The Business of Healing?

[fire_breeze]

This, I hope, will initiate a good, well-thought out and enlightening debate - not a flame war or fight about politics.

I have been checking out the How-To's (extensive) library on a particular health issue, and couldn't help but notice some disparaging remarks about the 'mainstream' medical community in general.

I have come across quite a bit of posts that includes "most mainstream doctors are not aware of X conditions" or "doctors don't know/accept/acknowledge said condition" or "mainstream doctors just want to sell drugs". This seems to be counter-indicative of medicine and the Hippocratic Oath, highly unethical and kind of doing the same thing that these posters are accusing doctors.

I understand that family or general physicians are not experts. They are there to keep a patient healthy and to diagnose the ailment to a field and send them to experts. I also know, through my year of pre-med before I left, that doctors are well-versed in medicine and that they also extensively read journals and reviews that discuss new breakthroughs, diagnoses, etc.

What confuses me is that my doc, for example, will tell me flat out if she doesn't know about a particular condition and then refer me to a specialist/look it up. That said, she also knows how to analyze data and symptoms. I don't, and I've learned not to rely on Dr. Google. While I applaud taking control of health, but I also know that we are NOT a medical experts. MDs go through years of in-depth, extensive and exhaustive training, a year residency, plus gruelling and brutal board exams, not to mention a high level of accountability and rigorous refreshers and re-examinations.

Furthermore, she will not prescribe me medications for no reason. If there is an alternative medication or path that is equally or more effective, that's what she will do. A quick, informal survey of my local friends - even those without a PCP or family doctor, reported similar experiences.

Please remember that I am Canadian, where preventative health care is highly encouraged and where most people do not go bankrupt when they have an illness and/or condition. Paying for basic health care -particularly preventative health care - is very alien to me, so perhaps it is a lack of perspective.

Is it true that unlike the universal health-care system, that doctors in for-profit systems are in the business of healing and that they 'really don't know anything', or are only interested in text-book cases? Has the medical community, in general, been solely interested in profit and not in keeping a population healthy? Do doctors, in fact, get money from prescribing certain medications? Are 'mainstream' doctors so dismissive with the alternative route - despite extensive studies that are published in exclusive peer-reviewed journals - in combination of also practicing conventional medicine?

Thoughts? Comments? Or am I just naive?

To quote Ed, my comments and thoughts yada yada yada.

 

[Miles Long]

Will this thread have pictures of hot nurses in addition to thoughtful, intellectual discussion?

 

[fire_breeze]

Will this thread have pictures of hot nurses in addition to thoughtful, intellectual discussion?

Anything to keep your focus, honey.

Some alternative medicine for you.

https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcTZK0B1E3cbppHGbhqXmcrfg_EzIFqwxSboYYiXBFmeSz4SVxQsdg

 

[Miles Long]

Anything to keep your focus, honey.

Some alternative medicine for you.

https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcTZK0B1E3cbppHGbhqXmcrfg_EzIFqwxSboYYiXBFmeSz4SVxQsdg

Thanks breezy! (And I'm interested to see what people's thoughts are on your questions, too.)

 

[unregistered]

 

[Bottomlover]

I think that most doctors have good intentions, but these days almost all are employed by corporations and some of those are bad. I had a SO who is a n MD, and the corporation she works for is a Medicaid mill. They are in neighborhood that has a lot of medicaid recipients. Their main business is physical therapy, chiropractic and such, and the only reason they hired a doctor was to be able to prescribe their own treatments. They are drooling over all of the new medicaid patients being signed up through Obamacare.

Worse yet is the large outfit in FL that was doing a lot of unnecessary cardiac catheter lab work in a number of hospitals. The Shands system was involved in that. I saw it up close and personal and called a couple of doctors out on it. It wasn't until 6 years later that the law caught up with them.

Another thing that has driven health care costs up and has driven doctors out of private practice is our third party payer system. The paperwork and billing games eat up a good chunk of what we spend on healthcare. Before the 80's you had insurance for hospitalization and major medical expenses. you paid out of your pocket for routine checkups and care, and the cost was reasonable. Once the insurance companies became involved in primary care, it turned into a nightmare and costs soared, as the physicians had to hire more help that is pure overhead just to handle the administrative nightmare.

Let me give you an example of how it works here in the states. You go to your doctor, and he examines you, comes up with a diagnosis and gives you an injection. Even though they have a contract with the insurance company that fixes the price for the office visit at $75 and the injection at $35, they send the insurance company a bill for $460: $180 for the office visit and $280 for the injection. After a few days or more, the insurance company rejects the claim and sends notices to both you and the doctor. The doctor then resubmits the claim for the contractual amounts (total of $110), and then can take a contractual write-off for the balance. Add to this that claims often get bounced back and forth multiple ties for improper coding and other nonsensical reasons, each time requiring multiple pure overhead people to deal with it. It is beyond stupid. Oh yeah - if you don't have insurance, you pay the $460 (plus a tax for not having insurance starting this year).

It doesn't surprise me a bit that people don't want to go to the doctor.

 

[GiggLeGasm]

I have found that healthcare trends can often be geographical, not just by country, but also by region. Healthcare is the largest industry in my city. We do it very well. I have a sister who lives in West Texas and I cringe every time she needs to see a doctor. This past December, she informed me that she found a doctor "willing to remove her brain cyst."
(Now - I've been to her neurologist's office. It reminded me of the movie, Texasville, complete with the dust laden floor and 3-blade fan in the corner.)
I flew her here where she learned that was advised AGAINST surgery and an alternative plan was offered. She will fly here for a follow-up in 6 months.

Much like Fire's experience, my insurance covers many wellness therapies like reiki, massage, and classes for things like meditation and tai chi. The cost of my health insurance is structured so that people who actively participate in programs that enhance health pay less than people who do not. I appreciate the resources. My personal experience is that I am exposed to healthcare professionals that are looking out for my future.

That being said... (there's always a but)...

Changes to healthcare delivery in the US is changing, especially changes to reimbursement. It is becoming increasingly difficult to prove that hospital admissions are necessary and people are being told that they need to manage chronic disease more efficiently at home.

I do not think that every person feels able to be held accountable for his or her health. A great many people find it confusing. They resent being told that they now need to become educated on something that they previously entrusted to the medical community. They are frightened by the uncertainty of a healthcare system upon which they used to rely for small things.

That being said (yikes!)
I believe these changes are necessary and will ultimately make for a stronger system - once old habits can be changed.
Shouldn't take longer than a half century or so.

 

[patient1]

Call attention to whatever is relevant in your chart! It could save your life.

There is too much crap there for everybody who treats you to read. They don't have the time, or always the expertise. My experience is in America, but a health care professional who's worked in Canada and Europe said it's too much the same.

Once an intern tried to give me a drug I was acutely allergic to because he didn't read the chart, or the warnings all over the outside of my file.

Another time a team preparing me for a procedure accidentally triggered unconsciousness and muscle spasms because they didn't read my chart. I should have told them about it when they wheeled me in instead of after I regained consciousness and they were all staring at me like deer in the headlights. I didn't think it was necessary, considering that very condition had been diagnosed a few hours before on the same floor of the same hospital.

Got some pain? Point out your history of cardiovascular problems. Chest cold? Point out your lung issues and surgeries. They'll test & prioritize you accordingly.
You get the idea. Help them get to the point.

In the case of another condition, I'm the only case my doctor has ever seen, and a rare case for specialists, for that matter. It pays to get informed in these circumstances, so that you can ask the right questions.

In my wife's case she was given less narcotics post-op than she was prescribed for home use, because they didn't pay attention, they just followed standard procedures. That didn't turn out well, either.

Another time she nearly died from surgical complications.

The doctors, etc. aren't bad, they're just busy. I can understand how laypeople could become bitter and distrustful if they lost a loved one.

All of that said, I strictly adhere to doctors orders, like it or not. I figure I can't hold them accountable if I don't follow their advice.

 

[LadyVer]

Doctors don't know everything. Before I was diagnosed with lymphoma (finally), I had been incorrectly diagnosed with rib inflammation, for six months. I ended up in the ER in extreme pain with other symptoms, and after a week I learned what was wrong with me, after going through excruciating tests. Medicine is not an exact science, even in the 21st century. It is still a game of guesswork. Fortunately, during this time period, I had a great job with great health insurance.

I've come to believe that healing should not be a business, but a calling, and that everyone should have access to healthcare. Unfortunately, medicine in the U.S. is controlled by corporate interests, and nothing else. If you can't pay for your healthcare needs, well, tough shit. So, in reality, despite all the gains and knowledge that the world has acquired about medicine and diseases, we are basically in the medieval ages as far as healthcare, and who has access to it.

 

[Christopher2012]

This for-profit scheme is very real and very scary. Take a look at pain management doctors. There's a documentary called the OxyContin Express (free to watch on Youtube) and it lays out a perfect example of MDs abusing their licenses. They make their money CASH only. They would hand out prescriptions for oxycodone like it was M&Ms. That's breaking the oath.

Pharmacists also break the oath. We break the oath because we work for HUGE corporations where stockholders and profit are the only concerns. A patient complaint to a large pharmacy corporation is WORSE than a failed DEA inspection. And a pharmacist will fill prescriptions that are suspicious, give early refills, or bend over backwards to prevent a complaint to corporate.

Am I incriminating myself here? Well, I look at it this way. I entered the field THINKING that it was honorable. Pharmacy used to be coined The Most Trusted Profession. I thought I was going to be a professional and that my job would mean something. Absolute shit. I am forced to meet metrics which are designed to fail, I'm a telemarketer asking people to come pick up their meds, and I cannot make judgment calls in terms of legal issues. So if this is incriminating, then fuck it. Fuck the healthcare system.

As far as knowledge is concerned? Big corporations could not possibly care less if I give incorrect information to a patient. As long as I create a sell, a new customer, and generate profit, corporate doesn't care if I tell people that eating Skittles will cure diabetes. And because of the long, stressful hours I have to put in at work along with the fact that my employer places no value on my knowledge, I do not put any of my personal life into bettering my own education and learning. I don't care to... I've realized what a failure of a system I'm in. It's sad, really.

Haha Funny moment today. I was walking by our TV when a commercial for a new drug came on. The drug is called Xeljanz. I have never in my life even heard of it and I have no idea what it's used for. Typically, you would think a pharmacist would either be all over that or have already known about it. But instead, I laughed and said "Looks like I'll have another reason to pull my phone out at work." Because I knew that patients would be asking me about it. I'm going to have NO IDEA what to tell them. Side effects? How to properly use it? Hell, what is it for!? I have no idea and I'm not looking it up. My employer DOES NOT CARE. Why should I? Wasted investment.

So yeah, I went off the beaten path here talking pharmacy instead of MDs. But I'm sure it resonates still. Money is the root of all evil. Healthcare and politicians go hand-in-hand. Sucks. Yep. Sucks.

Edit: Oh snap, Chris invaded the How-To Cafe.

 

[fire_breeze]

Thank you all for commenting. It is very intriguing to see the various perspectives about the attitudes towards the medical community. I find it fascinating how much of it is tied in with medical costs and its correlation of private or universal systems.

I am reminded of SweetErika's thread about Private vs. Universal Healthcare (here) which seems to compliment this debate.

One question that seems to come up is the ability to see a doctor. From what I understand, in private systems, you can only see an in-network physician - in other words, one is not free to chose a doctor, but must chose a physician from a list. Could this contribute to the attitude of many people?

I know many people who google diagnose themselves or change their medication times/doses/what have yous without consulting their physician. I think it's an effect of the overwhelming abundance of readily available information.

I am shocked by attitudes towards physicians, but at the same time I think it's a symptom of the times. We can access an app that can tell us what that man or woman went to school for a gazillion years to learn. We, as a people, seem to trust the Internet over the human. It's amazing and interesting and sad all together.

You know what surprises me? The commercials for medications. I know the premise is to inform and for people to go ask their doctor if that med us right for them. But I listen to the side effects and "small print" and I just know that I am not informed enough to choose something like that for myself or my family. I have great respect for our physicians and nurses and their staff.

Oh Gods yes! I can't even tell how many times I've had a serious illness after I've googled my symptoms. I have to actually prevent myself from doing so - the stress was unbelievable.

Do you think that commercials for medications should be reduced or not even advertised? After all, as you said, it misleads the person in believing that they are fully capable of prescribing themselves meds.

I think that most doctors have good intentions, but these days almost all are employed by corporations and some of those are bad. I had a SO who is a n MD, and the corporation she works for is a Medicaid mill. They are in neighborhood that has a lot of medicaid recipients. Their main business is physical therapy, chiropractic and such, and the only reason they hired a doctor was to be able to prescribe their own treatments. They are drooling over all of the new medicaid patients being signed up through Obamacare.

Worse yet is the large outfit in FL that was doing a lot of unnecessary cardiac catheter lab work in a number of hospitals. The Shands system was involved in that. I saw it up close and personal and called a couple of doctors out on it. It wasn't until 6 years later that the law caught up with them.

Another thing that has driven health care costs up and has driven doctors out of private practice is our third party payer system. The paperwork and billing games eat up a good chunk of what we spend on healthcare. Before the 80's you had insurance for hospitalization and major medical expenses. you paid out of your pocket for routine checkups and care, and the cost was reasonable. Once the insurance companies became involved in primary care, it turned into a nightmare and costs soared, as the physicians had to hire more help that is pure overhead just to handle the administrative nightmare.

Let me give you an example of how it works here in the states. You go to your doctor, and he examines you, comes up with a diagnosis and gives you an injection. Even though they have a contract with the insurance company that fixes the price for the office visit at $75 and the injection at $35, they send the insurance company a bill for $460: $180 for the office visit and $280 for the injection. After a few days or more, the insurance company rejects the claim and sends notices to both you and the doctor. The doctor then resubmits the claim for the contractual amounts (total of $110), and then can take a contractual write-off for the balance. Add to this that claims often get bounced back and forth multiple ties for improper coding and other nonsensical reasons, each time requiring multiple pure overhead people to deal with it. It is beyond stupid. Oh yeah - if you don't have insurance, you pay the $460 (plus a tax for not having insurance starting this year).

It doesn't surprise me a bit that people don't want to go to the doctor.

That is unbelievable! Why is there no caps on this? No regulation? If primary care, for example, was NOT privatised, do you think it would help? Would people be less dismissive of physicians?

I have found that healthcare trends can often be geographical, not just by country, but also by region. Healthcare is the largest industry in my city. We do it very well. I have a sister who lives in West Texas and I cringe every time she needs to see a doctor. This past December, she informed me that she found a doctor "willing to remove her brain cyst."
(Now - I've been to her neurologist's office. It reminded me of the movie, Texasville, complete with the dust laden floor and 3-blade fan in the corner.)
I flew her here where she learned that was advised AGAINST surgery and an alternative plan was offered. She will fly here for a follow-up in 6 months.

Much like Fire's experience, my insurance covers many wellness therapies like reiki, massage, and classes for things like meditation and tai chi. The cost of my health insurance is structured so that people who actively participate in programs that enhance health pay less than people who do not. I appreciate the resources. My personal experience is that I am exposed to healthcare professionals that are looking out for my future.

That being said... (there's always a but)...

Changes to healthcare delivery in the US is changing, especially changes to reimbursement. It is becoming increasingly difficult to prove that hospital admissions are necessary and people are being told that they need to manage chronic disease more efficiently at home.

I do not think that every person feels able to be held accountable for his or her health. A great many people find it confusing. They resent being told that they now need to become educated on something that they previously entrusted to the medical community. They are frightened by the uncertainty of a healthcare system upon which they used to rely for small things.

That being said (yikes!)
I believe these changes are necessary and will ultimately make for a stronger system - once old habits can be changed.
Shouldn't take longer than a half century or so.

Thank you. I find it sometimes odd that many doctors prescribe or recommend invasive procedures when therapy works just as fine. I have a friend, for example, whose insurance would have paid for surgery but not for intensive therapy. The surgery was more expensive on the book, and was also high-risk. The therapy was comparably cheaper and the only thing was that it didn't work as well and she would have needed surgery. Luckily, she was able to afford the therapy and chose that route, and she is pain free-free. But I shudder to think what it could have been...

What sort of changes do you think is necessary in order to have a good doctor-patient relationship?

 

[fire_breeze]

Call attention to whatever is relevant in your chart! It could save your life.

There is too much crap there for everybody who treats you to read. They don't have the time, or always the expertise. My experience is in America, but a health care professional who's worked in Canada and Europe said it's too much the same.

Once an intern tried to give me a drug I was acutely allergic to because he didn't read the chart, or the warnings all over the outside of my file.

Another time a team preparing me for a procedure accidentally triggered unconsciousness and muscle spasms because they didn't read my chart. I should have told them about it when they wheeled me in instead of after I regained consciousness and they were all staring at me like deer in the headlights. I didn't think it was necessary, considering that very condition had been diagnosed a few hours before on the same floor of the same hospital.

Got some pain? Point out your history of cardiovascular problems. Chest cold? Point out your lung issues and surgeries. They'll test & prioritize you accordingly.
You get the idea. Help them get to the point.

In the case of another condition, I'm the only case my doctor has ever seen, and a rare case for specialists, for that matter. It pays to get informed in these circumstances, so that you can ask the right questions.

In my wife's case she was given less narcotics post-op than she was prescribed for home use, because they didn't pay attention, they just followed standard procedures. That didn't turn out well, either.

Another time she nearly died from surgical complications.

The doctors, etc. aren't bad, they're just busy. I can understand how laypeople could become bitter and distrustful if they lost a loved one.

All of that said, I strictly adhere to doctors orders, like it or not. I figure I can't hold them accountable if I don't follow their advice.

I agree that we are responsible for our healths, but also that we are not experts. I just wonder where is the line. I've read many stories - granted, anecdotal - that has people insisting that they know better than the doctor. For example, I have a thyroid condition. An acquaintance of mine is pushing me to try herbal remedies and cutting out all dairy and all cruciferous vegetables and I will be cured of said disorder. I know I cannot. I also know, through studies, that it does NOTHING. My doctor and endo (both of them promoters of healthy lifestyle and alternative medicine if it is applicable) said nope. No can do, it will do nothing. I know that they are not paid by a pharmaceutical company. However, my acquaintance was adamant, even aggressive, in her insistence that my thyroid condition was actually a slow metabolism and that all I needed to do is XYZ.

So where does one draw the line in what s/he tells their doctor?

Doctors don't know everything. Before I was diagnosed with lymphoma (finally), I had been incorrectly diagnosed with rib inflammation, for six months. I ended up in the ER in extreme pain with other symptoms, and after a week I learned what was wrong with me, after going through excruciating tests. Medicine is not an exact science, even in the 21st century. It is still a game of guesswork. Fortunately, during this time period, I had a great job with great health insurance.

I've come to believe that healing should not be a business, but a calling, and that everyone should have access to healthcare. Unfortunately, medicine in the U.S. is controlled by corporate interests, and nothing else. If you can't pay for your healthcare needs, well, tough shit. So, in reality, despite all the gains and knowledge that the world has acquired about medicine and diseases, we are basically in the medieval ages as far as healthcare, and who has access to it.

I am sorry you had to go through that struggle and I hope you are on the path of better health

It is true that doctors are only human, are capable of making mistakes and mis-diagnosing. It is the unfortunate consequence of doctors, and I can see how having negative experiences would alter one's perception of going to the doctor's.

If medicine is not a for-profit business, and it in fact regulated (so not a business model) would that cause for a more trusting relationship?

This for-profit scheme is very real and very scary. Take a look at pain management doctors. There's a documentary called the OxyContin Express (free to watch on Youtube) and it lays out a perfect example of MDs abusing their licenses. They make their money CASH only. They would hand out prescriptions for oxycodone like it was M&Ms. That's breaking the oath.

Pharmacists also break the oath. We break the oath because we work for HUGE corporations where stockholders and profit are the only concerns. A patient complaint to a large pharmacy corporation is WORSE than a failed DEA inspection. And a pharmacist will fill prescriptions that are suspicious, give early refills, or bend over backwards to prevent a complaint to corporate.

Am I incriminating myself here? Well, I look at it this way. I entered the field THINKING that it was honorable. Pharmacy used to be coined The Most Trusted Profession. I thought I was going to be a professional and that my job would mean something. Absolute shit. I am forced to meet metrics which are designed to fail, I'm a telemarketer asking people to come pick up their meds, and I cannot make judgment calls in terms of legal issues. So if this is incriminating, then fuck it. Fuck the healthcare system.

As far as knowledge is concerned? Big corporations could not possibly care less if I give incorrect information to a patient. As long as I create a sell, a new customer, and generate profit, corporate doesn't care if I tell people that eating Skittles will cure diabetes. And because of the long, stressful hours I have to put in at work along with the fact that my employer places no value on my knowledge, I do not put any of my personal life into bettering my own education and learning. I don't care to... I've realized what a failure of a system I'm in. It's sad, really.

Haha Funny moment today. I was walking by our TV when a commercial for a new drug came on. The drug is called Xeljanz. I have never in my life even heard of it and I have no idea what it's used for. Typically, you would think a pharmacist would either be all over that or have already known about it. But instead, I laughed and said "Looks like I'll have another reason to pull my phone out at work." Because I knew that patients would be asking me about it. I'm going to have NO IDEA what to tell them. Side effects? How to properly use it? Hell, what is it for!? I have no idea and I'm not looking it up. My employer DOES NOT CARE. Why should I? Wasted investment.

So yeah, I went off the beaten path here talking pharmacy instead of MDs. But I'm sure it resonates still. Money is the root of all evil. Healthcare and politicians go hand-in-hand. Sucks. Yep. Sucks.

Edit: Oh snap, Chris invaded the How-To Cafe.

I hoped that you would post. Thank you for your insight - it's absolutely invaluable and honestly, like you, am shocked. I know that you entered the profession because you felt that it was a calling. I am so sorry that the circumstances forced you to be miserable and trapped you.

My question, Christopher, is why isn't there any lawsuits or control? If, after all, I trust a pharmacist with dispensing the proper information and they don't, and I have a severe adverse reaction to said interaction of medication, isn't that the pharmacist fault? (Not you - I know fully well that your hands are bound and there isn't much you can do).

My other question is that whether or not there is 'contract' to prescribe medication? For example - as a facetious example, if my doctor prescribes me an anti-inflammatory, would she write anti-inflammatory or will she actually say Aleve, or is it the pharmacist who would give me the brand? In other words, who gives me the actual brand of medicine - the doc or the pharmacist? And if it is the former, would she prescribe me the meds knowing full well that Aleve could give me a heart attack if ingested with my thyroid medication (it's just an example!!!! I know it cannot)

And also, is there any possibility of change, where the medical community ends up having a good relationship with the public?

 

[Christopher2012]

I hoped that you would post. Thank you for your insight - it's absolutely invaluable and honestly, like you, am shocked. I know that you entered the profession because you felt that it was a calling. I am so sorry that the circumstances forced you to be miserable and trapped you.

My question, Christopher, is why isn't there any lawsuits or control? If, after all, I trust a pharmacist with dispensing the proper information and they don't, and I have a severe adverse reaction to said interaction of medication, isn't that the pharmacist fault? (Not you - I know fully well that your hands are bound and there isn't much you can do).

My other question is that whether or not there is 'contract' to prescribe medication? For example - as a facetious example, if my doctor prescribes me an anti-inflammatory, would she write anti-inflammatory or will she actually say Aleve, or is it the pharmacist who would give me the brand? In other words, who gives me the actual brand of medicine - the doc or the pharmacist? And if it is the former, would she prescribe me the meds knowing full well that Aleve could give me a heart attack if ingested with my thyroid medication (it's just an example!!!! I know it cannot)

And also, is there any possibility of change, where the medical community ends up having a good relationship with the public?

Well there are lawsuits! And my 'company' is well-equipped to pay out when need be. They have the pharmacists ass 100%. Or at least that's their claim! Usually, when a serious mistake is made, the pharmacist KNOWS NOTHING about the end result of civil cases. We are kept completely out of the know. As a matter of fact, my district managers have told me not to even waste my time with malpractice insurance.

Let me tell you something truly shocking! When I first moved to Savannah, I had a group meeting and a case was brought up about a young girl who was permanently affected by a misfill. What was the main concern of the district manager? The customer that we lost. And then after she realized that was a serious fuck-up, she then added on the very end that "Oh and we don't ever want to see a young patient get injured." Yeah bullshit, bitch. Bull-fucking-shit.

I was WRITTEN UP for putting patients lives in danger because I wasn't meeting metrics, playing telemarketer and trying to get patients to pick up their medications. We have an in-depth metrics system which requires patients to pick up their meds within 7 days. If they don't, we get dinged for it. And so, we are CONSTANTLY tricking the system by returning to stock medications before they hit day 7. It's so bullshit. It's the most fucked up profession in the world. And I got into a downright fight with my boss, telling her how bullshit this was. She was pretty much going to fire me on the spot but I backed down and said "Look, this isn't a battle that I want to choose. I can't just lose my job. So... what do you want me to do?"

Do I get my prescriptions filled at my company? FUCK NO, FUCK NO, FUCK NO. I pay out-of-fucking-pocket for medications because I do not support my own company. Hell, I'm scared to get killed myself. And it's not the pharmacists that work there. They are truly good people. They are just pressured to do WAY more with no help and they have to meet impossible metrics which don't even make logical sense.

And oh... our company tries everything they can to loophole the law. Every time the Boards of Pharmacy crack the whip, my company immediately sends out computer-based learning modules to train its staff. The modules are stupid and they aren't taken seriously.

As far as your question is concerned about the writing of prescriptions, here in America, the doctor write for specifics. So he would write for Aleve 500mg, take 1 twice daily with food, #30, zero refills. We have to have all the specifics for it to be a legal prescription. We are never allowed to change a medicine even in the same class of drug without contacting and getting the okay from the doctor. However, when it comes to brand/generic drugs, a doctor can write for Aleve and we can legally dispense generic naproxen instead. That's considered acceptable.

A good relation with the public? I mean, I don't really think I'm able to answer that. I can think on it some more. It takes a lot of hard work on the patient's part to really find a genuine MD. Patients oftentimes think that providers are looking out for their best interests. Nope, not so... we are pressured by the higher-ups to show off to stockholders.

Bottom line, CUSTOMER SERVICE is priority number one in my field. Law is placed dead last. And if I was ever caught saying this, I would be fired immediately and blacklisted from my company. Well fuck them. They're are the absolute definition of the word "CORRUPT."

 

[GiggLeGasm]

As far as your question is concerned about the writing of prescriptions, here in America, the doctor write for specifics. So he would write for Aleve 500mg, take 1 twice daily with food, #30, zero refills. We have to have all the specifics for it to be a legal prescription. We are never allowed to change a medicine even in the same class of drug without contacting and getting the okay from the doctor. However, when it comes to brand/generic drugs, a doctor can write for Aleve and we can legally dispense generic naproxen instead. That's considered acceptable.

This is true in the outpatient setting. For inpatient hospital admissions, the healthcare facility can have pre approved substitutions. For example, my institution does not stock nexium. prilosec is automatically substituted. We can also alter the form of the medicine (liquid, tablet, etc) if no other adjustments need to be made.

To Fire's question about liability, a nurse can actually be held accountable if medications that contraindicated are prescribed and administered to a patient. Every set of hands can (and should) be held responsible.
Mots errors do not cause significant injury. By that, I mean that most don't have recognizable damages. I believe that lawsuits are diminished because of strong efforts to keep patients safe.. I can only speak for the inpatient setting though - and certainly only from my own exposure.

 

[patient1]

I agree that we are responsible for our healths, but also that we are not experts. I just wonder where is the line. I've read many stories - granted, anecdotal - that has people insisting that they know better than the doctor. For example, I have a thyroid condition. An acquaintance of mine is pushing me to try herbal remedies and cutting out all dairy and all cruciferous vegetables and I will be cured of said disorder. I know I cannot. I also know, through studies, that it does NOTHING. My doctor and endo (both of them promoters of healthy lifestyle and alternative medicine if it is applicable) said nope. No can do, it will do nothing. I know that they are not paid by a pharmaceutical company. However, my acquaintance was adamant, even aggressive, in her insistence that my thyroid condition was actually a slow metabolism and that all I needed to do is XYZ.

So where does one draw the line in what s/he tells their doctor?

People like that usually want a chiropractor or homeopath or something rather than a doctor. They can shop around until they find what they want. Somebody who will tell them what they want to hear, whether it's that they can be treated cheaply, or that it's possible to cure them unconventionally.

As far as second guessing the doctors and other medical professionals, it's merely a matter of me asking if they took something in my messy medical history into account.

Sometimes making one condition better makes another worse.

I have been given drugs I'm allergic to more than once, and the reactions tend to be more dramatic with each additional incident. The last time it was prescribed by my specialist , and the pharmacist caught it.


Now it gets different when it comes to a syndrome I have, that rare condition I mentioned before. Doctors don't agree on a cause, there's no cure, and an autopsy is the only definitive test for it. It's a differential diagnosis. It's idiopathic. There are various theories about treatments that work sometimes to treat symptoms for some people . Maybe 1 in 10,000 people have it., but there is a lot of misdiagnosis.

The specialist who diagnosed me advised me on a treatment and recommended I inform myself on the syndrome, because I have the time and motivation to become my own advocate. I took that advice.

I joined an online support group. I met people who were misdiagnosed and given useless surgery . I bought medical textbooks and copies of research reports over the years. I know about theories and treatments around the world. Drugs, surgeries, diets, therapies Etc. Etc.

When it comes to my syndrome I'm prepared to discuss the approaches of various famous doctors at different prestigious clinics around the country with my current specialist, and I have. I'm satisfied with her answers.

My internal medicine doctor is experienced and smarter than me, I trust her with my life, and I dread the day she retires. Time has proven her right about everything. She has never made one of these medical mistakes I've told you about.

When it comes to my syndrome, I'm not satisfied. She doesn't have time to keep up to date on the subject for one patient among a couple thousand. She doesn't deal with it every moment of her life. My syndrome is the sole exception.

So with my doctor the line is drawn at my syndrome.

With my specialist, and with various medical professionals I happen to meet in a hospital in the course of necessity, the line is drawn at "Did you take X into account?"

 

[FGB]

My Dad RIP had gone to several skin specialist that were helpless to diagnose his condition.

He was at his regular MD for a normal check up and complained about the pain and about not being able to find a "Doctor" that could help him.

The old regular MD "Horse Doctor" had him remove his shirt so he could take a look.

From across the room he nailed it it two seconds..."Hell Oscar!...You have the Shingles!"