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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

#221

Post by mkl »

toomanybeersies wrote: post #155
mkl wrote: post #99

Earlier quoted context omitted.

> the US is the only first world country where direct-to-consumer marketing is allowed for medications. Not quite. It's allowed in New Zealand too. There have been many calls to change that, but so far it's still allowed.

It's not quite as bad in New Zealand as the states though, since most of the time if you go to the doctor they'll prescribe you generic, state subsidised medicine. I've never really noticed much direct-to-consumer marketing, except for Viagra and Cialis.

I haven't watched broadcast TV in years, but I certainly remember quite a bit growing up - maybe rules have tightened? I have no experience with US advertising, but yeah, privatised medicine must lead to issues we don't get.

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

#222

Post by fjsolwmv »

ethbro wrote: post #212
exolymph wrote: post #198

Earlier quoted context omitted.

There are tradeoffs. My guess is that very few people will bother to abuse the drugs that can't get you high, relative to the benefits of increased accessibility.

Presumably the slippery slope would be the profit incentive for manufacturers. Being able to go from "Ask your doctor about..." to "Try..." is a major shift.

So? We don't require a prescription for fruits and sandwiches.

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

#223

Post by fjsolwmv »

api wrote: post #196
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…

Off topic but: birth control is OTC in Saudi Arabia? That busts a stereotype.

Assuming that Christian laws apply to an Islamic country is a strange stereotype.

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

#224

Post by cryptonector »

394549 wrote: post #105
thatcat wrote: post #91

Earlier quoted context omitted.

It's a trade off since Doctors have a habit of using their prescription power to force you to schedule unnecessary visits to boost profits and they are not immune from marketing pressure.

> It's a trade off since Doctors have a habit of using their prescription power to force you to schedule unnecessary visits to boost profits and they are not immune from marketing pressure. Citation needed. I'm sure are a few doctors out there who do that, but I have a hard time believing that's so widespread that it's a "habit" of "doctors." For instance, my doctor will reissue my long-term prescription if I call hi…

Citation needed? Have you never been to the doctor in the US?

This "citation needed" thing for every little fact and factoid is getting weary. Yes, often facts are cited that require more evidence than merely recitation. But if you overuse "citation needed" then it loses its power as you come across as attempting to pettily shut down people you disagree with. Use it with care.

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

#225

Post by fjsolwmv »

madhadron wrote: post #220
darkerside wrote: post #128

Earlier quoted context omitted.

There's a generalized problem in medicine that it takes a long time for new standards to trickle into common practice. It often doesn't fully turn over until an older generation of doctors retires. It seems to me that, of many imperfect systems, one where doctors have control is more preferable. They are legally and duty bound to serve their patients. The same can't be said of pharma company marketers, not by a long…

> There's a generalized problem in medicine that it takes a long time for new standards to trickle into common practice. In the US, where we have no standards of care, this is true. In centralized systems like France, doctors receive updates to expected standards of care annually based on analysis of the latest evidence. This has interesting effects. My father did the statistical work for a set of expert consensus gu…

Italy is 5x as dense as the USA. There is no equivalent to rural USA in Italy.

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

#226

Post by medntech »

anoncoward111 wrote: post #50
woolvalley wrote: post #21

Earlier quoted context omitted.

Does your GF really want to rubber stamp things epipen Rxs? Once you have the allergy diagnosis, it generally doesn't go away. It's kind of like low tech automation.

I think these days, whether or not a doctor or physician assistant "wants" to do something isn't really considered in the equation. Basically, the schools jack up the medical practitioners with hundreds of thousands in debt, and the practitioners will do absolutely whatever is required to pay it off and eek out a living :(

I wouldn't do absolutely whatever is required to pay off my debt nor would my peers. But we can relate to the concerns of hundreds of thousands in debt as far as we can't "want" anything. We're just as trapped in the system as the patients we treat. No wonder why there is a spike in suicides after medical school.

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

#227

Post by fjsolwmv »

kbutler wrote: post #140
394549 wrote: post #105

Earlier quoted context omitted.

> It's a trade off since Doctors have a habit of using their prescription power to force you to schedule unnecessary visits to boost profits and they are not immune from marketing pressure. Citation needed. I'm sure are a few doctors out there who do that, but I have a hard time believing that's so widespread that it's a "habit" of "doctors." For instance, my doctor will reissue my long-term prescription if I call hi…

Personal experience: I was getting an annual physical from the doctor who had written a prescription that was expiring. We discussed the condition and agreed I needed a renewal. I was told I had to come back for a separate visit "because Obamacare required it" My translation: because he couldn't bill for writing out the prescription during well-check, and because he wanted/needed to charge for it. Oh, and blaming Oba…

Doctors have to wrestle with insurance companies as much as you do.

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

#228

Post by cryptonector »

rdiddly wrote: post #64

When you already know what drug you need and just need somebody to sign a prescription, it's a very silly and awkward process to find a doctor, make the appointment, wait for the appointment, show up to the appointment, fill out the history forms and so on, meet with the doc, tell them you've got [disease] and the drug for it is [drug], let them examine you until they agree with your "diagnosis" of [disease], and let…

+1. Obviously not every drug can be self-prescribed, and not every condition can be self-diagnosed.

Remember when you needed to go to a doctor to get a prescription for Fexofenadine or one of the many other antihistamines? Seems ridiculous in retrospect. We should limit ourselves to a year, maybe two at most, of prescription-required status for new drugs that should be over-the-counter, and only to get some experience (data). Some drugs should require a new N-year prescription every N years as patient conditions might change requiring examination.

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

#229

Post by medntech »

exabrial wrote: post #81

My pharmacist friends have long bemoaned the 'go to the doctor for everything' scheme. Some conditions are easily diagnosable and the side effects of the drugs are minimal. They'd much rather see the doctor as an escalation if treatment isn't responding or the patient has additional symptoms that could indicate something more serious. The behind-the-counter system is a great idea.

"Some conditions are easily diagnosable and the side effects of the drugs are minimal."

Sounds like a good time to see an NP/PA. Things should be triaged more effectively. Pharmacists PA/NP MD/DO.

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

#230

Post by conanbatt »

thatcat wrote: post #91
Communitivity wrote: post #69

There are better ways to go about this. As others have noted, there must be a mechanism for a continual prescription to be easily filled, e.g. insulin, metformin, etc. I could see a long term prescription that has to be renewed each year and is good at any pharmacy. For the short term prescriptions though, cutting the doctor out of it makes people much more susceptible to marketing (instead of 'ask your doctor if you…

It's a trade off since Doctors have a habit of using their prescription power to force you to schedule unnecessary visits to boost profits and they are not immune from marketing pressure.

It would not happen if you could not sue a doctor for renewing a prescription after a 1 year period and the patient died because he shouldnt have taken that drug anymore.

Doctors have insane liability standards, particularly in the US.

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