I'm not sure I'm going to be able to answer the question particularly satisfactorily. The number of over-the-counter drugs that are available is relatively small, and I think there is some potential harm. With some of the drugs for arthritis, for example, for acute pain, I think some patients are self-medicating. My own personal bias as a physician is that it isn't a huge issue.
Many patients are on alternative medicines or natural therapies, and I think that's an area where we actually don't know (a) their effectiveness, (b) their safety and what ingredients are there, and (c) how they interact with conventional medicine. So I think that's an area to focus on.
But I would share your concern with the lack of accessibility to family physicians and, in people with chronic diseases like diabetes, to appropriate management. We've talked a lot here about the excess use of medications and their side effects, but I think patients are also being harmed if they don't have access to drugs that have been clearly shown to be effective.