XD I love that sarcastic quip...I'll bet your humor is similar to mine.

This gets the patient out of the office fastest while still getting their money. Plus, its good for big pharma. Everyone wins. Oh, except the patient.

As a physician, I can say that I have begged, pleaded, cheer-led, cajoled, etc and rarely do patients diet or exercise. I prescribe pain medications and taper them quickly because no one helps me help them. Then the patient gets mad. Last night, I talked with my wife about my leaving medicine because of this problem. If most would diet and exercise, the cost of health care would be cheap. Most diabetes, heart disease, hypertension, etc. would be extinct. We are a nation of irresponsible lazy fatties.

Insurance pays for a short visit only. They say that the doc can spend as much time as he/she likes, but they don't add that the reimbursement is virtually the same if the doc spends 15 minutes or one hour.

I don't like big pharma, but anyone can share in their riches by simply buying their stock. The US pays much more than any other country for each pill. If the US paid what Europe pays, pharma would be bankrupt. If Europe paid what the US pays, all of their health care plans would be bust.

Hey Russ, go into holistic medicine. People like me listen. Im over 50, no high blood pressure, no high cholesterol, my last check up doc said I would live to be a hundred...(oh great, more taxes). I have no ailments and probably healthier than most twenty year olds by today's standards. Im within my weight range and I've studied herbs and vitamins since I was in my early 20s. We need good caring doctors but traditional medicine is not the only choice. I rarely see a doctor, only for check ups and dont even get a cold or flu. But you might consider it? Dont give up.

Of course they do. They get kickbacks and all expenses paid vacations from the pharma ind. Ever wonder how many people die because of these legal drug traffickers? All the while the FDA goes after people who would prescribe and utilize simple herbal medicines. And, don't you dare refuse chemotherapy because you'll end up in jail. Chemotherapy, yes family, the procedure was a success but the medicine killed the patient.

Indigogal, you are so correct. holistic medicine saved my life all the while 'modern' medicine did nothing.

The average patient expects the doctor to do "something", "anything" that will make him feel better.

If your doctor didn't write a Rx every time you went in, you would feel cheated. You would feel like he didn't do hid job and wasn't taking care of you properly.

America is oh so hungry for a solution to every little ache and pain. "Give me a pill and make it go away," we say. I suspect this is simply not the doctor's fault.

I am lucky. My doctor says less is better.

pete,

the days of vacations are long gone

and kickbacks are illegal, so good luck with that

good for you, grump!

Yeah, calling it illegal makes it all go away. Good luck with that. We have three doctors in our family and the farma ind always approach them with gifts only to get their butts booted out the door. Less is always better. Not getting pills from a doctor's visit does not make me feel cheated.

of course it will never go COMPLETELY away, but are you trying to argue that making it illegal will INCREASE it? Or that it being illegal, it is still going on at high rates

Come on

What kind of gifts are drug reps offering? Not vacations, I guarantee you that. maybe pens, or at best a fancy dinner. Big deal

Pens are out. "Educational" dinners are Ok. If you (doctor) are the one giving the education then you can be compensated several thousand dollars for the night.

Apparently you aren't a key opinion leader. But, you should be aware of who they are in your field and at the CE seminars you attend. You are influenced you just don't know it. Do you read medical journals? Who are the authors in the journals. The are KOIs most likely. They work for pharmaceutical companies. Who do you think creates policy and standards? Like a fish in water. He doesn't know he's in water.

robert

you arent a key opinion leader either, so don't get high and mighty

And I'm much more aware of them than you. I doubt you've even been to a lecture

You don't know who or what influences me, or to what degree. Its more fair to state that I'm exposed to bias...how I let that obvious bias affect me you cannot know

Can you be compensated "several thousand dollars" for these events--maybe more like 2 grand or so. Not a bad chunk of change, definetely. But what's your point?

I think your big problem is you think bias is the only factor in any opinion, and it negates everything else, whether that is good evidence, well designed study, good hypothesis, etc. Something tells me you would have no idea how to recognize a solid study

The fact is that bias is all around us. Should we identify it--yes. Should we try to cut down on it--yes. But to ASSUME that this bias outweighs everything else is ridiculous. If Merck shows me a great study that is well designed and supports their drug, I'll consider using it. But not just because some drug rep or hired gun says to

Your problem is youre in a pond and have never had swimming lessons . Take it from someone who knows much more about this than you

You don't know who or what influences me, or to what degree. Its more fair to state that I'm exposed to bias...how I let that obvious bias affect me you cannot know

You're right. Your prescription writing data determines that. Merck and co. knows that.

you arent a key opinion leader either, so don't get high and mighty

I don't think highly of KOLs so I won't.

But what's your point?

You made it sound like drug companies don't compensate anymore. They do. I pointed this out. Granted it's not like the good ol days, though. No more vacations.

they compensate speakers for talking, not joe schmo doc for prescribing them as you insinuated in your earlier post. Big difference

While merck has access to my prescription writing habits, luckily I couldn't give a sh!t what they think about it, nor do they have any power or influence over me to change them. So I ask you, so what?

While merck has access to my prescription writing habits, luckily I couldn't give a sh!t what they think about it, nor do they have any power or influence over me to change them.

Drug Co. CFO's and marketing beg to differ. Somebodies writing all of those rx's. Must be Joe Schmo. They wouldn't keep doing what they're doing if it didn't work. They get their return on investment.

your post makes no sense. I don't prescribe drugs based on what drug company makes them. I couldn't tell you who even makes lipitor and that's the drug I prescribe most. Or zocor--and I don't know who makes that either. I prescribe them because they WORK, not because I care about the company one bit. Again, I don't even know which company it is!

Come on, use some common sense...

I prescribe them because they WORK, not because I care about the company one bit.

http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm

Do Cholesterol Drugs Do Any Good?

"Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated"

The second crucial point is hiding in plain sight in Pfizer's own Lipitor newspaper ad. The dramatic 36% figure has an asterisk. Read the smaller type. It says: "That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.

http://www.thincs.org/

The International Network of Cholesterol Skeptics (THINCS) is a steadily growing group of scientists, physicians, other academicians and science writers from various countries. Members of this group represent different views about the causation of atherosclerosis and cardiovascular disease, some of them are in conflict with others, but this is a normal part of science. What we all oppose is that animal fat and high cholesterol play a role. The aim with this website is to inform our colleagues and the public that this idea is not supported by scientific evidence; in fact, for many years a huge number of scientific studies have directly contradicted it.

ahh...business week and some random website--the bastions of evidence based medicine

This is my problem arguing with people like you online. No offense, but you have absolutely no clue what youre talking about. And to make matters worse, you go to any random BS website to back up your ridiculous claims. I'm sure I could find a website that says sarah palin was sent from alpha centauri to enslave humanity...doesn't make it the truth.

IF you want real evidence, look at data, not someone else's conclusion that you regurgitate. I suggest you google the jupitor trial--had to be stopped early because people benefited too much from crestor and it was unethical to keep the trial going

Furthermore, i wont even bother with your website link...that's obviously garbage. But i did look at the business week article...it preys on people like you who have little understanding of statistics

Its true that the NNT for statins is 100, or in other words, you need to treat 99 people to save 1 life. But heart disease is the leading cause of death in the US. If you include stroke, which has the same pathophysiology, more deaths are attributable to cardiovascular causes than all others COMBINED. Meaning even 1/100, when you multiply it by 350 million, saves a lot of lives. Not bad for a $4/month pill like zocor

Again, I urge you to learn statistics, look at DATA instead of someone elses opinion, and form an educated opinion on your own.

I find it extremely hilarious that you have accused me this entire time of just listening to others (ie the drug companies) and following them blindly, when you demonstrate that very behavior now

At least I'm smart enough to look at data and form my own opinion.

I suggest you google the jupitor trial--had to be stopped early because people benefited too much from crestor and it was unethical to keep the trial going

And who funded the JUPITER trial Mr. I am not influenced by Pharma?

AstraZeneca the maker of Crestor.

Hook, line, and sinker.

is bias your only argument?

Like I said, bias is an important factor BUT NOT THE ONLY ONE!!!

im shocked you can't understand that

If its a well designed trial, with good results, then you can cry bias as long as you want, its still the results

But fine, here's a basic science one...see if you can follow along

http://eurheartj.oxfordjournals.org/content/24/3/225.full

here's a chinese study that WAS NOT industry funded:

Eur J Cardiovasc Prev Rehabil. 2009 Aug;16(4):445-50.
Beneficial effects of statins after percutaneous coronary intervention.
Zhang ZJ, Marroquin OC, Weissfeld JL, Stone RA, Mulukutla SR, Williams DO, Selzer F, Kip KE.

Source

Department of Epidemiology, School of Public Health, Shanghai Jiao Tong University, Shanghai, China. zhz232@gmail.com

Abstract

BACKGROUND:

Evidence about the efficacy of statin treatment among patients after percutaneous coronary intervention (PCI) is very limited. The rapid advancement in PCI technology and near universal use of adjunctive cardioprotective medications make it necessary to formally assess the effect of statin therapy on cardiac events after PCI.

DESIGN:

This was a multicenter prospective cohort study.

METHODS:

Patients who received stent implantation and survived to hospital discharge from the National Heart, Lung, and Blood Institute Dynamic Registry from 2004 to 2006 formed the study cohort. Patients with cardiogenic shock, in-hospital adverse events [including myocardial infarction and coronary artery bypass graft surgery (CABG)], liver disease, renal disease, alcoholism, or drug abuse were excluded. The occurrences of death, CABG, and repeat PCI, and repeat revascularization were collected over 1-year follow-up.

RESULTS:

Of the 3227 patients evaluated, 2737 (85%) were prescribed a statin at discharge. By 1-year follow-up, incident events were 98 deaths, 44 CABG, 290 repeat PCI procedures, and 328 repeat revascularizations. After propensity score adjustment, postdischarge statin therapy was associated with lower risks of death [hazard ratio (HR): 0.58, 95% confidence interval (CI): 0.36-0.93, P = 0.02], CABG (HR: 0.49, 95% CI: 0.24-1.00, P = 0.05), and repeat revascularization (HR: 0.74, 95% CI: 0.56-1.00, P = 0.05).

CONCLUSION:

These results support the routine use of statin therapy after PCI.

Now what? Whos line and sinker now, b!tch?

Robert, I know who is writing all those prescriptions. An anesthesiologist I know of who constantly asks the nurses to take script pads from other unsuspecting colleagues so that he can get his kicks. He has been known to go into surgery while still groggy and under the effects. His father, another doctor, got prosecuted for the same abuses.

The article clearly states that doctors are over prescribing. Obviously studies were done on the subject. Now the reasons for pushing 'legal' drugs must be researched and a way to protect innocent patients must be found. There are a myriad of reasons this is happening. Meeting sales quotas is only one reason and bribing doctors may be another. I have seen it before and it still happens.

With that attitude you have eric, I hope you are not a doctor. If so, patients beware. There is a COH you signed when you joined the Vine. Calling other people 'bitch' is not the way to win your argument. I hope Tyler finds your comment and takes an appropriate action.

Meaning even 1/100, when you multiply it by 350 million, saves a lot of lives. Not bad for a $4/month pill like zocor

350 Million? It sounds like you want to give statins to everybody!

http://www.ti.ubc.ca/letter77

• The claimed mortality benefit of statins for primary prevention is more likely a measure of bias than a real effect.
• The reduction in major CHD serious adverse events with statins as compared to placebo is not reflected in a reduction in total serious adverse events.
• Statins do not have a proven net health benefit in primary prevention populations and thus when used in that setting do not represent good use of scarce health care resources.

pete,

remember when i asked you your opinion? I don't either...

Also, I don't believe you for a second. I don't believe you've ever seen anyone being bribed with money or vacations or anything on that level. There are no "quotas" for doctors. There are for sales reps, but who cares?

Robert,

your poor understanding of statistics again shows. And again you cite other people's conclusions without any raw data supporting it, then accuse me of "accepting pharm's word for things blindly"

Youre joking, right? I mean, i don't think you could be more hippocritical.

I just showed you STUDIES that contradict your findings. You need data to back up your conclusions. Otherwise its just worthless. Watch

I can fly over buildings

I can pull roses out of my nose

Robert has made excellent points

See how lying works? I can say anything I want--doesn't make it true.

It is difficult to show a benefit with statins in a trial. That is not a function of statins inability to prevent disease, but rather the difficulty in showing a mortality benefit in a limited population in a limited time

For example, take a low risk population. By definition, their event rate over 10 years is <1%. So if you have a study that takes 10,000 patients and follows them over 5 years, you may have only about 50 deaths for the entire study. Statins may cut that risk in half. So in the statin group you see 25 deaths. So 25 deaths/10,000 patients is a 0.25% risk reduction in mortality. Pretty poor, probably not even statistically signficant...But, your PERSONAL mortality has been cut in HALF--a 50% reduction. That is signficant.

I sincerely hope that helps

http://www.ti.ubc.ca/about

The Therapeutics Initiative (TI) was established in 1994 by the Department of Pharmacology and Therapeutics in cooperation with the Department of Family Practice at The University of British Columbia with its mission to provide physicians and pharmacists with up-to-date, evidence-based, practical information on prescription drug therapy. To reduce bias as much as possible the TI is an independent organization, separate from government, pharmaceutical industry and other vested interest groups. We strongly believe in the need for independent assessments of evidence on drug therapy to balance the drug industry sponsored information sources. Over the years the TI has substantially enhanced its ability to assess the clinical evidence presented in published articles, meta-analyses by the Cochrane Collaboration and scientific material presented by the pharmaceutical industry.

I write all that and that's all you can come back with?

Even if it is unbiased, you still need evidence. Again, bias IS NOT THE ONLY FACTOR. You need good study design, randomization, etc. You have provided evidence for none of that

Please address my earlier points. I've stated some good ones that have gone unchallenged.

Including how it is difficult to show a difference in hard enpoints when there is an overall low event rate within a relatively short predetermined timespan. Which your unbiased source fails to acknowledge.

My friend, everyone has an agendad

Thank God I can write my opinion without your permission. But of course an egocentric existence would center the Universe around itself. The COH is a public contract and should be respected by all who would participate in his forum. It is also of great importance that your validation and belief are not necessary to make my experiences any more or less truth. Again egocentric existence. God complex??? Again, patient beware.

peter,

while you can definetely write your opinion without my permission;

a) no one cares

b) it doesn't matter

People a lot smarter than you thought I would make a great physician and awarded me a degree. Your insignificant, uneducated, irrelevant, and petty opinion nonwithstanding

Don't be suprised if I continue to have a healthy practice over your whiny objections

Now you speak for everyone? I sure do hope your patients read your public antics in order to get an idea of the quality of service you may provide through an over inflated ego.

People a lot smarter than you thought I would make a great physician and awarded me a degree. Your insignificant, uneducated, irrelevant, and petty opinion nonwithstanding

Now it all depends on how you put it in practice. Otherwise you will let many smarter people than I down. It isn't the fact that you got a degree but how you put it to work and how many lives you save. I hope, for your patients sake, that when you say a healthy practice that you mean their health and not that of your wallet. Remember your oath of not harming others and service to others???

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

http://en.wikipedia.org/wiki/Hippocratic_Oath

Good luck eric.

Peter is right. Wouldn't be my doctor.

These are the doctors our schools are producing these days?

i took the hippocratic oath, so I know it, you don't have to paste it from wiki...you may not be familiar with it, so feel free to read it

The rest of your post is about money...i never brought up money, YOU are the first to mention it. Its on your mind, not mine

Stop making assumptions about me. You don't know me

Like i said, why don't you keep your uneducated and irrelevant objections to yourself. Go through med school, residency, fellowship, then judge me. Until then, shut the hell up

Who are you imagine? I don't want you for a patient

joe,

what did I do? what are you objecting to? I don't think you know what you are talking about

Hey, you know what they say, if the shoe fits..... Again an egocentric existence would centralize everything around itself. In case I came across as judging you then by all means my apologies.

Stop making assumptions about me. You don't know me

Like i said, why don't you keep your uneducated and irrelevant objections to yourself. Go through med school, residency, fellowship, then judge me. Until then, shut the hell up

Yeah, like you know me enough in order to call to bear my 'uneducated and irrelevant objections'.

eric, the way you communicate, or try to debate, is called circular argumentation. It is like looking in a mirror, loving your reflection, and calling it a burro. I guess it is ok because debate and or basic English is not a medical school requirement.

Thanks for answering my question about money. My sincere wish that your motivation was not economics has been confirmed by you. So tell me eric, what motivates you to be so passionate about medicine and about what confirmed studies are showing as a tendency of over prescription in this industry? You seem to be angry about something and it certainly can not be about the posters on the Vine since you know none of them personally. If you are angry about something then don't take it out on others. DO something about it.

Peter,

I'm not sure where to begin with you. You call me egocentric...upon what do you base that? I have given up a LOT in order to dedicate my life to making others live longer and feel better. IN what way is that egocentric?

Your definintion of circular argument is wrong. If you are going to throw around terms, at least learn them first.

A circular argument is one that goes in a circle (not that hard, right?). An argument that relies on the conclusion as evidence. Since youre a big fan of wiki, here's the link:

http://en.wikipedia.org/wiki/Circular_reasoning

I guess debate and english aren't YOUR strong points

This brings me to the most important point. You say "studies show a tendency to overprescribe"

Now I spent a good part of my life learning how to interpret study results. Any trained monkey, or peter jacobs in this case, can read the last line of the conclusions portion of a study and then cite it. What takes actual intelligence is actually READING the study, analyzing it for both design and flaws, and then coming up with YOUR OWN CONCLUSION. It may be the same conclusion as the authors, or it may be different. I strongly encourage you to actually READ the studies instead of regurgitating what the authors want you to believe

Finally, the fact that you ask what motivates me to be so passionate about medicine answers all of my questions. Someone who truly understands medicine would know the answer to that question. Its way too long to post here, but if you actually read the hippocratic oath instead of just copy and pasting it you would know.

How did i violate it by the way? I see you are quick to say I did but have yet to provide any evidence. But I guess that's your evidence

Circular logic, huh?

Physician, heal thyself

An argument that commits the logical fallacy of assuming what it is attempting to prove. Also known as begging the question

http://grammar.about.com/od/c/g/circargterm.htm

Do I really have to repeat your circular logic for you once more? Look at the two sentence in which I quoted you as stating that I do not know you and to stop making assumptions and afterwards you call me uneducated and irrelevant. Obviously I am relevant because you continue on your quest to demean others on the Vine starting with calling others 'bitch', 'trained monkey', 'uneducated', need I go on? It is exactly this attitude of superiority which will come back to bite you in your 'healthy' medical practice. Good luck eric. Just like a fish does not know it lives in water until the day you take it out into the atmosphere so will it be for you. It will take a while for you to understand what I am talking about. Until then, keep looking in the mirror and try not to kill anyone.

peter, your example of circular logic was incorrect. How does me loving my reflection and calling it a burro fit your definition? But that's beside the point

Your posts show you to be uneducated, at least about medicine.

And you are irrelevent to my medical practice and to me, whether you like it or not

You demean me by telling me I betrayed my profession and broke my oath. And you have the gall to complain that I called you uneducated? I'm going to add one more word to the list of things I have called you: Hippocrit. I'd like to see you argue your way out of that

I try not to kill anyone everyday, with or without your blessing. I will continue to do so, with or without your blessing. As I have stated before, you are irrelevent.

I also take much pleasure out of the fact that you ignored every single point I brought up in my last post. About how to intelligently read articles. About how you don't understand the hippocratic oath. I take your silence as acquiesence.

Hahaha, now you are a fortune teller, huh? Suits you better than a commentator on today's medical practice. You were pretty bad at that

You demean me by telling me I betrayed my profession and broke my oath.

My statement reads, 'Remember your oath of not harming others and service to others???'

When is a question a statement of fact? Did you really read all that into my question? Look at the biases you bring to the table when you translate someone's words into your meanings. Again, an egocentric existence always center ANY argument upon itself.

How does me loving my reflection and calling it a burro fit your definition?

It has to do with circular, reflection, mirror, begging the question, etc... It will take time to understand but a clue would be poetic license.

I take your silence as

acquiescence (sp). You may utilize that interpretation if my acquiescence is all that important to you or that maybe I am directing our debate towards the points I am trying to make. Either way is fine with me.

......commentator on today's medical practice. You were pretty bad at that.

Medical practice is the practice of medicine. I have commented on the illegal activities that I have witnessed practiced by doctors which is not about medicine but about greed and fraud. All of which you dismissed as unbelievable. Please show my comments on the practice of today's medicine. Don't be blinded by the biases you bring to the table.

eric, I have had fun playing our little game. You may now have the last word. Remember what this fortune teller has said to you here today. Pride walks in front of the fall.

I will take the last word, thanks

You heavily implied I broke my oath. But if you don't want to believe that, fine. You also called me egotistical in every post. Then you get your feelings hurt when I label you. Again, youre hippocritical

In a debate, you should at least acknowledge the other person's points. But I know debate is not your strong point

You explain your mistake with circular logic as "poetic license" Hahahah...i wish life worked like that. What if I messed up at my job, and then invoked "poetic license" Hahaha..nice try

Finally ,the practice of medicine involves ethics, which you challenge. Yet you have provided ZERO evidence. When I point that out to you, thats not being blind, its smart

Pride may come before a fall, but ignorance doesn't even let you know youve tripped. and you are one of the most ignorant people I have encountered

This is getting tiresome but you still intrigue me.

You heavily implied I broke my oath. But if you don't want to believe that, fine. You also called me egotistical in every post. Then you get your feelings hurt when I label you. Again, youre hippocritical

You can't hurt my feelings. I am amused at best. I never called you egotistical. I spoke of an egocentric existence which is a temporal and not a permanent situation. It can be corrected. If ignorance allows the error to be recognized change would be the next step.

In a debate, you should at least acknowledge the other person's points. But I know debate is not your strong point

OK, ok, I now realize that it is important to you so I acknowledge your points and chose not to answer them.

You explain your mistake with circular logic as "poetic license" Hahahah...i wish life worked like that. What if I messed up at my job, and then invoked "poetic license" Hahaha..nice try

I am really glad to know that you take your work seriously. Debating on the Vine is some what less serious, don't you think? Please don't make the mistake of viewing your work as meaningless as debating on the Vine. You see mistake at your level, sure, from my point of view it is subtle poetic license.

Finally ,the practice of medicine involves ethics, which you challenge. Yet you have provided ZERO evidence. When I point that out to you, thats not being blind, its smart

Everything in life involves ethics. Not just medicine. Greed and fraud are not about ethics but a lack of and I would not consider the two part of medicine. I can not provide you with proof of what I have witnessed otherwise I would have done something about it. I only stated my personal experience which you quickly dismissed. I hope you don't dismiss a patient's personal experience and miss an important clue.

Pride may come before a fall, but ignorance doesn't even let you know youve tripped. and you are one of the most ignorant people I have encountered

Exactly as mentioned before with the little fishy, beware! You catch on pretty quick.

peter,

again, however you want to define it, you called me egotistical, whether temporary or permanent. In every post. Don't cry foul when you get called names back. Again, for the last time, hippocritical. If you write another post, please, please address how that is not hippocrtical

Are you still hiding behind this poetic license excuse??? Fine, then tell me which fact I assumed to be true (ie, the conclusion) and how I used that assumption to support said conclusion.

I still can't get over your "poetic license" excuse. Next time I take a test, if I get a wrong answer, I'll just tell the medical board it was "poetic license"

You didn't "choose" not to adress my points. You can't. Either you don't possess the necessary intellect, or lack the evidence. Probably a combination of both. But don't blame it on choice. Thats laughable

Dont compare debating on this meaningless website with patient care. They are not even close to the same thing. That being said, in a debate, anecdotes are by far the weakest form of argument. It is logical to brush anecdotes aside. To do otherwise would be ludicrous. Your personal experience:

a)I doubt. I really believe you are flat out lying

b)Is not generalizable

I shouldn't have to tell you that

Your last statement is simply childish, and ill ignore it

again, however you want to define it, you called me egotistical, whether temporary or permanent. In every post. Don't cry foul when you get called names back. Again, for the last time, hippocritical (sp). If you write another post, please, please address how that is not hippocrtical (sp)

Again, if the shoe fits? There is a certain level of personal quality which a doctor should strive for. Calling people names such as 'bitch' is not an example of this. Especially on a public forum which needless to say is accessible by all. I merely called this to your attention which started this entire snowball. Me, you can call any name you want and it will be of no consequence. Take it as a simple advice.

I still can't get over your "poetic license" excuse. Next time I take a test, if I get a wrong answer, I'll just tell the medical board it was "poetic license"

Again, please do not demean the importance of such an important exam with word play on a forum.

You didn't "choose" not to adress (sp) my points. You can't. Either you don't possess the necessary intellect, or lack the evidence. Probably a combination of both. But don't blame it on choice. Thats (sp) laughable

eric, simple rules to go by. I can not address your points, only you can. Both intellect and evidence would demand I address only the points I am trying to make. Which I have.

Dont compare debating on this meaningless website with patient care. They are not even close to the same thing.

What if I messed up at my job, and then invoked "poetic license" Hahaha..nice try

Next time I take a test, if I get a wrong answer, I'll just tell the medical board it was "poetic license"

Since you were the one that compared patient care with a simple debate my answer is also simple. I am glad you realize the difference. Thanks.

That being said, in a debate, anecdotes are by far the weakest form of argument. It is logical to brush anecdotes aside. To do otherwise would be ludicrous. Your personal experience:

a)I doubt. I really believe you are flat out lying

b)Is not generalizable

I shouldn't have to tell you that

I wasn't debating until you chimed in. I was just sharing my experience with the Vine. In a debate anecdotes may weigh in less than facts but in a forum many common experiences could be tallied to form the basis of a study. These public forums are used for that, did you realize?
a) We all have our opinions
b) Correct. Which is why studies on the subject are important and should be done in order to protect the general public. Do you agree or not?
You didn't have to tell me that but I thank you for your reminder.

Your last statement is simply childish, and ill ignore it

No answer necessary. As childish as the seed may be it has been planted in your subconscious. One day it will remind you.

You misunderstood the point of my first paragraph. You hound me for the fact that I called someone a name, yet you continue to call me names. Again, the definition of a hippocrit. That remains unchallenged. YOU LOSE.

You ignore my challenge to show how my prior statements fit the definition of circular logic. Again, YOU LOSE

You try to take a stab at me for comparing this debate to an exam, yet you compared this debate to patient care just one post prior. Again, youve already proved you are a hippocrit, enough already

I don't understand your third sentence. It doesn't make sense. You can address my points, if you wish. As I have addressed yours. The circular logic point, for example

While you may draw knowledge from childish statements, I have moved past that point in my life. You can keep them to yourself from now on

You werent debating...really? Then why attack my debate skills as you did in an earlier post? Was that in reference to our current "debate" or just unrelated? Come on....

NO. The pleural of anecdote is not fact. Not in a debate, not on a public forum, not anywhere.

Sure, studies should be done. Whats your point?

Anyway, since you refuse or cannot answer my questions, call me egotistical with NO evidence to back it up, and then cry when I give you the same in return, I'm done with you

But I'll leave you one last piece of advice. I don't come by the trash heap and tell you how to do your job. You have NO experience with medicine, NO education in the medical field, so you are in NO place to comment on medicine or its practice

Let me know in 20 years when you have accomplished what I have, and I'd be happy to hear your opinion. Until then, your word is

a)irrelevant

b)uneducated

How can you argue with that? Its a fact

eric, you may have a need for me to lose but I do not share that need. If you want me to lose so badly than I say you win. I am not in any competition with you. You can let your guard down. Breathe....

By the way, I do have medical training and do not have a need to flaunt that fact. Like I said in a prior post, we have three doctors in our family. I seriously doubt you are a doctor simply based by the attitude you have displayed on this Vine.

Look at the sequence of posts and realize that I was not debating anyone until you chimed in with your disbelief of my stated experiences. Somewhere near the post were you called Robert a 'bitch'.

I don't understand your third sentence.

Try harder or leave it for a later date when you may get it.

NO. The pleural of anecdote is not fact. Not in a debate, not on a public forum, not anywhere.

That would be why public surveys are conducted then.

I don't come by the trash heap and tell you how to do your job. You have NO experience with medicine, NO education in the medical field, so you are in NO place to comment on medicine or its practice

Once more for your benefit, there is a certain level of personal quality which a doctor should strive for. The above comment would not be one of those qualities.

While you may draw knowledge from childish statements, I have moved past that point in my life. You can keep them to yourself from now on

You may call a Universal Truth childish but to everyone's delight you can not argue it away. Universal Truth is just that. Pure Truth and can often be heard straight from the mouths of children.

Let me know in 20 years when you have accomplished what I have, and I'd be happy to hear your opinion. Until then, your word is

a)irrelevant

b)uneducated

You are the only one that can attain such lofty goals. Congratulations.You certainly keep coming back for more of my irrelevant words.

A child once told me that pride walks before the fall.

then why did you go to the doctor? How would you have felt if he told you to do nothing and it didn't get better or even worse? Then you would be on here complaining that doctors don't listen, and our healthcare is so much worse than Sweden's

eric, it is rather presumptuous of you to claim that what_the_81 would be complaining....if he's smart, which I can tell he is, then he's already figured out that doctors are WAY too quick to prescribe two or three, LET ALONE, just one drug.

You need to face up to the fact that healthcare in America, has gone to @!$%#, despite the improvements we're struggling to make. Only when we realize just how twisted in on itself healthcare has gotten can we truly reform it.

But a lot of these pen/paper/prescription writing happy doctors, need to get off their ass, and rule out other conditions, and if they don't, then it becomes up to the patient to seek a second opinion.

Unless you happen to be a minor, in which case your opinions will likely be brushed aside...I had that happen a few years back...never again.

isis,

i can't understand your first sentence. I'm very forgiving of spelling and syntax errors online, because this forum is rather informal, but that first sentence just makes no sense whatsoever. I encourage you to keep trying

I will face the fact that healthcare in the US sucks when and only if you prove it with facts. Until then, its just your opinion, which is (no offense) but meaningless

So doctors need to "rule out other conditions" before they are too "Rx happy"? What does one have to do with the other? If I rule out pneumonia, don't I still have to treat your bronchitis? Again, no offense, but you clearly don't know too much about medicine

How many doctors own stock in pharmaceutical companies? Follow the money.

Eric, my point was this: You claimed that user What_the_81 would have complained that our health care system is @!$%#ed up. How do you know? It is PRESUMPTUOUS of you to say whether or not he would complain.

And FYI, I'm talking about ALL branches of medicine, so you can stop trying to one up me. They thought I had bipolar, and tried to test for meningitis, even though I HAVE the vaccination. There's a fact for ya.

I don't need to know a lot about medicine to know that doctors are quick to prescribe. You see all these titles on MSNBC like:

More Americans taking an antidepressant

Or "antidepressants linked to suicidal thoughts"

Or "risky side effects may outweigh benefits of 'fill in the blank' drug"

You also see all these prescriptions being advertised on TV, and if you listen carefully when they list all those NASTY side effects, most people in their right mind would say "I'd rather just ride it out, rather than risk all that bull@!$%#".

Maybe I should be a little more clear....doctors should be throuough in making sure they know what the patient has, and how to treat it as well, and other methods should be tried before they reach for their prescription pads.

eric-2573068

then why did you go to the doctor?

Actually I went to the doctor for another reason, not just because I had a small ear ache. He did tend to the other condition I had and I praise him for it but to prescribe 3 meds for a minor ear ache I knew it was crazy and I didn't even go to the pharmacy for them and in 1 week I was back to normal.

isis,

I don't call it presumptious, i call it experience. Ive heard enough and seen enough to know. A poster here brought up a good point about a recent article on here that criticized docs for not giving out enough pain scripts. Damned if you do, damned if you dont

Hahaha...here's another fact for you. The meningitis vaccine only protects against N. meningitidis...NOT the most common cause of meningitis, which is strep pneumo. So you could EASILY still get meningitis after being vaccinated. It helps to know what you're talking about before you start typing

Those side effects are mentioned not because they are common, but because drug companies are covering their behinds for lawsuits. Most of the time, the risk of NOT taking a prescribed medicine is worse than the chance of you suffering from some obscure side effect that no one even knows if the medicine causes

How do you know if the doctor is being thorough or not? Do you have any clue what is going on in his mind? Your HUGE mistake about meningitis shows you are, no offense, very ignorant about medicine and are in NO place to judge physicians

what the,

fair enough...you make a good point

Excuse, you eric, for telling me I don't know what I'm talking about. I was well informed of what the vaccine prevents when I got it. You got a lot of nerve.

See that above? It says I WAS well informed. Still am. But maybe YOU would like to explain to me why they decided to keep me in the hospital even after all tests showed up normal.

How do you know if the doctor is being thourough or not? I WAS IN THE ROOM WHEN HE SAID THE RESULTS OF MY TESTS CAME BACK NORMAL, BUT THAT THEY WERE NOT GOING TO RELEASE ME, EVEN THOUGH I WAS DOING FINE. THEY KNEW THAT THEY COULD BILL OUR INSURANCE FOR INPATIENT TREATMENT, AND THEY DID. Expanding on that, I was 16 years old, and do you honestly think that that doctor gave a rat's ass if I was at the age of consent? NO! All the decsions were made on my parents' part, I didn't even get a say. THAT is how I know.

And you do know that there are plenty of other adverse side effects, but they don't tell you that, because they KNOW that if people were aware of the dangerous side effects, then they'd stop buying their meds, and that would mean less money for their doctor/big pharma marriage.

And you say the risk is higher if I choose not to take the medicine. Well, here's a NEWSFLASH for ya, hotshot:

I am now at a 50% higher chance for diabetes, because of prescription medicine.

My metabolism will never be the same, because of prescription medicine.

My emotions (you know, the happy go lucky emotions) will always be dulled and practically nonexistent because of prescription medicine.

I will never be the person I once was because of prescription medicine.

Last, but not least:

I will always be wary of doctors and how they abuse their power, and will always be extremely cautious when seeing a doctor.

you are wrong about the meningitis vaccine. Thats a fact

http://www.cdc.gov/meningitis/vaccine-info.html

That's from the CDC's website. You are typical in that you are not nearly as well informed as you think

That tells me everything I need to know. Someone who makes that big of an error has no place judging doctors. Just as you misunderstood the vaccine, you misunderstood your doctors reasons for keeping you inpatient i'm sure

As for the "doc/pharma" marriage, tell me ONE benefit a doctor recieves for prescribing a SPECIFIC drug.

Let me save you some time. A sh#*ty pen

I did not misjuge the reasons for the doctor's keeping me as inpatient.

Reason 1: it was never my choice to begin with, and my parents just went along with it.

Reason 2: we had insurance. They wouldn't have even admitted me if we had been uninsured.

And I acknowledge that I made an error, but that was ONE error about a vaccine that I had BEFORE BEFORE BEFORE all that other BS happened to me. I'm judging doctors based on how corrupt they can be.

One benefit a doctor gets? They get paid for writing prescriptions, and nowadays, all it takes is about 10 minutes with a doctor before their pen and paper is out. It happened with the doctor who jacked up my dose one week, then turned it down the next week, in a CONTINUING pattern, until I ended up with a UTI infection from all the water build up...thankfully I'm not on those pills any longer.

The only doctors I don't judge nowadays are the ones who work in the dental field or women's health field.

The experience mentioned is just ONE bad experience. I had a traumatizing doctor visit at five years old, years before the labelling and prescription drug nightmare began. With the scars that sort of thing creates, I think I have the right to pass judgement on certain TYPES of doctors.

I don't know how I can make it anymore clear, so I'll end this MYSELF with, "Have a good life".

PS.....watch your mouth, if you want to debate, fine but don't disrespect me the way you did at the end of your post. What's that I smell......oh!! He always has to be right!

Damn. Where's my check for writing those prescriptions last week?

No, they don't get paid for writing prescriptions.

right sandy? Immediately after isis posted that, I ran out to my mailbox---no check. Must be late this week:)

As you can tell from our sarcasm, docs getting paid for rxs is so false its actually pretty funny.

I apologize if I offended you, but keep in mind you are berating my profession apparently without end. I take that personally, and I don't think that's unreasonable

Fine, I was wrong about them getting paid part, but my POINT is that the pharmeceutical companies reap the benefits of the high costs of these drugs.

And you guys have to admit, doctors nowadays are VERY quick to write prescriptions. I've had it happen in my own experience, I've seen it happen to neighbors, to friends, and it's rather disturbing.

Seems like you spend most of your time in the waiting room, and once your vitals have been taken, the doctor fires a round of questions at you, runs one test (if that), then comes back with a prescription.

It should not be that quick.

Eric, the ONLY reason you're taking this personally is because you ARE trying to make it look like I'm attacking you. NOT ONCE in my post did I say something like "Dr. Eric does this...or Dr Eric does that". You're twisting my words around to victimize yourself. You think you're so clever, and then you take it TO HEART, and paint me as the villian....nice try...who the hell do you think you're fooling?

I don't know what you take me for, but I'm smart enough to recognize those moronic (word games) so knock it off.

I think this is the first time i agree with you...drugs are very expensive and doctors often do not spend long enough with patients.

I'm not intentionally trying to victimize myself, and if I offended you I am sorry

Just to look at it from my point of view, take a look at the posts on here. 99% of them are negative, and that's just not here. Everywhere people say that doctors are greedy, lying, money hungry power mongers. I really think most went into it to help people, and I see physicians at work every day who do everything they can to keep people healthy and alive. They sacrifice themselves and their families for their patients

While I don't think every doctor is a saint, and surely I've seen doctors do many things for money, its not common at all. And never once, ever, ever for insurance companies or drug companies. Docs hate them just as much as patients, because they deny needed care as much as they deny proper payments

So its very frustrating for me to read these things knowing that I put myself in huge debt and worked myself to exhaustion for people to tell me it was all so some Forbes 500 CEO can get himself another jet.

I'm not sure what you expect the doctor to do. "Fire a round of questions" - the patient's description of their chief complaint is invaluable in making a diagnosis. What's wrong with running one test, if that's all it takes to make a diagnosis? Sometimes, no lab testing is needed at all. But, if the test confirms the diagnosis the doctor suspects, what good does it do to keep running more tests? Are you then going to complain about the cost of running a bunch of unnecessary tests, after implying that one test is inadequate? If your symptoms and a step test all point to strep, is the doctor wrong for handing you a prescription for an antibiotic, which is how strep is treated? Why?

I've never had any doctor "push" a prescription on me, except for one who wanted to prescribe a painkiller for a broken bone when I was in the middle of midterm exams in college. I refused because I knew I couldn't take codeine and stay awake to study.

I tend to have high cholesterol. When I first discovered this, no statins were recommended. Instead, the PA I saw recommended dietary changes (I was already exercising daily, which he knew). My numbers improved. My current doctor recommended the same course of action, and said if I wanted to try a statin, she would prescribe it, but she didn't see the need as long as I watch what I eat and exercise. As I am otherwise pretty healthy, she has seldom had reason to prescribe anything for me. She has seen my son multiple times when he's had high fevers, determined he had viral infections, and recommended TLC and liquids, not antibiotics.

What a lot of people seem to be forgetting is that we have an aging, overweight , sedentary population with more chronic health problems than were seen 50 years ago. We also have more drugs available to treat those problems and keep people functioning fairly normally who, 50 years ago, would have been forced into retirement and limited activity. Should we, in the name of prescribing fewer medicines, stop managing treatable chronic illnesses?

Do pharmaceutical companies make money from the sale of these medications? Of course. They are in business to make a profit, just like grocers, clothing stores, landlords, construction companies, and every other business that provides the necessities of life. They don't work for free; I don't work for free; and I don't expect pharma employees to do so, either.

What's wrong with running one test, you ask? Well, most patients KNOW (gut feeling) that it's something serious, and it kinda comes off as the doctor blowing us off when he/she only runs one test. A lot of times there are other things they could check for, but do not. When I see a doctor, my mindset is "have them check for this as well". If they would do as the patient asked, and be thourough about checking out the illness, then maybe we wouldn't have so many people going to get SECOND opinions, where they discover that it WAS something serious, even though their doctors either paid them no mind or were too busy.

The fact is, MOST of the time, it's nothing serious. That's just the way it is. Most of the time, your headache (as an example) is stress, eye strain, or sinus congestion. It's only rarely cancer. Routinely testing for something that isn't likely drives up costs for everyone. If routine problems don't respond to routine treatment, then further isnvestigation is warranted. Every headache doesn't need an MRI.

Doctors missing serious diagnoses is more the exception than the rule. The exceptions tend to stand out in our memories, though.

I'm not talking about MRI tests at a hospital, Sandy. I'm talking about when you go to the regular doctor, and you end up getting the vibe that the doctor isn't really listening or could care less...I had a doctor that was not comassionate, I wanted to slug her but resisted.

It's difficult to be pleasant though, when they expect you to lose 10 pounds on Lithium and Abilify, then come back weighing 10 pounds MORE.....any girl that age would be dissapointed and upset.

As I stated, I was using the MRI for a headache as an example. Many routine diagnoses require no or minimal testing for confirmation. You also spoke of the doctor "firing a round of questions" - that is still necessary for diagnosis, especially for suspected psychiatric problems, for which there are probably no laboratory tests to confirm diagnosis. Such diagnoses are generally made by interview and observation.

I'm sorry you had a bad experience. Your doctor should have been more compassionate regarding the weight gain when weight gain is a known side effect of those meds.

"suspected" psychiatric problems. Pscyhiatric illnessess are FAR more rare, but the mental health system of America has become so disgustingly turned in on itself, that there are now hundreds of little blurbs added to the REAL mental illnesses, everyday. The reason they add these blurbs is so that they can manufacture different types of one dangerous drug, to treat type 1, or type 2, or type 3, or type 4, or type 5, or type 6..........see what I'm getting at?

Probably no laboratory tests? THERE ARE ZERO tests that prove "chemical imbalances", that's just a load of crap. Anyone with a brainstem ought to know that psychiatry is a pseudoscience of labels and mind numbing pill cocktails.

And a lot of people taking these psychiatric drugs are on more than one. Worse, many of them are under eighteen, or they're young adults in their early 20s....these drugs are not approved for EITHER age group....that's what's scary, and a lot of these drugs are fairly NEW, yet they're still prescribing them, blindly assuming that they're safe.

And when these "doctors" fire their questions, sooner or later, you're bound to hear the same question, only worded differently, to confuse you so that you'll give a different answer. These "interviews" are disturbing and creepy, I should know. Even now, I'd still be just as uneasy having to answer them again.

Such interviews are also usually conducted BEFORE involuntary comittment, and a 72 hour lockdown. That's when you start to realize how terrified the situation truly is...but wait....after the shock of the poking and prodding wears off, THAT'S when your brain shuts off all its emotions ENTIRELY (with or without drugs), and goes into survival mode. Mine did, and it still is in survival mode to an extent. I promised myself that I would NEVER let that happen to me again.

I'm not Matt Lauer. Don't stop jumping on Oprah's couch, now.

Here's the story of a young woman who lives near me. She was diagnosed as bipolar after several periods of severe depression with suicidal ideation, followed by manic phases when she would disappear for days at a time, sometimes with a random strange man she picked up at the local truck stop. Her parents did everything they could to help her, but doctors would not commit her against her will, so their hands were tied. She was not considered to be an imminent danger to herself, despite the suicide threats. She was prescribed meds, but went off of them because of the weight gain. Then it was back to the truck stop to pick up another strange man. When she was home, her parents tried to stay with her because of the suicide threats. She refused to stay under a doctor's care long enough to find a medication combo that worked for her.

After about a year of this, she was finally committed to a psychiatric facility, and, after staying on her meds (you know, the pseudoscientific ones), she got better and stayed better. She is now a wonderful mother to her son and has a great relationship with her parents. On her meds. A far cry from the woman she was 3 years ago, when she was running away and suicidal. Does she weigh more? Yes. But she's happy and functional, thanks to her medications. Her mind is not numbed, she jokes and laughs and goes out with her friends just like before, she is very protective and loving toward her son. She is no longer suicidal, and no longer picking up random guys.

Involuntary committment was the best thing that could have happened to her.

Sorry if I'm finding this hard to believe...she maybe be happy, but that's the chemicals talking, sweetheart.

Did they ever really dig deep down to find the root of why she hated her home so much? Did they ever really ASK her why she felt the need to kill herself? What's that? NO?? No, they didn't, they carted her off and filled her brain with chemicals...just wait. In a few years, you'll probably be seeing another one of those "Bad Drug" commercials on tv.

I hope for HER sake, the happiness is TRUE happiness....if she can actually FEEL good feelings on those drugs, let's hope that whatever chemicals she's swallowing don't impair that, because if they do(which COULD happen), she'll get off those pills someday(yes, sweetheart, not all people have to STAY on drugs for life)....but her emotions will be damaged.

Involuntary committment was the best thing that could've happend to her.

Says YOU. Says her PARENTS. What about her? My guess is she probably went along with this, not wanting to rock the boat. Sounds like what she needed was to get the hell away from her parents, if she felt that horrible around them, then no wonder she was running away to truck stops. I don't know what her home situation was like, but when you're kid is running away, you have to examine the HOME LIFE, not the brain matter. And I HOPE she wasn't on those meds while pregnant....now that would be disturbing.

I know her parents. Her home life was fine. She was not abused. Her brothers are all well-adjusted, happy, productive members of society who have chosen to live close to their parents. You think that's a worse situation than ending up dead on the side of the interstate because she took up with the wrong trucker? Her parents have been her greatest support through the whole thing, helping her to take care of her son, helping with the custody battles with the boy's absentee father, giving her a place to live after her divoce, getting her out of the house for the social interaction a single mother often doesn't have the opportunity to experience. They were in anguish at the thought of her disappearing and never being found, or coming home to find her hanging from a closet rod. They were sure they were losing their daughter, one way or another.

No, it's not just the meds talking. When she was refusing care, THEN she showed hardly any emotion - quiet, flat affect, couldn't carry on a conversation. It was hard to see her that way, because in high school, she was popular, happy, and artistic. She had a degree in cosmetology, and was offered a teaching job right out of school because she was so good at what she did, and loved it. She is now the same woman she was BEFORE all this happened. The popular, pretty, loving, talented, humorous girl is back, while the depressed, suicidal, living-on-the-edge girl who might end up dead, by her own hand or someone else's, is gone. Yes, she also had counselling, once she would cooperate with it. This allowed her to reduce the number of meds she was on, but no, she couldn't eliminate them completely in the long term. Yes, she still experiences negative emotions, too, such as when she has custody issues with her ex. In other words, she experiences a NORMAL range of emotions appropriate to the circumstances she's in, and copes with them normally.

It's naive to think that everyone can get off the meds. Sometimes, there really IS something wrong with the brain matter, which can't be fixed by counselling alone. Their home life, social life, etc., can be fine, but THEY aren't. Just like some people can never get off the blood pressure meds, no matter how much they diet, exercise, and watch their sodium intake. There are occasionally organic problems with the brain, the same as with any other organs in the body. How is it that happy, productive, and non-suicidal are better than otherwise, even if that is achieved with meds? She was off the meds when she was pregnant, and relapsed, but pulled through. Yes, even with psychotherapy, she relapsed. Even though she wasn't living with the parents you've already decided were the cause of all her problems. Back on the meds once she delivered.

She doesn't have to "be close with her parents"...just because her siblings were. Sounds like her parents couldn't accept a child who was more independent...but the suicidal part, fine maybe she does need meds....but I still can't help but wonder what kind of damage they MAY (not saying they will) cause. And running away, aside from the suicide part, maybe she wanted to write HER OWN book.

Quiet does NOT mean she isn't feeling anything. Maybe she was just shy...I know I tend to be quiet a lot, and EVERYONE I know treats me like I have a disease, when really, I just take longer to warm up to new people...sickening how shyness has been turned into an illness....

I hope all of this was HER choice, voluntarily...but it probably wasn't. That's what really breaks my heart about all these stories...most patients just go along with it, so they don't rock the boat.

You're making an awful lot of ASSumtions based on your own prejudices. Her parents did and do accept her. YOU can't accept that some people have mental or emotional problems despite having had a good family life, and rewrite the story of someone you've never met to suit your own agenda. Laughable that you talk about her writing her own book, when you've already done so for her. You really think picking up men at a truck stop and leaving with them a few minutes later is healthy behavior? Please. Any one of them could have raped and/or murdered her.

Shy? Odd that her shyness developed late in her teens, don't you think? She wasn't shy before, and in fact was very outgoing. Again, you are ASSuming that I think there is something wrong with being shy. I don't, and am somewhat reserved myself. In this woman's case, though, shyness was not "normal" for her - she was an extrovert before she became ill. And it wasn't just that she was quiet - in conversation, I could see her trying to interact and smile, but she could hardly finish a sentence and the smile never reached her eyes. She was a shell.

YOU can't accept that some people have mental or emotional problems....WRONG BITCH.

My best friend has dislexia. My older brother is slow from being hit in the head by my mother, and I accept them....only difference is that THEY manage their symptoms without pills.

Sorry about my ASSumptions....odd way of spelling that.......don't you think?

Pretty sure there aren't meds to correct head trauma, unless there is resulting seizure disorder, and there are none for dyslexia. So why would they be taking nonexistent meds?

Judging from some of your posts on other pages, you could use help, medical or otherwise, with anger managment. You persisted in making assumptions about a situation with which you were not familiar, making up nonexistent facts to suit your own agenda. I called you on it. Deal.

And you didn't even bother to read my apology in my last post.

I'll take it back and tell you this instead:
I'm NOT sorry, and will NEVER tell anyone "I'm sorry"...it just belittles me to actually say "I'm sorry". But I will say this: I apologize for making assumptions.

There is one part which you are wrong, with a CAPTIAL W.

Now, this isn't anger talking, this is me, making sure it gets shoved through your brick of a skull.

I have no agenda.

I have no agenda.

I have no agenda.

I have no agenda.

I have no agenda. NO AGENDA. If I had an agenda, I'd be expecting money for it, but I do not. I'm just very passionate about how corrupt the mental health system is, that does NOT mean I have an "agenda"....I can just see you there, sneering at your screen, thinking "she has a pointless agenda". Well now YOU'RE the one making assumptions...and I sure as HELL am calling you out on that.

Deal.

FIRST AND FINAL WARNING TO ALL NEWSVINE BLOGGERS: THE NEXT PERSON WHO BLATANTLY ACCUSES ME OF HAVING AN AGENDA IS GETTING REPORTED. If you REFUSE TO UNDERSTAND my posts, fine, but don't ACCUSE (that's right, sandy, you accused) me of having an agenda. I'll bet little miss Sandy only read my posts on the mental health system, and no other.

Political parties and campaigners have agendas. I am not a political official in any way, so watch your wording, Sandy.

You think I need anger management? HAHAHAHAHAHA! That one made me literally laugh my ass of, AND facepalm...this is just online arguements, sweetheart. I'm one of the most quiet people you'd ever meet in real life.

The reason I put these posts up is to INFORM parents that they have other options to try, and that meds should be a last resort.

You can get all pompous and call it "your agenda" or whatever the hell you want, but it is FAR FROM AN AGENDA. It is simply me trying to raise awareness about psychiatric drugs, and yes, a lot of is is based on my own experiences, I'll grant you that.....BUT, a lot of it is what I've seen happen to kids, and young teenagers...a lot of times the teens and young adults that have had this happen are WOMEN.

Oh, and Sandy, I have HAD medical "help"....the help left me with the following:

While getting "help"(psychotropic drugs), I had:

A UTI infection from excessive thirst and urination.

EXTREME hunger.

EXTREME tiredness, depression.

I ALWAYS looked like I was in a comatose state.

Stuttered and stammered so severely that I could barely even introduce myself or order food at restaurants.

That's not even half of it, but let's see what else you wrote..."medical help or OTHERWISE"....yea, "otherwise"....clever wording to shade what you truly mean: she needs therapy, or counseling, or blah blah blah.

If you were as informed as you think you'd know that these companies are all tied to the mental health industry, if not directly, then they all have their connections.

And I know for a fact that therapy would not help me...I was sent to the school therapist for being a loner, and all she did was ask questions that went in circles. I didn't even feel better, I felt like I had been reported for being different. I felt belittled.

I'm not going to waste my money on "otherwise", as you put it, help, when I have other outlets for my problems: my art, classical music, my journal, taking photos....all talking (to anyone, therapist or not) ever did for me was end in the other person looking down their nose at me....the people I talked to were the REAL nutjobs....considering that...................why in the hell would I even set foot into a therapist's office?

"I don't have an anger problem, I have an idiot problem". Hank Hill....may be a TV show, but it rings true.

I'd hate to be living in your head, always angry when someone disagrees with you. But you're always right, right? Like about meningitis. And doctors getting paid for writing scripts. Oh, wait...

BTW, trying to raise awareness IS an agenda. An agenda isn't necessarily political, or a bad thing. An agenda is just something you're trying to accomplish or get someone else to consider. Trying to end world hunger is an agenda, too. Having an agenda isn't a bad thing in and of itself. Twisting and fabricating stories to suit that agenda is. That is what I accused you of, and if you back down from your assumptions, then I retract that accusation. And no, people with agendas don't necessarily get paid for them.

Your apology seemed pretty insincere, which was why I took no notice of it.

I did notice that your brother's injuries were a result of violence by your mother. I am sorry that you came from such a background. Whether you suffered abuse or not, that must have had a terrible effect on you. But not everyone's mental or emotional problems are a result of dysfunctional family situations.

Number one, don't EVER smart off to me with comments like "I'd hate to be living in your head"....you'd be surprised how intelligent I am, the things I ponder, what I think of when I meditate out in the yard....I'm not ALWAYS angry when someone disagrees with me, and did I say I'm always right? NO. I'm just set in my OPINION. Do me a favor, Sandy. STOP talking down to me, RIGHT NOW, and TELL ME THIS:
WHERE in my post does it say "I'm always right"? Answer that, right now. Wait, you can't....because it doesn't say ANYWHERE in ANY of my posts that I'm always right, lady.....but I'll let you search my posts for these imaginary words that you think I wrote, and ANSWER ME anyway. It does NOT say "I'm always right." Now I'm calling YOU out for putting YOUR WORDS into MY mouth.

NEVER put YOUR WORDS into MY mouth again. EVER!!!!!!!! NOW I'm pissed. NOBODY @!$%#ing takes THEIR OWN DAMN words, and tries to write them off as mine. I can spot that @!$%# in a split second, so don't even @!$%#ing try it. Yep, NOW I'm angry. And considering you tried to put YOUR words in MY mouth, I should be angry.

Number two, the first apology was insincere, but read the bold part in the NEXT post after that. I won't apologize twice, and if you are not willing to look for it, then that's really not my problem anymore, so tough. I will not apologize a second time.

Number three, I did NOT fabricate my story. I was involuntarily comitted, sedated when I asked what's the IV for, and drugged beyond belief...my metabolism will never be the same. My emotions will NEVER be the same. My crippling fear of doctors is probably going to take some years to overcome. They had me on that old drug Lithium for crying out loud. Fabricated, my ass....HOW DARE YOU. You try being put on the drugs I was on, telling your story, and then being ACCUSED of fabricating it...see how YOU FEEL. Don't you DARE accuse me of fabricating something that happened to me. I'm horribly traumatized by that, and for you to say that I'm lying about it? Un@!$%#ingbelievable.

Number four, I do not consider my posts to be an agenda. If this were an agenda, I'd have a website, and protests going on, but I do not. I simply try to reach people through my posts, and if you think that's an agenda, then, in my opinion, you're waaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaay off base.

Oh, and I'm sure you got the message, but I'll say it one more time:
NEVER

put

YOUR

words

into

another

person's (me)

mouth.

The quick ones like myself will catch that @!$%#, and when they do, THEN they get angry, and will NOT tolerate it.

If you thought I was angry before, well....I'll bet you're NEVER gonna try to put words in my mouth again.

First off, whatcha gonna do about it on the Internet, hon? Big talk through a keyboard.

Second, who's putting words in whose mouth? I never accused you of fabricating. Look up the word "agenda". You'll forgive me for doubting your intelligence when it is obvious you can't read and have a limited vocabulary.

No, you didn't say you're always right, but you have, several times, belabored points on which you were clearly wrong. I gave two examples - meningitis vaccine, and doctors getting paid for writing scripts. If you establish a pattern of bahavior on a thread, don't get pissed when someone notices it and calls it what it is - you always thinking you're right, when you're wrong.

I noticed you mentioned no friends in your list of outlets. Small wonder, that.

You're the one who actually thought you could pass off your words as my own. Idiot. Maybe you're the one who's "big talking"...I know what was said.

Second, I don't make friends with other posts.

Yea, do you know what HAPPENED when I tried talking to my friends? Did you even bother to @!$%#ing read it, you bitch?!
No of course you didn't read it.
When I tried talking to my friends they couldn't just sit back and listen....they all turned into condescending judgemental @!$%#s.

You think I have no friends, your reeeeeaaaaally off base.

There's the two I met in art class, that I've recently gotten back in touch with. Then there's the guy who took guitar classes with me. One of them TAUGHT me to channel my emotions into art, although I had trouble grasping guitar.

And the others deal with their problems in the same way others do.

Not everyone has to blab their darkness, to their friends, hon....oops, Sandy.

Second, who's putting words in whose mouth? You totally missed my point on that one, hon. I was talking about how you said I'm always right....I NEVER said I'm always right, you just accused me of saying that. My opinions are just stubbornly rooted, and you aren't going to change that, so accusing me of always having to be right is pointless.

If you think I'M the one who always has to be right.......I'd give up my front seat in HELL to watch you argue with my EX friend, whose psychology course turned her into a busybody knowitall.

I won't forgive you for @!$%#. Granted, my vocabulary is more limited than I'd like it to be, but I can work on that. You'll always be an accuastory bitch.

But you have a lot of nerve telling me I can't read. You ought to go to my highschool. I was one of the FEW there who could finish a 300 page book within a week span, and actually remember what was read, and understand it. I get out the dictionarys and thesauras when I'm bored......see what I mean? I can work on my vocabulary, but you'll always be a bitch. I even see new, longer words in my album booklets....and I get out the dictionary again. I've read up to WWII in Chronicle of the 20th Century, and that book is HUGE. I've finished Angels and Demons, The Da Vinci Code, and am in the middle of The Lost Symbol.

The part about my friends, I'll admit that I have few friends, BUT I KEEP IT THAT WAY ON PURPOSE. I actually ENJOY being a loner. It gives you time to REALLY ponder things, to learn about new things....overall, I'd say it made me more intelligent (oops, aside from my "limited vocabulary".....OH GOD, A LIMITED VOCABULARY?!! ANYTHING BUT THAT!!!!!!)....more intelligent when it comes to people, why they do the things they do...but I could never explain it to you. You probably see being a loner as a bad thing, and would NEVER open your eyes to the postive side of it.

I've had friends who were more down your nose condescending than you, Sandy. I've been left with a goddamn knife in my back enough times to lose a lot of my trust in people.

But why am I even still trying to justify my "limited vocabulary" and my VOLUNTARY being a loner to you? You're not going to listen, especially since to you, being a loner is probably horrible. And you never did acknowledge my apology that I actually put in bold letters...you're just not going to listen.

I was wrong. There. I already apologized, not doing it again. And I'm not going to sit here and justify how smart I am to you, or how many friends I have to you. I don't have to, and I can't believe it took me this long to realize that I'm wasting my breath....and words. Later

When I state my opinion about you, I am not putting words in your mouth. You persist in beliving I am. Whatever. You've posted similar irrational, angry statements on other discussion boards, and nobody there put words in your mouth, there, either. You, however, have no problem projecting your own emotions to the subject of the story I told, to fit your own agenda. Hypocrite.

Yes, I said agenda. I'm going to leave you with some advice. Quit using your own, incorrect definitions of words so that you have an excuse to perceive them as insults. That is why you need to improve your vocabulary - perhaps then you won't perceive everything as an insult because you give words pejorative meanings they don't actually have. Pretty much everyone on here has an agenda. Raising awareness is an agenda. Getting others to consider your point of view, on any subject, is an agenda. An agenda is NOT a bad thing, as I said before. Think of it as a to-do list, if you will. Nothing wrong with having a list of things you want to accomplish. Twisting and embellishing a story with which you are not familiar to suit your agenda is what I have a problem with. Get it through your head.

Another word of advice - don't preface an apology with "BITCH". Your indignation when such an apology is not acknowledged makes you look stupid.

No, there is nothing wrong with being a loner (see there, you put words in MY mouth), but when you lose lots of friendships, is the problem really always with everyone else except you? Not usually.

Number one. In the SECOND apology, it does NOT say bitch anywhere in that post, although it is true. It says: BUT I WILL SAY THIS: I APOLOGIZE FOR MAKING ASSUMPTIONS. It DOES say that, but you are TOTALLY NOT willing to look for it, so I had to spell it out for you.

Your eyes are only reading what they want to read and pick to death out of my posts.

GO READ THAT POST!!!!!!!!!!!!!!!!!!!!! IT DOES NOT NOT NOT NOT NOT NOT SAY BITCH ANYWHERE! CAN YOU GET THAT THROUGH YOUR HEAD?! Probably not........

Number two. I've only lost two friends over the years, and I was the one who ended them. Granted, I have things I could work on, but I was NOT going to be played by a bunch of manipulative, controlling, aggressive, catty, toxic "friends". I still have plenty of friends....but I've already told you this, but I'll spell it out:

I

DO

NOT

HAVE

TO

JUSTIFY

MY

SOCIAL

LIFE

OR

AMOUNT

OF

FRIENDS

TO

AN

ONLINE

POSTER.

I

WILL

NOT

JUSTIFY

IT

EITHER!!!!

Number three..I do not consider this an agenda, you're not going to change my mind, SO GET OFF IT. Jesus H Christ, it's a @!$%#ing tirade.

State your opinion...fine...you took YOUR THOUGHTS and tried to say that I said that I was right, when it didn't say that anywhere in ANY of my posts. There...you used your OPINIONS of me to accuse me of saying or implying things which were not implied. They were only implied to yourself.

I'm gonna END this on this note...in MY opinion, using my other posts of IRRELEVANT TOPICS against me, makes you look:
petty

reallly stupid...since you're using posts about OTHER topics in this thread

bored with too much time on your hands

and overall, makes you look UNWILLING to just drop this whole back and forth bull@!$%#. I thought we were done discussing...and correcting (at least on your part) but no.

OH....lecturing me for my vocabulary makes you look like an uptight writing teacher who's a serious grammar NAZI.

Goodbye, I'm ending this NOW. have a good life.

How are doctors paid to write prescriptions?

11,

excellent question, but I doubt anyone will take you up on it. Its just easier for people to believe in the straw man of the medico-pharm complex, instead of realizing that docs prescribe drugs instead of exercise because they know if people actually exercised, they wouldn't be in the doctors office to begin with

I do think that docs overprescribe for varied reasons. First, many patients expect a "fix" when they go to the doc. They demand quick solution. Also, doctors are heavily trained to use the drugs to solve the problem. I think they enjoy the science involved...the solution orientation. Sometimes that is misplaced. I do not however believe they offer meds as the solution for any financial reasons. They are trying to help.

I thinks that doc ( sadly correctly) are very cynical regarding the general populations willingness to change behaviors i.e. diet and excercise.

I thinks that doc ( sadly correctly) are very cynical regarding the general populations willingness to change behaviors i.e. diet and excercise.

I agree. But I think this shows a lack of leadership. If MDs are in charge of public health then they are failing miserably.

MDs are not in charge of public health

YOU are

You might want to tell that to those military wearing MDs at the CDC!

?

...and step up to the plate. It's a nice way to escape accountability, though. More chemicals are not the answer to America's health problems. Less chemicals are part of the solution. Are MD's helping or contributing to the problem? No excuses!

CURE

ALLHAT

TRITON-TIMI 38

just 3 large trials off the top of my head that show a mortality benefit to "chemicals"

My main point is that the person most in charge of your health is....you. What you eat, how much you exercise, if you smoke, how much you drink, etc

My main point is that the person most in charge of your health is....you. What you eat, how much you exercise, if you smoke, how much you drink, etc

Yes. I agree. ARe medical doctors the most trained in diet, exercise, etc., than any other profession or civilian duties? I don't think so. I think they are no more experienced than the avg. citizen in these capacities that you cite are the most important. Maybe you don't think they are so important. You're hours spent studying them should indicate the importance, no? Do you have any evidence that they are?

But do pharmaceutical corporations benefit from that. Do you think they are benevolent in that endeavor? Do you know what a fiduciary duty is? Do you know what a shareholder is?

Could you tell us what percent of physical training and practicalities makes up your training and expertise? Could you tell us how many hour you have put into studying the most important aspect of an individuals health routine compared to you chemical and interventionalist hours? Could you tell us how many hours are devoted into actual nutrition studies compared to medicinal studies?

chirp chirp

Exactly!

MOST doc want to treat patients (we all know the bad apples), but, in general, docs are doing a piss-poor job of treating their patients.

It is a complex problem with many causes, and no one is free from blame.

Patients come into their dr's office armed with their symptoms, a diagnosis and the desired medication, usually because the patient (who has spent their life--as I have--being seen by doctors in 5-minute increments) believes that their doctor isn't really going to listen to them. Patients (uneducated? scared?) are just trying to do their best.

The Dr, assuming that the patient has no interest in anything other than a quick fix (rX), travels the path of least resistance. They are trying to help, but they are being told to see more and more patients by the insurance companies.

Healthcare is ultimately the responsibility of the patient, but drs need to be advocates of health.

I do have evidence that doctors are trained well in proper diet and nutrition

First, they have the basic science knowledge--things like the krebs cycle, glycolysis, fatty acid metabolism, etc. These are covered mostly in biochemistry, but also pathophysiology, endocrinology.

Then they take clinical nutrition courses in med school. Nutrition aspects are also built into other courses. Cardiology, for example--in that class, you will discuss the benefits of fish oil, antioxidants, saturated vs monounsaturated vs polyunsaturated fats, etc

Finally, during residency they get practical experience counseling patients DAILY on proper nutrion, habits, etc. They'll rotate through physical therapy at some point, as well as cardiac rehab, occupational therapy. They will attend lectures on various diets including weight watchers (the only popular diet with proven wt loss results), atkins (which, despite unknown effects on organ function long term has short term benefits), and the heart healthy diet, DASH diet, etc

IT would take some time to add this all up, but I would estimate that the average med student through residency spends a few thousand hours dealing with these issues

Of course I know what a shareholder is. What I don't know is what your point is.

But I think I've made mine

I get a physical every two - 3 years. But rarely see a doc between those physicals. Colds, sore throats, stomach issues generally resolve themselves with rest, better diet, and a little time. I know so many people that run to the doctor every time their throat is sore or their sht is a little runny. Its crazy. However, that being said, my last int med doctor chided me at my last physical because "she had not seen me in almost two years".......Is there a revenue motivation involved??

i agree with 99% of that...my only point of disagreement would be caving in to drug reps--they're very easy to say no to, there are really no bad repurcussions if you do

The time constraints are based upon revenue expectations. No one makes an internest schedule patients in 15 minute intervals.

300 bucks a pop??? Where? No way do doctors get 300 dollars for an office visit

Would you like to see how ridiculous your number is? Lets take you number as an average--15 minutes per patient, 7 hours a day, 5 days a week, 50 weeks a year

300 x 28 x 5 x 50=

$2,100,000

so, according to your math, the average family practitioner or internist makes over 2 mil a year. Do you honestly believe that?

You have absolutely no concept of medical reimbursement or payments.

Eric, I have gotten bills from docs who spent less than three minutes with me as a new patient in for a first visit, did not do even the most cursory exam, did not take a history or read the one they had me fill out, and charge far more than $300. Not only that, but I have had them schedule multiple $2000+ treatments for things that weren't even the reason that I was there and tht didn'need to be treated, all without doing any of the clinical testing that is a minimal requirement for such treatments.

More than once, in fact.

I also know docs who prescribe invasive treatment and long term narcotics without so much as a baseline set of vital signs, much LESS an even cursory exam.

so your anecdotes aside, as they prove nothing, how do you argue with the math I have presented?

If 300 dollars a visit was the norm, as you suggest, every family doc would be a millionaire a few times over...do you really think that's the case? Do you really think they make that kind of money that you suggest?

Again, please address the simple math I have provided

The $300 per visit is nonsense...unless maybe some esoteric specialty..even then a stretch.

However, I do tend to agree that in my experience the visits for physicals are rather pretty weak. Minimal discussion around diet excercise, sexual habits, alcohol, etc. I have often wondered if it would be about as effective if I simply gave blood and urine and waited for the results without a visit at all. Alot of this is cause by lack of time. However that is a revenue based decision made by the the doc.

11,

very true. Doctors do spend less time with patients now than before, and much of that is because of shrinking revenue. But is that the doctors' fault? How much is an hour of a doctor's time worth? The average patient visit probably reimburses around 50 bucks--a patient every 15 minutes means about 200 bucks an hour--is that unreasonable for a profession such as medicine? Most lawyers bill out at at least that amount...hell, most mechanics and plumbers are pretty darn close. Why should medicine, which requires more training than any of those fields, be paid less?

They are not paid less. I dont have the source, but I read recently that the level of physcian income as compared to income of population has increase over the last several decades. Granted that the numbers are probably skewed with the inclusion of highly compensated specialists that perform a large number of prodecures.

I think that doctors expectation of compensation is largely a cultural issue. Doctors in places like France, Germany do not receive the level of comp that they do in America. Most assuredly a different model in play i.e. litigation, and educational expenses. But that being said, our current model is totally broken and not sustainable. We cannot continue to spend 15 to 18 percent of GDP on healthcare. I can identify the problem...i just dont have the solution!!

Many many attorneys barely make a living. Same with many of the trades. Income in those professions are extremely variable with the economy. They do not have a continuous source of income (reimbursment system) that the medical community has.

But is that the doctors' fault?

Not directly. The system is set to reward specialists. Hence the vanishing generalist, or the old family doctor. 3rd party reimbursement plays a major role in this catastrophe of a health care system.

Show's you how money influences, though.

Its hard to argue with math

Like I said, if the average visit is 50 bucks, and a doc sees a patient every 15 min, then he is making 200 an hour...certainly comparable with other professionals

My point is that shrinking reimbursements, which are government mandated, means that a doctor has to see more patients in the same amount of time to keep a living commisurate with his training and comparable to his peers in other fields. So its not that doctors want more and more money, its that they are getting paid less for the same amount of work

Sure, doctors in europe don't recieve the level of compensation that US doctors do...but the important point to remember is that european lawyers, actors, politicians all make less than in the USA. So is it fair for doctors to recieve european wages while the other professions here get US level wages.

The answer is no

Finally, I agree that medical spending is way out of control. But physician payments are less than 1% of medical spending. Not only would it be difficult to shrink that down anymore, but it would not yield near the returns as attacking other, much larger expenses in the system

many attorneys barely make a living, and many make millions. what is your point?

While medicine is more resistant to economic fluctuations than other professions, it is far from immune

http://www.physicianspractice.com/staff-salary-survey/content/article/1462168/1850762

I think part of the solution is to take a hard look at the roles and associated level of training of physicians, NPs, PAs, etc in providing medical care. We are training these professions with the same model that has been in place for many many years even the world is much different. I would argue that much of the patient load of primary care physician could be delivered by someone with less training and much lower expense. That process is beginning in some states.

I think that primary care providers are underpaid in some instances. However, the specialist procedure guys and associated diagnostics are over prices. When was it decided that an MRI was worth $800? It wasnt the free market. Who decided that orthodontics cost $3000??? We have capitalism overlaid over a vast reimbursment system. Worst of both worlds.

When was it decided that an MRI was worth $800? It wasnt the free market. Who decided that orthodontics cost $3000??? We have capitalism overlaid over a vast reimbursment system. Worst of both worlds.

I agree madness.

Eric

My point around attorney income is simply in response to your stating that their billable hours are similar to physicians. There compensation is not similar. There do not have the inelastic demand for services that meds have. They do not have a system of reimbursment. They do not have the managed supply of labor that exists in med profession. Not comparable.

if you read my citation, you would see that medicine is not completely inelastic.

Right, they do not have a system of reimbursement. They simply have fee for service--which is much better. No haggling with insurance claims, no denied payments because of incorrectly filled out forms. Simply pay what you owe. And you try to argue this results in LESS reimbursement? Really?

What is a "managed supply of labor?"

don't get me started on NPs being able to provide the same quality of care as doctors for less. I really don't want to have that discussion but its so false its laughable

don't get me started on NPs being able to provide the same quality of care as doctors for less.

It's a futile fight. It's going to happen. PA's too. The system dictates it.

Would you include " the same quality of care" when many people do not go to the doctor at all because they cannot afford it?? My children see a PA for almost all their sick child visits....ears and throat..no issues and lower cost. Referred to the doc for things that appear to be chronic or more serious. Works fine for me and many other people. Keep in mind that I mention that the training model needs to be changed to provide more training for non physician providers, but not to the level of int med doc. Do your really thing that things are going to remain the way they are?? Laughable.

So, you are suggesting that attorneys have no issues collecting their fees??? Not the real world. They have huge collection costs and large bad debt expense. I have a solo attorney friend who spends 10 percent of his time collecting.

Inelastic. No business has totally inelastic demand. The ones that do approach that level ( think utilities) are highly regulated regarding costs to consumer. However , the med is much more inelastic than most business models due to reimbursement system and the very nature of the product --health.

do i think things are going to remain the way the are? and then you say laughable? Did I ever say otherwise? Before you say "laughable", check and make sure I disagreed first

Of course things are going to change. That doesn't mean I agree, nor do I think its right. IF youre happy with the care you recieve from a PA, fine. Whether it works or not remains to be seen. All I can tell you is medicine is too complicated to learn in 2 years, and the worst kind of ignorance is not knowing what you don't know

I don't really care to continue this attorney compensation talk going since its so off topic, but if I only spent 10% of my time on paperwork making sure i got reimbursed, that would be the best day of my life. Doctors probably spen 50% of their time on average doing paperwork to document their medical decision making so they get paid.

You provoked attorneys compensation in your post so get over it being off topic.

Since your posts pretty consistently defend the status quo it is obvious that you either dont want change or somehow expect no change. Both are laughable.

Regarding non physician care, it is the direction that things are moving for basic primary and preventative care. You may not like it, but a large segment of the public seems to have embraced it. The jury may be out on this style of care, but the verdict is definately in on the current system of delivery.

I haven't consistently defended the status quo, but you just haven't asked the right questions. That and i guess anyone who disagrees with you is laughable. The point is you said my answer was laughable before I even gave it. Thats funny

Obviously things need to change. I don't think hiring underqualified people to fill a need is the right way to go though. If you call defending patient safety laughable, then I pray for you

A large segment of the population may or may not approve of it, but that proves squat. Most people have no clue about what it takes to be a doctor, what the practice of medicine entails, etc. Just look at this article and the comments--complete ignorance abounds. Someone above was SURE they couldnt get meningitis because they had been vaccinated, which is dangerously incorrect.

My point precisely.

mike,

I guess I'm not sure what your point is. As for RN, remember that out of the 1400 maybe 100 bucks or so goes to the doctor, which is exactly contrary to your point

I also question the 1400 dollar figure. Remember that billed charges mean virtually nothing in medicine. A doctor can bill a hundred grand for your visit--he is reimbursed from a fee schedule based on the care provided and medical complexity involved.

As for your claim of doctors "owning stock in med/pharm industries" I doubt that claim and challenge you to provide evidence to back it up.

Also, I disagree that medicine is more concerned with profit than patient care. Sure, doctors want to make a living, and a comfortable one at that, but not if it means patient care suffers

I agree that doctor are generally in their profession because they want to care for people. However, the level of care they provide is driven by many dicisions that are revenue focused. In some cases those conflicting motivations are nicely balanced. In some cases they are not.

sometimes that is true. I hope mostly its not though

Sarita

In my opinion, healtcare is going to be rationed whether we have the current insurance based system, Obama care, or totally socialized medicine. In any model there will have to be guidelines regarding what will be allowed (paid) and what will be disallowed. Without such guidelines the costs would be astronomical.

show me how doctors make money by prescribing drugs

Let me save you some time--they don't

You really think a doctor, even a geeky one, would sell out his patient to please a beautiful woman he knows he has no chance with nor cares about him? What if the doctor is married, as most are--do you argue that most of them are unfaithful?

Do you honestly believe what you are saying? Its really difficult for me to argue with complete nonsense

Yeah! and i got some friends who are docs who are pretty rico sauve with the ladies and dont need the drug rep connection!!!

What is "leadership status"? I've never heard of that, and I doubt it exists

those kickbacks you describe are highly illegal and do not occur regularly

You are paranoid my friend

I often have the same problem. I even had a primary care doc yell at me for not prescribing narcotics to his patient whose urine was positive for illegal drugs.

I'm an MD - Family Practice my speciality. And this morning is unusually slow with 2 no shows and one cancellation so...

While I disagree with the posts saying providers serve the Pharmaceutical companies, I don't think it's even worth arguing over. Peoples opinions and perceptions can be subjective, and emotional. Best to just agree to disagree. But your post above talking about "pressure applied by patients..." I'd like to address.

It is true that when a patient comes to our offices, he or she already has an idea of what they need or desire from the office visit. Patients as a rule do not want to take their time and pay their co-pay and leave an office empty handed.

But that is the "culture of Medicine" that must be changed. And the only ones who can change it are us, the medical profession. Frankly I believe it has to begin with me, the Primary Care Provider. And that is exactly what I do.

I simply take a few extra minutes and explain the other treatment options for any given problem. Some patients are amenable to these treatment options, some are not.

For the ones who are not, I take a few extra minutes explaining my thinking process, in a way that they understand. Right at their level. No BS. Just straight shooting. Again some are amenable, some are not.

But I make the effort. My observation is that when I make the educational effort once, I don't normally have to do it again at a later date. Admittedly, the "drug seekers" don't listen or care what I have to say, but I've found that if I do not prescribe for them and help them to find an outpatient addiction treatment program, they understand that my motivation is to help and that I'm not just trying to be an as_hole. I'm not saying they are happy campers, but I've never felt threatened by any patient - mainly because they get that I'm actually wanting to help them. Now of course, some of these patients never come back for a return visit....

Changing the culture of medicine from diagnosing a problem, and treating the problem, as if the problem was somehow its own separate entity and has nothing to do with the "whole of the person" to creating one that offers more preventative care is going to take time and effort. Probably a lot of effort. But as this is what I'm doing already, I find the effort to be less strenuous than I first imagined it would be, and the rewards far greater than I imagined.

I've really enjoyed reading the previous few posts, especially the last one. Bravo to your efforts--I think you make great points and I applaud your attempts to change medical practice

wow...physical therapy would have been the very first place I would send you--and most doctors I know

I don't know why you had such a bad experience but its clearly outside the norm, I promise you

Vested interests won't let that happen.

please name me any incentives the drug company gives doctors

please name me any incentives the drug company gives doctors

CASH to Key opinion Leaders. Your influential colleagues. Even though the rules have tightened, this still happens.

any evidence?