Useful Links

Danny · 05-11-2006, 03:28 PM

Some never have to take a prescription drug, while others are faced with a handful everyday.

MikeD · 05-11-2006, 03:37 PM

I take 13 prescription drugs every day. I had diabetes for 46 years and a kidney/pancreas transplant. I need lots of drugs to stay alive. My wife probably has to work 'til she's 65 just to keep us in insurance.

Mike D.

frayne · 05-11-2006, 08:34 PM

I really feel for those who need to take drugs for legit reasons. That said I truly believe we are an overmedicated society where illness are dreamed up on Madison Ave. and marketed to the trusting and unsuspecting masses.

Rich_by_the_Bay · 05-11-2006, 08:48 PM

Quote:

Originally Posted by frayne

I really feel for those who need to take drugs for legit reasons. That said I truly believe we are an overmedicated society where illness are dreamed up on Madison Ave. and marketed to the trusting and unsuspecting masses.

I agree.

When I was practicing general internal medicine, I spent a good bit of my time talking patients OUT of medications. Typically they wanted antibiotics for viral infections such as colds, or valium/xanax type drugs because life was a bit more stressful than usual, or pain medications when their real problem was depression, or antidepressants for modest situational ups and downs.

Often, a direct-to-consumer ad in a magazine like Newsweek would precipitate the visit. Other times, well-meaning "support groups" would misguide patients. Usually, they would listen to reason if I treated their concerns and requests with respect and patience.

Ironically, there is another large group who decline to take medications which would prolong their good quality life (statins after lifestyle changes failed, antihypertensives). Over time, I became pretty laid back about it, informing but not coercing, and being sure they had good information and an unbiased recommendation. If they agree, great. If not, that's OK, too, once the risks and benefits were well understood.

Some of my younger colleagues would get huffy with patients who didn't follow the plan. I never quite saw it that way.

razztazz · 05-11-2006, 08:51 PM

Quote:

I really feel for those who need to take drugs for legit reasons. *That said I truly believe we are an overmedicated society where illness are dreamed up on Madison Ave. and marketed to the trusting and unsuspecting masses.

here. You can throw this in to any dynamic scoring on medical costs and why we spend so f'ing much and who should be denied insurance.

I am on medication, likely for life, in order to deal with a permanent "adverse reaction" to medications I was given by my doctor for conditions he thought I had. I had to trust him. *He's the expert, right? Don't take it or die/die sooner. Don't take croak soone and have a crappy life *in teh mean time.

So, I am now f'ed for life and on medication and still have a diminished quality of life due to being medically f'ed up

Here the dr and the misapplied drugs were the cause. *Mis/over-porecrbed drugs and drs not talking to each other just recently almost killed my mother. Fortunately a couple hundred goddamned dollars worth of hospital time fixed.

And all of a magical sudden she doesnt have to take all those medications they insisted she had to have for the past 7 f'ing years and she's just fine.

I wonder how much all this adds up to in the scheme of things?

Maximillion · 05-12-2006, 06:37 AM

Americans are Over Medicated and over Daignosed, but a large part of this is due to the Medical communities need to provide documentation to protect themselves from the Americans' propensity to sue their Health Care providers.

My Dad is 87, he takes Baby Aspirin a day, they have detected a small heart irregularity, now they want him to take this new Drug that requires monthly visits to the Hospital.

I have asked him to question the doctor, I would hate to see him adversly affected for what?A few more possible months?

Dawg52 · 05-12-2006, 07:04 AM

I have been taking a Lovasatin for my cholesterol but recently decided to give it one more shot at a better diet(which includes blueberries daily), exercise and taking the over the counter supplement 'red yeast rice'. After being off my prescription for 3 weeks my cholesterol count tested yesterday at 150. Old drug may still be in my system so I will have have it tested again in a few weeks to see if it is still down. Time will tell.*

Rich_by_the_Bay · 05-12-2006, 07:15 AM

Quote:

Originally Posted by Maximillion

Americans are Over Medicated and over Daignosed, but a large part of this is due to the Medical communities need to provide documentation to protect themselves from the Americans' propensity to sue their Health Care providers.

My Dad is 87, he takes Baby Aspirin a day, they have detected a small heart irregularity, now they want him to take this new Drug that requires monthly visits to the Hospital.

I have asked him to question the doctor, I would hate to see him adversly affected for what?A few more possible months?

Huh?

I think you're confusing some issues. There is a tendency in American health care to over-test - that has been documented and part of it may be defensive medicine. And there is a tendency among patients to overuse the system, and that is in part cultural demands.

But I have never seen evidence that there is a financial incentive (malpractice or other) for American doctors to over-prescribe (that is more often due to poor decision making or intense pressure from patients).

Care to provide any evidence linking high prescription rates with malpractice risk? If anything, such behavior would increase liability exposure (side-effects without benefits = unnecessary risk). We don't get paid by the prescription, you know...

Maximillion · 05-12-2006, 08:50 AM

RIT, how often could a life style change, a diet change, a refrain from drinking change, remove the neccessity to pop a pill

The Instant Fix is part of the problem, but that does not solve the problem, it just means that they keep popping pills for the rest of their life instead of dieting, walking a mile a day, and lay off the booze.

Do Doctors not get paid every time a Prescription they wrote is filled??

Rich_by_the_Bay · 05-12-2006, 09:37 AM

Quote:

Originally Posted by Maximillion

RIT, how often could a life style change, a diet change, a refrain from drinking change, remove the neccessity to pop a pill

The Instant Fix is part of the problem, but that does not solve the problem, it just means that they keep popping pills for the rest of their life instead of dieting, walking a mile a day, and lay off the booze.

Do Doctors not get paid every time a Prescription they wrote is filled??

I am not sure if you are kidding about docs getting paid every time a prescription is filled, but I will assume you are sincere: no, we get no reimbursement for prescriptions dispensed or filled. Zip Zero Nada Rien. What a horrible system that would be.

Regarding "often could a life style change, a diet change, a refrain from drinking change, remove the neccessity to pop a pill

"

So true. I and my colleagues routinely counsel patients to lose weight, get more exercise, curb the salt intake, etc. Long-term compliance in such matters: 10% or less. Out come the statins or an unwanted event. I always try lifestyle changes first in a willing patient, but my inner self has become pretty jaded about the likelihood of success. In fact, national guidelines now recognize the noncompliance issue and advise in most cases that you just go ahead and treat (you can always stop if the patient succeeds in losing weight, exercise, etc. but meantime you have protection for an additional year for the 90% who fail).

No easy answers here, I'm afraid. It's the dreaded "multi-faceted problem." Docs share part of the blame but maybe not as much as some would suggest.

lazygood4nothinbum · 05-12-2006, 10:29 AM

Quote:

Originally Posted by Rich_in_Tampa

I and my colleagues routinely counsel patients to lose weight, get more exercise, curb the salt intake, etc. Long-term compliance in such matters: 10% or less. Out come the statins or an unwanted event. I always try lifestyle changes first in a willing patient, but my inner self has become pretty jaded about the likelihood of success.

eating hamburger & coldcuts everyday for lunch and steaks almost every night, even in my late 30s my choresterol level was scarey. doc wanted me on statins and insisted i get blood tested every other month, all the while urging me to change my lifestyle.

a year of worrying about the destruction of my organs from taking pills, those annoying blood tests and, frankly, that annoying doctor and i became a vegetarian for life.

look ma, no pills.

SteveR · 05-12-2006, 11:43 AM

First rule of drugs........

All drugs are foreign to your body and can create side-effects; sometimes very nasty ones.

Second rule of drugs.....

No drug is 100% safe or effective for everyone. (See rule #1).

Third rule of drugs......

If there is a way to abuse them....people will find a way to do so.

Fourth rule of drugs.....

All the easy drugs have already been found and made. Only the hard ones are left and these cost more to find, get approved and make...they also have more side effects.

Fifth rule of drugs...

For the most part..drugs do not "cure" anything...they treat symptoms, increase or decrease some body chemical, create condition in the brain that modified how it perceives incoming nerve signals (pain, depression, etc) or replace something missing. There are some others but these are the most common used for drugs.

I am sure there are others but these are the ones I see most.

"Better living through chemistry" is what it is all about.

Danny · 05-12-2006, 02:33 PM

http://hearthereeverywhere.blogspot....medicines.html

Maximillion · 05-12-2006, 02:50 PM

RIT, I believe under the Canadian System the doctor gets paid when the script is filled.

Today's drugs are synthesised versions of old herbal treatments, doseages are more accurate, results are quicker.

Homeopathic Doctors claim they work with patients to cure the underlying cause as opposed to giving them drugs which just hide the cause.

Rich_by_the_Bay · 05-12-2006, 03:14 PM

Quote:

Originally Posted by Maximillion

RIT, I believe under the Canadian System the doctor gets paid when the script is filled.

I really do not believe that is the case, Max. It is a common misperception, at least here in the states.

Danny · 05-12-2006, 03:17 PM

Quote:

Originally Posted by Rich_in_Tampa

I really do not believe that is the case, Max. It is a common misperception, at least here in the states.

But with all do respect to you and friends of mine that are doctors - doctors do get perks from the drug companies, etc. as well as wined & dined, junkets, right?

Rich_by_the_Bay · 05-12-2006, 03:42 PM

Quote:

Originally Posted by DanTien

But with all do respect to you and friends of mine that are doctors - doctors do get perks from the drug companies, etc. as well as wined & dined, junkets, right?

Well, that used to be the case. Currently (and I always abstain), the most that one can legally receive is a dinner talk on some new medical topic by a third-party expert at a fancy restaurant. It is illegal to provide perks that are over $20 other than independent medical educational affairs. Junkets were outlawed about 15-20 years ago, as I recall it. Good riddance.

So, if you consider pens with viagra written all over them to be a perk, yes that persists. Anything beyond that is not done legally. The only exception I know about is that speakers are paid an honorarium for giving a talk (say, $1000) but that is probably less than market for hours of a physician's time in preparation, travel and expertise.

I am sure there are some who abuse the relationship, but it is not common. I just got back from the national convention of a major medical society at which I am one of, if not the, senior member. I came home with a box of mints from a recruiter, a pen with no logo, a CD of medical demo applications, and a rubber model of a prostate gland (my personal favorite).

I guess with all those misperceptions going around, it is understandable why there is so much negativity toward my imperfect, but generally still pretty decent profession. Hope that helps.