Why US Healthcare is so messed up. (2 Viewers)

[RazorOye]

Consider many pharmaceutical sales representative influence physicians to prescribe their drug by over-sampling, free lunches for the staff and by creating revenue streams for the physician by engaging them to speak to other physicians on their behalf through expensive dinner programs.

Do you agree with this sort of incentivizing of prescription medication dispensation? Whether dispensation generally (when there are other, non-prescription alternatives) or specifically pushing a brand.

Going into a physician office as educated as possible is important. If the consumer does their due diligence and researches beyond the television commercial they will find numerous blogs of individuals who have nothing to gain other than trying to help someone from their personal experience.

I just don't understand this.

You're going to see the doctor. What diligence are you supposed to do? Let's say that you don't have access to that information. Let's say that you're told that you or your kid has something that you aren't able to diagnose yourself - so you don't even know if the treatment options that you are being given even work for what the diagnosis is. An emergency situation arises - one you have no time to study up on or look at the internet to investigate potential prescriptions or treatments you might get and the various pros/cons about them. Or what about when you log on the internet to find out about how a drug works or what it can cause or how effective it is against X and that information is, in fact, unreliable. Etc.

I think you are overstating the ease with which this "research" and "due diligence" can be conducted by a lot of people.

Why is that type of unbiased information not coming from the doctor? I think that should be part of his job. That's why we go to them - for them to do what is in the patient's best interest. Not pushing a certain drug that might not be optimal, blaming the patient if they take it and it's not the best option because he/she knows better.

The amount of trust that's given to doctors to be caregivers and to answer questions honestly and fairly and dispense information and medicine forthrightly is considerable.

It's one thing to get a second opinion. It's another thing to expect me to do the homework I trusted the doctor to do for me in the first place.

I don't think his job should be to push a particular drug because he's getting a sweet deal on the side from PharmaCorp XYZ and it's then up to the customer to decide if that drug is actually what he/she should be taking.

That's a pretty poor way of arranging a healthcare diagnosis/prescription transaction between a patient and his/her doctor.

It defies logic. I'd think it defies ethics.

And you're giving them a free pass? And then invoking some sort of caveat emptor because the panic-stricken single dad, in the ER with his infant daughter for the first time, didn't google treatments and prescriptions on WebMD before he left for the hospital.

This sort of expectation just doesn't make sense to me.

I'm not absolving the patient of responsibility here - my post above was entirely about taking one's own healthcare into his/her own hands whenever possible. But there's a difference between that and second-guessing everything a doctor says because his priorities might have been compromised and, well hey, that's on you.

 

[RazorOye]

Dude, you were awesome in those Pizza Hut commercials.

it's better than

 

[RazorOye]

On a side note, now that you are Dr. Oye, do you ever go see yourself?

I talked to myself looooooong before I finished the PhD.

 

[daybreaker]

2. Excessive regulation - Not saying all regulation is bad, but, for example, the criteria for becoming a medical practitioner is way too strict. There is no reason why I should need eight years of schooling to say, “Hey, you have an ear infection. Take this for a week.”

Probably half the nurses at most hospitals could handle a lot of the GP work that gets done, but they can’t, because the government doesn’t allow them to.

Sorry, but this is flat out ridiculous logic. "Lets cherry-pick one simple case to make our point"

And yes, I bet half the nurses could handle simple GP stuff, thats why they have NURSE PRACTITIONERS who *do* do that.

How many regular nurses with < 10 yr experience could handle every day GP stuff though? And would you trust them?

 

[jbourque]

Do you agree with this sort of incentivizing of prescription medication dispensation? Whether dispensation generally (when there are other, non-prescription alternatives) or specifically pushing a brand.

I just don't understand this.

You're going to see the doctor. What diligence are you supposed to do? Let's say that you don't have access to that information. Let's say that you're told that you or your kid has something that you aren't able to diagnose yourself - so you don't even know if the treatment options that you are being given even work for what the diagnosis is. An emergency situation arises - one you have no time to study up on or look at the internet to investigate potential prescriptions or treatments you might get and the various pros/cons about them. Or what about when you log on the internet to find out about how a drug works or what it can cause or how effective it is against X and that information is, in fact, unreliable. Etc.

I think you are overstating the ease with which this "research" and "due diligence" can be conducted by a lot of people.

Why is that type of unbiased information not coming from the doctor? I think that should be part of his job. That's why we go to them - for them to do what is in the patient's best interest. Not pushing a certain drug that might not be optimal, blaming the patient if they take it and it's not the best option because he/she knows better.

The amount of trust that's given to doctors to be caregivers and to answer questions honestly and fairly and dispense information and medicine forthrightly is considerable.

It's one thing to get a second opinion. It's another thing to expect me to do the homework I trusted the doctor to do for me in the first place.

I don't think his job should be to push a particular drug because he's getting a sweet deal on the side from PharmaCorp XYZ and it's then up to the customer to decide if that drug is actually what he/she should be taking.

That's a pretty poor way of arranging a healthcare diagnosis/prescription transaction between a patient and his/her doctor.

It defies logic. I'd think it defies ethics.

And you're giving them a free pass? And then invoking some sort of caveat emptor because the panic-stricken single dad, in the ER with his infant daughter for the first time, didn't google treatments and prescriptions on WebMD before he left for the hospital.

This sort of expectation just doesn't make sense to me.

I'm not absolving the patient of responsibility here - my post above was entirely about taking one's own healthcare into his/her own hands whenever possible. But there's a difference between that and second-guessing everything a doctor says because his priorities might have been compromised and, well hey, that's on you.

I do not agree with incentive's for physicians to prescribe anything, or to influence a physician by any other means than education through double-blinded, placebo controlled randomized studies that out line efficacy. Studies should also have patient limits and not be allowed to promote with a very small sample size. Research and due diligence were more of a suggestion in ones own best interest, than a mandate for every situation. I'm not sure how you came to your conclusion that I thought any different.

My suggestion is to do as much research as possible for medications and disease states was based on the premise that one has the capacity. There are great resources out there like WebMD. Ask intelligent questions to your doctor? Become a part of the process as opposed to just believing anything the doctor says. Ask the doctor for information on the product he/she prescribes for you. In many cases, it's available in the office. This applies to routine visits and cases which may require surgery. If you can't, then you can't. I've worked in the medical industry my whole life and I can unequivocally tell you not all doctors are the same, and the level of trust I place in them is different. The old adage is this. What do you call a Doctor who makes a D in medical school? The answer is Doctor.

your quote:
I don't think his job should be to push a particular drug because he's getting a sweet deal on the side from PharmaCorp XYZ and it's then up to the customer to decide if that drug is actually what he/she should be taking.

That's a pretty poor way of arranging a healthcare diagnosis/prescription transaction between a patient and his/her doctor.

Neither do I. And no physician worth his salt will allow a patient to choose what is best for them. Having said that, in many instances there is more than one option available for a patient and a disease state. For example, multiple cholesterol medications, multiple anxiety medications, multiple anti-depressants etc.. So if I read and viewed on TV that Abilify has a side-effect profile as adjunctive therapy for an anti-depressant, that can cause death. I may want to ask my physician about that as opposed to driving to the pharmacy.

I do not give physicians a free pass. When they are in the treatment room I want to understand whats going on, what my options are, the side-effects from treatment are and decide together what is in my best interest.

 

[BHM]

There's your problem, you shouldn't have went to a OB/GYN for a cyst on your knee.

That explains why at first she just thought my knee was pregnant.

 

[bclemms]

A certain in-law is the prime example. You can make up the name of a disorder and just throw together random symptoms and as long as there isn't a blood test available that says positive or negative for that disease/disorder she has it and is on medication for it. The doctors love her, the pharm companies love her, her pharmacy loves her and the government enables her. Meanwhile, the same doctors fill her head with ideas while writing a list of reasons she should be on disability. She is in too much pain to work but she can go to the mall all day with two kids on her hips with no problems.

All this is happening while the guy that works 40 hours a week and can't afford healthcare but makes just enough money to be above the poverty line and gets pushed to the back of the line the one time in 5 years he needs healthcare because doctors know he isn't going to make them much money and probably wont be a "good customer". Then he also gets to pay his bill out of pocket and the other persons bill because the cost of healthcare is so high. Also, he gets to pay more taxes to compensate her "disabled lifestyle".

And that is just one reasoin.

 

[Dre]

A certain in-law is the prime example. You can make up the name of a disorder and just throw together random symptoms and as long as there isn't a blood test available that says positive or negative for that disease/disorder she has it and is on medication for it. The doctors love her, the pharm companies love her, her pharmacy loves her and the government enables her. Meanwhile, the same doctors fill her head with ideas while writing a list of reasons she should be on disability. She is in too much pain to work but she can go to the mall all day with two kids on her hips with no problems.

All this is happening while the guy that works 40 hours a week and can't afford healthcare but makes just enough money to be above the poverty line and gets pushed to the back of the line the one time in 5 years he needs healthcare because doctors know he isn't going to make them much money and probably wont be a "good customer". Then he also gets to pay his bill out of pocket and the other persons bill because the cost of healthcare is so high. Also, he gets to pay more taxes to compensate her "disabled lifestyle".

And that is just one reasoin.

Just to clarify every doctor who sees her shudders when he has to see her again lol

 

[Goatman Saint]

Also we live in a country where people for some reason don't realize you will be sick and the body can take care of itself and don't need to see a doctor for every single thing. Also, people need to take personal responsibility. I had high blood pressure, pre diabetes and aches pains, chiropractor for back, heart work up all that. Then one day I looked in the mirror and said to myself wow you are a fat *******. 5'8" 260 pounds. So I ate right, got off my fat *** and became a Tony Horton disciple. 3 years later my pre diabetes is gone. Blood pressure is 115/60. Only aches I've got anymore are from lifting or running too much. I'm saving my insurance a bunch of money and plan on staying that way. As a nation we can complain about the system but really let's look at ourselves first.

Also, everyone wants the newest, latest and greatest thing. I've seen so much over treatment with my amazing insurance I have it's sickening. Milking the system. Doctors are scared of getting sued. Patients can't accept personal responsibility. So doctors max out the tests. Those are just the issues I deal with.

The other problem, and my family went through it is terminal care. Spend any amount to keep great grandma alive. While at the same time she is just wanting the pain to end. But that gets me off on a whole other rant that makes people uncomfortable. But she was the toughest person I've ever met and will never question the last thing she told me.

The regulations and such are a pain I'm sure but I have no knowledge so I won't speak of them.

 

[Mile_High_Saint]

Just drink your ills away. It will be cheaper and more pleasant.

 

[sbadeaux]

Very interesting article.
==============================================================

The United States healthcare system is completely broken; it has become a huge money pit, with insurance companies, pharmaceutical corporations and greedy lawyers at the bottom filling their pockets. Mind you, I do not blame the practitioners or their staff, because they do an exceptional job, even when they are sleep deprived from working doubles.

Is our health a commodity?

Healthcare is a strange commodity. If you are starving, you can’t walk into a restaurant and demand a hamburger, and you certainly can’t walk into a steakhouse and demand a ribeye. If your water gets shut off, you can’t walk into a gym’s locker room and demand a shower and use of their shampoo.

If you can’t afford a cell phone, you can’t bust up into a Sprint store and demand to see Dan Hesse the CEO. But in healthcare, if you think you need care, regardless of actual physical acuity (severity), you can go to a hospital and they have to give you the best care they can provide, by law, and for FREE!.

11 reasons why healthcare is broken

Today I’m going to talk about 11 reasons why I think healthcare has been down in the gutter for so many years.

1. Insurance companies - In a short-sighted view, insurance rates are a big problem. They cost so much that people outside of large business plans cannot get coverage unless they’re in perfect shape, under 40, and have no family history of medical problems. Which, given that last qualifier, discounts pretty much everyone. However, simply saying insurance rates are the problem is like saying inflation is the reason things cost so much; you’re actually only describing an effect of a larger system of problems, not the problem itself........


2. Excessive regulation - Not saying all regulation is bad, but, for example, the criteria for becoming a medical practitioner is way too strict. There is no reason why I should need eight years of schooling to say, “Hey, you have an ear infection. Take this for a week.”

Probably half the nurses at most hospitals could handle a lot of the GP work that gets done, but they can’t, because the government doesn’t allow them to. When it takes a couple hundred grand in education costs to become a doctor, doctors are going to demand a $%#! Ton of compensation for their services.

When doctors demand a %@#! Ton, it drives the cost of health care up. If we opened up certain branches of healthcare to people who can do the work even without all the schooling, it would drive costs down for at least some forms of healthcare................


11 Reasons Why Our Healthcare System is So $&@%#! Up - referralMD

And Obama care regulations will only make it worse. If everybody has insurance, they will go to the doctor for everything. Why not it did not cost them anything. Cost will go up, lines will get longer, we will have waits to see a doctor, and there will be limits on what tests you can get done.

 

[bigdaddysaints]

also some places of employment are to blame.. some employers require a doctors excuse if you miss work.. one place I worked, if you wanted to use a paid sick day, you had to have a doctors excuse. sometimes your too sick for work, but not quite sick enough to go to the doctor, but forced to if you want to get paid, or go to work sick, get others sick, or jepardise your safety because you are not 100% focused..

Sent from my Samsung Infuse using Tapatalk 2

 

[bclemms]

Just to clarify every doctor who sees her shudders when he has to see her again lol

No shuddering involved. They get her in the office, listen to all her complaints, write a couple scripts, run a wide spectrum of tests and then send her on her way with a couple more appointments (referrals) to specialists and schedule at least one follow up. She is at the doctor several times a week and her follow up appointments have follow up appointments. To be sure she keeps coming back they prescribe her some class 2 narcotic in large quantities.

 

[RazorOye]

question: Do you think that the US can ever even come close to that and how many years of growing pains do you think it would take.

sorry Zack - I missed this the first time.

I don't really have any answers - just a few guesses. And I say this while Canada levels of obesity rise as does the frequency of prescribed drugs. So it's not as if all doctors here are treating me as the doctor at UT did. Nor does it meant that Canadians, generally, are going to take that advice of exercising more or changing diet or finding non-prescriptive means.

I will say, though, when I go back home one of the first thoughts that occurs to me is: "there's a lot of fat people here."

Anyway, that's all sorta beside the point. Personally, I am not optimistic about change so long as there are so many incentives tied to popping a pill. And those incentives exist for pharmacorps who profit considerably, doctors who might not benefit as they once did but still do - e.g. in material ways as jbourque described or mental/fatigue issues dealing with patients as Dre described, and patients who can more easily pop pills and change nothing else about their lives.

So it's a culture or mentality around medication where some attitudes need to change before practices do. And I don't have a lot of confidence that those attitudes will.

More and more, I keep thinking of Brave New World's model of medicinal dispensation.

 

[Zack Lee]

Personally, I am not optimistic about change so long as there are so many incentives tied to popping a pill.

I have experienced first hand the benefits of exercise. I had panic attacks at one time that I believed was due to my job. Truth is, I hated my job and I was drinking a few cocktails as soon as work was over every afternoon to unwind from the day. I also would wake up at 3:00am and start thinking about the next day and no go back to sleep. It was a snowball.

I got out of the job eventually then got into exercise again when I got in a better situation and cut out the unwinding. By getting your heart rate going some kind of way everyday and actually pushing that to a new level whenever you can, you can overcome so much. I lost about 40lb. I even notice it in fight or flight situations. I few months ago I went around the side of the house and swung my leg over my bike before I realized that there was a snake coiled under it. That would have given me a heart attack a few years ago but I just calmly backed out of the situation. He won round one.

I was obviously medicating myself there but the point is the same, there is usually a much better way.