drips include the following:
1. Temporary inability to eat or when the doctor advises against eating, such as in cases of coma, myocardial infarction, gastrointestinal bleeding, post-surgery, shock, etc.
2. When the gastrointestinal tract cannot absorb food after eating, such as in cholera, gastrointestinal obstruction, etc.
3. When IV injections may be needed at any time, such as in various critically ill patients.
4. When IV injections are needed several times a day, such as in bacterial pneumonia, cholecystitis, and other severe infections.
5. When medication must be administered via IV drip, such as in meningitis therapy, chemotherapy, etc.
The above conditions have already reached the level where hospitalization is necessary. As for general outpatient cases, I can't think of any necessary situations for IV drips at the moment. I mentioned earlier that I have also administered a few IV drips at the Dacun Health Center. I remember the first one was for a welfare recipient who came to see me for the first time and requested an IV drip. I was worried he might misunderstand that welfare insurance is worthless, so I administered it for him. There were also two IV drips for an elementary school girl who had asthma since childhood. Every time she had an attack, she was sent to a major hospital for hospitalization, which was quite costly (the last time was over nineteen thousand yuan for one night). When she was sent to the health center that day, it was almost closing time, and I decided to provide her with special service, allowing her to be hospitalized at the health center. I administered two IV drips for her, and her symptoms were relieved. The next morning, when she was discharged, the total fee was two hundred yuan (though her family treated me to fried rice noodles and fish ball soup for dinner). After that, I recommended she use inhaler therapy (inhaling medication is more convenient and can reduce side effects), and she hasn't had an attack in one or two years. Until one day when she had another attack, and since there was no medication at home, I prescribed two inhalers for her, and she was fine after using them!
Other IV drips were either because I couldn't refuse due to the person's status or because I was in the mood to satisfy their request at the time.
Conclusion
Medical care is a highly professional job, dealing with people of various levels, so doctors have a lot of room to maneuver. In the same health center outpatient clinic, one could administer one IV drip for every ten thousand patients or six thousand IV drips.Gouty arthritis can often be resolved with just two or three days of medication (with few exceptions), but it's also common to hear about patients being hospitalized for several days and receiving dozens of IV drips. There are too many similar cases! Who is right and who is wrong? Where is the reasonable standard? By the time you finish reading this article, your knowledge about IV drips will have greatly improved! But if you are a doctor and a patient tells you, "Just give me a big shot! It doesn't matter how much it costs," would you refuse?
I firmly believe that, with the exception of teaching hospitals, at least 90% of the IV drips administered in general primary care hospitals (including inpatient care) and clinics are completely unnecessary. If we consider only outpatient care, a conservative estimate would be that over 99% of IV drips are unnecessary. In other words, when you visit an outpatient clinic, not requesting an IV drip and firmly refusing one is appropriate in over 99% of cases.
Ideal medical care should involve multifaceted concern, taking into account not only the patient's physical condition but also their convenience, financial situation, dignity, and acceptance. On July 4, 1994, it was reported in the news that National Taiwan University Hospital pioneered a "feigning illness" training course for new resident physicians. Seventeen new resident physicians at NTU experienced what it's like to be hospitalized, with the hope that they would treat patients more kindly in the future! During an interview, one physician said, "I never realized how painful an IV drip can be!" and "Being a patient is really restrictive—when the phone rings, you can't reach for it because your hand is hooked up to an IV."
For the doctor, the entire process of administering an IV drip is just a matter of writing a few words on a prescription. However, the patient often endures ignorance, pain, and wasted time and money. Perhaps every hospital and clinic faces operational pressures, but is this a sufficient justification?
Writing this, I suddenly recall the recent toxic grape incident. A few fruit farmers used the banned carcinogenic pesticide tetrachlorodinitrobenzene, which was exposed by the media, leading to a severe drop in grape sales and prices. Consequently, the farmers protested and petitioned everywhere. By so blatantly writing about the misuse of IV drips, might I cause a drop in IV drip sales, leading to dissatisfaction, protests, or even harm from manufacturers? I think not! Didn't I mention earlier? "Drinking an IV solution is healthier than receiving it intravenously." So, when you're sick, drink more IV solutions! But by the way, while glucose water is sweet, remember to dilute saline solution, or it will be too salty!