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Opioid makers made payments to one in 12 U.S. doctors

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Re: Opioid makers made payments to one in 12 U.S. doctors

#61

Post by _wp3r »

csr12928834 wrote: post #53
zjaffee wrote: post #33

Earlier quoted context omitted.

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

The problem in my mind, that the parent is intimating at, is that we confer far too much control to and assume far too much competence and beneficence on the part of physicians. I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it. The entire drug regulation system is predicated on the idea that y…

Aren't there multiple groups that provide the guidelines for treatment? Specifically all of the specialty associations. (Gastro, Oncology...)

Going outside recommended guidelines can be very very expensive for a physician.

The understanding of opioid use has clinically changed drastically in the last 40 years, similar to SSRIs in the last 70 years.

Not that I do not agree with your premise, but the issue seems to be much more institutional and related to human, research, and implementation error than a bunch of individual bad actors.

https://www.guideline.gov/

Re: Opioid makers made payments to one in 12 U.S. doctors

#63

Post by stephengillie »

lr4444lr wrote: post #35
zjaffee wrote: post #33

Earlier quoted context omitted.

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

I think you're raising an interesting point, but I disagree with your example - what pain that is so bad its sufferer needs "to lay in bed in agony" can be relieved by ibuprofen, acetaminophen, or any other OTC pain reliever? The Great Binge[0] ended long ago - perhaps for the wrong reasons, but ended nonetheless, until recently when legal opioid prescriptions spiked. This is about doctors putting their patients at r…

Tangental - having never heard of The Great Binge described before, it's interesting to note the time period begins just at the end of the Opium Wars. Almost as though it was just a shifting of focus.

Re: Opioid makers made payments to one in 12 U.S. doctors

#64

Post by stephengillie »

bostik wrote: post #30
elipsey wrote: post #5

Reminds me of what Rostand said about murder: "Kill one man, and you are a murderer. Kill millions of men, and you are a conqueror. Kill them all, and you are a god." Sell one oxycontin and you're drug dealer; sell a million and you're a C level.

That can be generalised. Petty thieves break the law. Mafiosos skirt and avoid the law. The real kingpins write the law.

Smart criminals don't commit crimes; they change the laws and then act freely.

Re: Opioid makers made payments to one in 12 U.S. doctors

#68

Post by alexanderdmitri »

lr4444lr wrote: post #27

Maybe it's because Americans just have this cognitive dissonance that their trusted doctor could be any less than 100% conscientious about their health, but we need to plainly face the fact that if members of the press were able to write exposés about drug makers' fudging the data about the addictiveness and effectiveness of their products, that doctors with their medical training and responsibility over actual peopl…

The problem seems to me that in the United States, the most common metric for success is money. Within most fields, if someone has a nice house, takes great vacations with the family, drives a nice car, those around them will say: Wow, { person.name } has really done well for themselves!

The example I always use is imagine two foot doctors (podiatrists). One has all those things above, the other doesn't (or at least not to the same extent). The reason the first has all those nice things is because this doctor performs the job well and makes extra money working with big pharma and big consumer-screwing insurance companies. The second doctor, while he/she also does a great job, decides not to work with big pharma or cut deals with insurance companies that screw his/her patients because that's the right thing to do.

Most people these doctors come into contact with, will not know (or even care to listen to [ever brought up server config during a family reunion?]) what goes into podiatry and what makes a good podiatrist actually good. They will perceive wealth and judge based on that for the most part. Can you really blame the doctor? They aren't being rewarded for doing the right thing, they are being penalized.

The travesty to me is that the doctors really are just being given peanuts compared to what big pharma and insurance are making with the rigged system.

Re: Opioid makers made payments to one in 12 U.S. doctors

#69

Post by PeanutCurry »

alexanderdmitri wrote: post #68
lr4444lr wrote: post #27

Maybe it's because Americans just have this cognitive dissonance that their trusted doctor could be any less than 100% conscientious about their health, but we need to plainly face the fact that if members of the press were able to write exposés about drug makers' fudging the data about the addictiveness and effectiveness of their products, that doctors with their medical training and responsibility over actual peopl…

The problem seems to me that in the United States, the most common metric for success is money. Within most fields, if someone has a nice house, takes great vacations with the family, drives a nice car, those around them will say: Wow, { person.name } has really done well for themselves! The example I always use is imagine two foot doctors (podiatrists). One has all those things above, the other doesn't (or at least…

This doesn't sounds like an issue of too much money though, it sounds like a combination of baseline compensation not yielding a high enough return, inadequate oversight agencies to catch this sort of behavior, and the consequences of being caught not being strict enough. It could even be argued that just paying more would discourage the corrupt behavior in your hypothetical examples because the doctors are taking those actions to simply make more money.

Re: Opioid makers made payments to one in 12 U.S. doctors

#70

Post by refurb »

erdewit wrote: post #23
elipsey wrote: post #5

Reminds me of what Rostand said about murder: "Kill one man, and you are a murderer. Kill millions of men, and you are a conqueror. Kill them all, and you are a god." Sell one oxycontin and you're drug dealer; sell a million and you're a C level.

31 billion$ earned on the sale of oxycontin... https://en.wikipedia.org/wiki/Oxycodone#History

Lipitor was over $150B through it's lifecycle.
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