why do they prescribe medication so much?

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guywithAS
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11 Aug 2011, 3:14 pm

a poster here on WP wrote to me confidentially about why he suspects there is so much medication:

Quote:
I live in Canada. From what I understand, they get paid more by the government if they can provide a diagnosis of a one time or a chronic condition requiring a referral to another physician (low value client) or a in house treatment (high value client: like a broken arm) or a prescription (high value event) for care or medication. A prescription shows the government (who pays the doctor) that there is a clear issue. Otherwise they have acres of paperwork and proof to fill out that the client was anything but a placebo (negligible value client).


does anyone have any thoughts about this for canada/us/other countries?



Troy_Guther
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11 Aug 2011, 5:30 pm

Doctors prescribe lots of medication because it's what many patients want. Why do they want it? Taking a pill is far easier than making a conscious effort to change.



Zen
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11 Aug 2011, 5:52 pm

You might find this interesting.

http://abcnews.go.com/Health/Wellness/d ... d=11929217

Good doctors will make the effort to solve your problem instead of throwing pills at you though. I need to find one of those.

What Troy says is true also, though. It's the same reason for all those diet fads and products.



shadowmage
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11 Aug 2011, 9:57 pm

The more drugs they sell the more money they make.



liveandletdie
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11 Aug 2011, 10:15 pm

probably the same reason there is a war on drugs =/

Sorry for the profanity....had to post it.
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Last edited by liveandletdie on 11 Aug 2011, 11:28 pm, edited 1 time in total.

Sweetleaf
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11 Aug 2011, 10:26 pm

I tend not to trust a lot of pharmacutical companies...I really have no issue with drugs in general, but that prozac I tried was terrible and made things worse......years of perfecting my emotions enough to not get quite so upset when things bother me gone all because of prozac so now I have to do it again. But then again I have much deeper issues than depression so that may have something to do with it.

Anyways if I could be prescribed marijuana I would be all for (legally) taking meds, but other then that no way.

Why do I think they prescribe drugs so much? well there are a few reasons:
Population control
chemical lobotomy
to sell a product
so people will take other prescriptions to relieve the side effects
because a pill is easy to take
and finally, there are the people that need a specific medication and thus are prescribed it.



MagicMeerkat
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11 Aug 2011, 10:43 pm

Laziness and incetives from the companies that make the medication


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LornaDoone
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11 Aug 2011, 10:51 pm

Physicians in Canada do not get paid more for appointments where there is a diagnosis. They do not get paid more when they refer to a specialist.

They get paid for their time and the service provided. Just like the DSM lists disorders, physicans have a similar book for procedures and they are paid according to the procedure.

They do not get paid, or get kickbacks from prescribing meds. But what they do get are free samples that they try and get the physicians to give out to their patients. Many physicians do not even accept samples from the drug companies.

Drug companies are a for big profit business. But don't think all physicans are prescribing things their patients don't need to line their pockets. There are bad apples in every profession, but it's ridiculous to think there is a major conspiracy as was suggested.


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emtyeye
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11 Aug 2011, 11:25 pm

The drug companies like their big, fat obscene profits and the doctors like their expense paid excursion trips to Indonesian brothels paid by the drug companies and the sicker you are the more they get.



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12 Aug 2011, 5:53 am

I have no issues with medication, except I don't think you should have to go through a doctor to get it.


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syrella
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12 Aug 2011, 6:13 am

There is a very significant drug industry here in the US, so it doesn't surprise me that there is some influence. I don't think that most doctors are corrupt. If a medication works, it works. If it doesn't, find a new one. And there are many cases where medication does indeed help people.

The part that bothers me more is that it is legal for drug companies to advertise drugs directly to consumers. Drug commercials have always bothered me because the products they are trying to sell can be dangerous and ads are often misleading. They play up the benefits, while minimizing the potential side effects. So if a patient sees the commercial, they may think they need to be taking medication, when in reality they are fine without it.

To make matters worse, I've also heard that doctors will sometimes prescribe a patient a medication if the patient specifically requests it. The reason being is that the doctors are sometimes too busy to spend that little extra time with their patient and so they take the patient's word for their symptoms. Why someone would want to take medication if they don't need it baffles me, but I've heard of people who "fake it" to get sleep aids, pain medication, and other drugs.


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ValentineWiggin
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12 Aug 2011, 6:28 am

syrella wrote:
Why someone would want to take medication if they don't need it baffles me, but I've heard of people who "fake it" to get sleep aids, pain medication, and other drugs.


Because the rules for prescription are so strict.

I've eaten a whole bunch of bananas directly before a blood-test to counteract my genetic pre-disposition for my potassium to be on the low side, because I knew a doctor wouldn't write a prescription for something I *did* in fact need, if it was outside the reference range, regardless of the fact that my mother's has always tested low, as well, and I've been diagnosed as not having any kidney problem causing it.

I've lied to a new doctor about a skin condition before, leading him to believe I had run of the mill acne, when in fact I had a terrible infection previously-cultured as gram-negative folliculitis, because I knew the only drug that would treat it after the failure of over a dozen antibiotics (Accutane) was not at that time listed for G-N F treatment, whereas cystic acne was it's main label use.


When you've been put through the wringer and left multiple doctor's offices in tears because they refuse to give you the only drug that will help, that's when people start lying or being deceitful. In an ideal world, people wouldn't have to prostrate themselves before someone in a white coat to get treatment according to this or that FDA-defined guideline or indication for "need".


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OJani
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12 Aug 2011, 7:21 am

I don't like medication in general. I'm convinced that in a lot of cases (but not all) other methods than taking medication would help just as well, or even more. I'm quite sure doctors wouldn't prescribe medication unless the patent needs it, apart form cases where the doctors are not at their high point. It's just more convenient for both of them. And the person in need would be left on his own to find out what else might help to relieve his problems. This is why I don't really trust doctors any more, NHS being in the first place, of course. At least it worth to keep an eye out.

syrella wrote:
There is a very significant drug industry here in the US, so it doesn't surprise me that there is some influence. I don't think that most doctors are corrupt. If a medication works, it works. If it doesn't, find a new one. And there are many cases where medication does indeed help people.

The part that bothers me more is that it is legal for drug companies to advertise drugs directly to consumers. Drug commercials have always bothered me because the products they are trying to sell can be dangerous and ads are often misleading. They play up the benefits, while minimizing the potential side effects. So if a patient sees the commercial, they may think they need to be taking medication, when in reality they are fine without it.

To make matters worse, I've also heard that doctors will sometimes prescribe a patient a medication if the patient specifically requests it. The reason being is that the doctors are sometimes too busy to spend that little extra time with their patient and so they take the patient's word for their symptoms. Why someone would want to take medication if they don't need it baffles me, but I've heard of people who "fake it" to get sleep aids, pain medication, and other drugs.

It's all the same here in Europe, Hungary.



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12 Aug 2011, 9:08 am

Quote:
Neurodevelopmental consultation
Neurodevelopmental consultation is payable when the physician provides all the elements of
A195 for an adult with complex neurodevelopmental conditions e.g. autism, global
developmental disorders etc., and must include a minimum of 90 minutes of direct contact
with the patient and caregiver. The start and stop times must be recorded in the patient’s
permanent medical record. Maximum one per patient per physician every 5 years.
A695 Neurodevelopmental consultation............................................. 375.00
Note:
Neurodevelopmental consultations for children or adolescents or for less complex conditions
e.g. attention deficit disorder are payable at a lesser fee.

A195 = "Consultation" a 15 minute chat and on the spot decision.
Quote:
GENERAL LISTINGS - Psychiatry
A195 Consultation .............................................................................. 185.50

A195 describes a common visit to a psychiatrist, which is rated at 15 minutes with the patient.
This means that 90 minutes worth of patients at 15 minutes a patient allows for $1113 income while the same 90 minutes spent on a person with "complex neuro" issues is worth $375. And if it turns out to be a kid, or "just" adhd (less complex condition) you only get 95$ for your 90 minutes. Oh, and multiple comorbids don't get extra payment; you may bill only one issue. And don't try doing it more than once every 5 years or you won't even get paid the $375.

-------------------
Quote:
GENERAL LISTINGS - Family/General Doctor
A005 Consultation .............................................................................. 67.50
A905 Limited consultation .................................................................. 54.80


Again. 15 minutes per patient in most situations is more financially rewarding. Thus to spend the time to realize a patient's full history and needs is frowned upon by the businessman (the person who runs the clinic's financials - the doc's boss) and it's simply easier to throw a quick fix (yay drugs!) rather than face The Wrath of Khan... um, I mean, the boss's displeasure.

After all you wanna get paid right?
Then be done each patient in 15 minutes or you're gonna be replaced.

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12 Aug 2011, 9:17 am

syrella wrote:
Why someone would want to take medication if they don't need it baffles me, but I've heard of people who "fake it" to get sleep aids, pain medication, and other drugs.


Recreational use.
And/Or street sale if you have a drug plan.

I don't do this, but I know that people do engage in these activities.



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12 Aug 2011, 9:19 am

guywithAS wrote:
why do they prescribe medication so much?

So that they do not have to commit themselves to providing personal treatment 24/7.