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U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

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Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#161

Post by csdreamer7 »

refurb wrote: post #152
athenot wrote: post #19

I have mixed feelings about this, especially considering the US is the only first world country where direct-to-consumer marketing is allowed for medications. Bypassing the prescription requirement is of course of significant value to drug companies, who expend quite a bit of resources to sway doctors with free lunches, conferences and soft persuasion tactics. Usually I welcome the freedom to chose but this doesn't i…

What you’re talking about goes far beyond what the FDA is proposing. The drugs the FDA wants OTC are drugs that have already gone generic like statins. There is very little financial incentive to push consumers to buy drugs they don’t need.

> There is very little financial incentive to push consumers to buy drugs they don’t need.

I have to disagree: Homeopathics and Viagra.

In general I am in favor of this change, but homeopathy and vitamins are 'generic' and companies see a huge incentive to sell them, even if we do not need them. Supplemental vitamins are mostly wasted when you urinate.

Viagra is another drug I can (and do) see a lot of money spent to encourage people to take even if they do not need it.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#162

Post by Analemma_ »

mrfusion wrote: post #143
madamelic wrote: post #74

Earlier quoted context omitted.

>it's a very silly and awkward process to find a tech person, make the meeting, wait for the meeting, show up to the meeting, tell them your issue and the solution for it is [solution], let them examine your problem until they agree with your "diagnosis" of [problem], and let them recommend and prescribe [solution]. It makes you feel sorry for the tech person almost. There is a reason why we have specialists. Yes, yo…

But medicine is dealing with your own body and I would argue that you’re the world expert on your own body.

This is the kind of logic that has brought us the plague of “As a mom, I know what’s best for my kids’ health and that’s why I’m not getting them vaccinated.” Despite what a charming mantra it sounds like, people are not automatically experts on themselves any more than on any other subject.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#163

Post by cassowary37 »

I'm always struck by the intensity with which some HN folks hate their doc - reminded of this by the number of comments invoking conspiracy theories about docs scheduling extra appointments to bill more or push more generic drugs.

Perhaps obvious but perhaps not: in the US and most EU countries I'm aware of, you can choose a new doc. You can shop around. Despite the flaws in online reviews, just as with Amazon, you can read between the lines. Choosing instead to avoid healthcare completely seems self-defeating.

I'm sorry to read so many horror stories - going to the doctor even for docs (especially for docs?) can be a frustrating experience. But while you're burning down the FDA, at least shop around and find yourself a good primary care doc.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#164

Post by csdreamer7 »

refurb wrote: post #4

Similar to this idea, the province of Alberta in Canada allows pharmacists to write prescriptions for patients with only the only limit that they can't prescribe controlled substances.

I like this, with the exception of anti-biotics because misuse would spread immunity.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#165

Post by seibelj »

cassowary37 wrote: post #163

I'm always struck by the intensity with which some HN folks hate their doc - reminded of this by the number of comments invoking conspiracy theories about docs scheduling extra appointments to bill more or push more generic drugs. Perhaps obvious but perhaps not: in the US and most EU countries I'm aware of, you can choose a new doc. You can shop around. Despite the flaws in online reviews, just as with Amazon, you c…

A rural hospital kept my grandma alive 10 extra days to milk Medicare for the maximum allotment. There is nothing American healthcare won’t do to make a buck

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#166

Post by adrr »

phil21 wrote: post #151
aesclepius wrote: post #86

Earlier quoted context omitted.

Thanks for speaking for the entire medical profession. That is in fact what a terrible physician does, and not what myself or other newly trained physicians aspire to do.

You may not aspire to it, but you likely will have to do it if you want to remain employed in many areas. I have multiple friends who made it all the way through residency and have since stopped practicing within years of "graduating. The OP describes the profession much better than you do, as a whole. Double booking patients, requiring certain revenue targets, massive amounts of useless paperwork, etc. Considering t…

They should start their own practice and set their own rules. Good practices/doctors in my area are so in demand most aren't accepting new patients.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#167

Post by someguydave »

xamuel wrote: post #39
rsynnott wrote: post #23

> Patients could answer questions on a mobile-phone app to help determine whether they should be able to access a medication without a prescription. Day 2: Websites showing the correct answers to get anything you want show up. This is an absolutely bonkers idea.

As opposed to the alternative where people buy said meds from a dude in an alleyway?

No, the real "bad scenario" is "people go without drug that could help them because doctors & insurance are seen as too troublesome and expensive"

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#168

Post by refurb »

csdreamer7 wrote: post #161
refurb wrote: post #152

Earlier quoted context omitted.

What you’re talking about goes far beyond what the FDA is proposing. The drugs the FDA wants OTC are drugs that have already gone generic like statins. There is very little financial incentive to push consumers to buy drugs they don’t need.

> There is very little financial incentive to push consumers to buy drugs they don’t need. I have to disagree: Homeopathics and Viagra. In general I am in favor of this change, but homeopathy and vitamins are 'generic' and companies see a huge incentive to sell them, even if we do not need them. Supplemental vitamins are mostly wasted when you urinate. Viagra is another drug I can (and do) see a lot of money spent to…

The margins on homeopathic are way higher than generic drugs and there is a ton of competition among manufacturers.

Most generic companies make their profit off the first 6 months of exclusivity. The rest of the time they are barely breaking even (hence the drug shortages).

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#169

Post by rjurney »

seibelj wrote: post #165
cassowary37 wrote: post #163

I'm always struck by the intensity with which some HN folks hate their doc - reminded of this by the number of comments invoking conspiracy theories about docs scheduling extra appointments to bill more or push more generic drugs. Perhaps obvious but perhaps not: in the US and most EU countries I'm aware of, you can choose a new doc. You can shop around. Despite the flaws in online reviews, just as with Amazon, you c…

A rural hospital kept my grandma alive 10 extra days to milk Medicare for the maximum allotment. There is nothing American healthcare won’t do to make a buck

But your parents have control over hospice arrangements. The only thing a hospital can legally in most states do once you decide to let her die is to sedate if necessary and cut off food and let the body shut down.

What gives you the idea it was a conspiracy?

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#170

Post by jessaustin »

Lanthanide wrote: post #111

I live in a country where this scheme is already the norm (Saudi Arabia) and I can say that while it's not necessarily ideal, I much prefer it to the alternative. It plugs some seriously annoying holes in the healthcare experience and frees up doctors' time for more patients. As it is, the only medications that require a prescription to buy in Saudi are psychotropic ones, narcotics, and most recently, antibiotics. Th…

Things like... hypertension medications, ...are all OTC.

This would be so nice. Every time I switch providers, I have to hear the same tired "Lisinopril is the modern blood pressure medication and it's certainly all that you need!" "No asshole, it doesn't work for me and it makes me cough 17 times a minute, 1440 minutes a day. Just give a water pill, which does work and has worked for years."

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