Thank you for sharing all of your thoughts on this!! It's a very complex topic with a ton of countervailing forces and considerations and I'm grateful to you raising them.

I think you're absolutely correct that understanding how various medications function and their possible interactions and contraindications is massively complex, and we cannot expect the average member of the public to be able to parse all of it and to make reasoned judgements. I think it also bears pointing out that even most doctors and prescribers don't know many of these things -- to this very day we don't know why antidepressants work after all! We just have a few leading hypotheses, as well as a few marketing cliches about chemical imbalances that have become "fact" in the public consciousness. Members of the public are ill informed and easily exploited, and even the knowledge bases that doctors are working with are limited and influenced by corporate greed, bias, and misinformation -- so if this paradigm is ever going to work, we need a dramatic rehaul of the medical system, how we train doctors, how many doctors we have, and how easy it would be for patients to access trustworthy information and someone to really counsel them and fully listen to their concerns while supporting them in making the right decisions for themselves. That might sound pie in the sky, and maybe it is. But the current model sure is not working.

You mentioned the over prescription of antibiotics and I think that example is a perfect object lesson in all the factors at play really! As long as I've been conscious of this being a public health problem, I've read and heard that the public really contributed to the overprescription of antibiotics by demanding them in situations where they were not warranted. My own experience is that medical providers have pushed antibiotics *on me* even when there was no evidence I had a bacterial infection, because they were so overworked and tired and burnt out that they didnt care that they couldn't figure out what the cause of my months-long laryngitis was (for example) so they just wrote me an antibiotic scrip and hoped that it helped. (I ended up not taking the antibiotics in that case, because I knew my problem was caused by overexertion of my vocal chords from teaching -- and I told my doctor that. But he prescribed antibiotics anyway).

I don't know how common experiences like that one are, but I imagine that the overprescription of such meds does have systemic causes too, related to just how harried and stretched thin doctors are and how rare it is for them to have the time to truly get to know a patient or what ails them. The public needs a way better education on how these meds work of course too, and I dont know how on earth we'll get ourselves out of problems like conspiracy theories helping themselves to medications they erroneously believe will cure COVID. Admittedly thinking through many of these issues out loud in this essay, so I'm thankful for you giving me more to chew on.