Re: Gear Grinding Part 5: The Story of the Broken Tooth
Agree - but - it seems that the Pharmaceutical gang and doctors seem to want to give you a pill for everything/anything. Why not a lifestyle change? Proper prophylaxis? Nowadays it seems they give you pill 1 for symptom 1, pill 2 for symptom 2 and then because 2 overrides 1, pill 3. I try to avoid pills whenever possible.
Meds are more specific now so sometimes you give one med for one pathway and another to cover a different pathway. We used to just increase doses to get the coverage of the second pathway but that causes increased side effects. Example Prozac covers Serotonin but at high doses covers Dopamine. It also then causes sweats, and other stuff. Or you can give a much smaller dose, add a little dose of Wellbutrin, get same coverage with much less side effect.
The complaints are not about the good they provide. If you never cheat on your wife, but you're absent and physically abuse her does that make you a good husband? Never mind I've purchased items over the counter in SE Asia that would never be approved by the FDA, cost pennies, and actually work without producing a list of side-effects that would make Jim Morrison blush.
Watch out. THey recall a lot of that stuff d/t heavy metal content and contamination. I have seen some really scary stuff with chines meds. (not Chinese herbs- those seem great except for the heavy metal content in those too.
Many of y'all can count yourself blessed that your body's biochemistry is working normally. For certain chronic conditions, modern medicine has turned a short bleak life into something close to normal.
That being said, generally I do agree that in many cases physicians over-prescribe medicine for what used to be normal life events that could better be "treated" by proper diet, regular exercise, rest, and avoidance of substance abuse.
Ahhhhhhhhhhhhhhhhhhhhhhh!!!
Agree many providers write for too many meds and do not suggest what they should. However.....
-we're now being judged on certain 'measures'. If the patient does not meet the measures, no matter what the chart says we lose $$. (I mean 10's of thousands even for our 2 person practice). Lifestyle is slower, and people are not always compliant. The easy way is to give pills which are more predictable in their outcome. Many providers take that way because the financial reward/penalty is so high. By sticking to the lifestyle recommendations, which should always come first or at least be involved it is a roll of the dice (hence we lost cash).
-We also get 'marked' on patient satisfaction. You cannot believe how many people are ignorant and entitled at the same time. If they sneeze they expect to be cured, NOW!! They insist on being seen, get so nasty they get an apt and then are pi55ed when they are given the same advice they would have gotten on the phone. They want a pill, dammmmit and you have to give it to them. Of course there is no pill but many providers just give a prescription to shut them up.
We had one of those in our practice who has now left. It takes 2 times as long to see people who saw this person because they expect something and are not convinced no prescription will fix it.
-even if you convince a person they don't need pills some buffoon in their life invariably will tell them they rec'd suboptimal care because they didn't get a prescription. (yes, I get my jollies withholding meds I know will help just to get a giggle
)
-If we do the right thing it takes 2ce as long, kills our 'satisfaction' rating and ends up costing us $$. Costs us $$ if we write the prescription too because the 'measures' say you need to show proof they needed med. Many places give the med because it at least increases the amt of people you can see.
