Medical Doctors / General Practitioners

[Neally]

How do you see that saving money?

When people don't have to pay for a doctor visit just to get a prescription for which they are comfortable with making their own decision about, they save money.

 

[The Atheist]

Well, immensely boring topic so far, so I'll try to liven it up a bit, having given the matter a little critical evaluation.

Beacuse this is about legal drugs, I wondered how illegal drugs fit into the equation.

I believe there should be no illegal drugs; heroin, meth, LSD, salvia, the lot, should all be quite able to be grown/produced and sold as any other commodity.

So, why should medical drugs differ?

To my mind, they shouldn't. If I see a world where a person can legally buy heroin, why would I discriminate against diazepam or romicin?

Would those opposing self-prescription just quickly note their attitde to illegal drugs, because my experience is that quite a heavy majority of skeptics favour no drug laws, yet most of the skeptics here seem to be against Richard writing his own scripts.

 

[Richard Masters]

Unfortunately, the solution that you proposed where the patients take on the responsibility after somehow being certified is even more complex and even more dependent on circumstances.

That's true. That's why the test/license/certification emphasizes critical thinking, safety, and reacting to new information instead of on memorizing static drug profiles as drkitten suggested.

What if someone is deemed competent to self-prescribe and then develops dementia or has a stroke? What if new information develops about the safety of one of the drugs he takes?

See above.

How about this for a solution. Doctors currently write their prescriptions with refills, either a fixed number or for a fixed time (up to a year).

We could, I suppose, allow a doctor to write a prescription with unlimited refills, lasting indefinitely. Or at least a longer time: three years, for example. Is it unreasonable for us to require that a patient's medication be reviewed at least once every 3 years?

The problem I see is that this places the responsibility on the doctor to decide the patient is competent to manage the medication himself. If something goes wrong, the doctor is still liable.

That's slightly better, but it ignores medications with similar mechanism of action.

 

[fls]

OK, I'm probably exaggerating your position.

If by "exaggerating" you mean "represented as the opposite of what it is".

What then, (setting instances of intentional abuse aside) would you consider a sufficient condition for some patients to have safe access to medication without resorting to doctors as gatekeepers?

Drugs that don't require special monitoring that are used to treat conditions that are amenable to self-diagnosis and self-monitoring.

Linda

 

[Richard Masters]

If by "exaggerating" you mean "represented as the opposite of what it is".

I wouldn't go that far. Now it is you who is exaggerating.

Drugs that don't require special monitoring that are used to treat conditions that are amenable to self-diagnosis and self-monitoring.

Linda

You mean like water and salt?

 

[fls]

I wouldn't go that far. Now it is you who is exaggerating.

You mean like water and salt?

You may as well just jump ahead to the punch line.

Linda

 

[Richard Masters]

You may as well just jump ahead to the punch line.

Well, alright.

Water
Salt

Linda

Here's one with a festive theme.

Saltwater kills freshwater fish

It gets worse:

Interactions between H2O and NaCl can cause hallucinations (do not try this at home):

Saltwater abuse

Bars reported to intentionally induce salt intoxication in customers

All that extra salt in seawater means that, if drank, it causes the person to suffer the effects of dehydration [...] This is why bars often put out salty peanuts or pretzels as free snacks. The kidneys respond to an increase in salt by taking more water from the body to flush out the extra salt.

 

[fls]

Well, alright.

Water
Salt





Here's one with a festive theme.

Saltwater kills freshwater fish

It gets worse:

Interactions between H2O and NaCl can cause hallucinations (do not try this at home):

Saltwater abuse

Bars reported to intentionally induce salt intoxication in customers

So this is another one of your arguments with an imaginary foe?

What has this to do with anything I've said?

Linda

 

[Richard Masters]

So this is another one of your arguments with an imaginary foe?

What has this to do with anything I've said?

Linda

You said to go right to the punch line. If you look carefully, there is a smiley in my response.

 

[Richard Masters]

Sorry I couldn't make this thread more interesting, The Atheist. I am waiting, however, for responses to your question.

As for my original question, I have found a solution.

I declined unemployment benefits when I was laid off; and think it would be better if that money was simply set aside for employees regardless of circumstance, or not collected at all.

But now that society has chosen to make people dependent on welfare through retarded policies, I will be applying for every socialized government program there is, whether I'm eligible or not.

It will be my tax on society.
When I file my tax return, I will engage in creative accounting. Everything will be a business expense, including movies I rent, the food I eat, and the cost of any plasma TVs.

Any gifts I give to people will be listed as donations to non-profit organizations.

Any time I waste seeing a doctor and the gas spent to get there will also be listed as a donation to my doctor.

I will deduct any such gifts from my gross income as if they losses from theft.

(Yes, that's double dipping).

I will also start charging society for any time I have to waste at a line at the airport, i.e. TSA.

I will also apply for food stamps and purchase only the most expensive brands of any item, and only at the most expensive stores, even if they are worth less.

I will also deduct from my gross income any expenses having to do with wrongly imprisoned people in Guantanamo, for every person that died because the FDA was too late to approve a medication.

I will also apply for healthcare and every time I am subjected to wasting time with a General Practitioner, prescribed a medication that doesn't work, I will also deduct that time and those expenses from my gross income.

I will also create fake prescription pads, (I'm an expert when it comes to practical applications for handwriting analysis and document falsification), and use them liberally. Heck, I might just fill my medicine cabinet with prescription medications. Not because I need them but so I start investing on collectibles for a museum of collective stupidity.

If you think doctors and the FDA are gods and there is no place for personal responsibility because it's too costly, you might change your mind when I send you the bill.

 

[gdnp]

If you think doctors and the FDA are gods and there is no place for personal responsibility because it's too costly, you might change your mind when I send you the bill.

You owe me a dollar for reading that post.

 

[Richard Masters]

You owe me a dollar for reading that post.

Put it on my tab, send me an invoice so I can claim it on my tax return.

 

[Richard Masters]

To add to The Atheist's question, would any of you be opposed to amateur genetic engineering?

 

[ponderingturtle]

From what I can glean from the non-answers to my questions (), the OP is talking about self-diagnosis and treatment of mood disorders. Taking this into consideration, what is being asked for is what already happens - just too slow, in this particular case, to solve his current problem. When medications are made OTC, what is taken into consideration are just the sorts of questions that I asked earlier - what condition does the drug treat? how amenable is it to self-diagnosis and self-monitoring? is it relatively easy to use the drug safely? If the answers to those questions are reasonable, as Richard demonstrates they may be, then those drugs will be moved to OTC status.

I doesn't seem out of the realm of possibility that some anti-depressants may be made over-the-counter. What hasn't been shown here, is that considering the issue on a case-by-case basis should be abandoned in favour of making all drugs OTC.

Linda

My understanding is that there are good reasons to not make anti Depressents OTC. This is that you do not want people with real serious depression not going to a doctor and just taking OTC medication. For individuals with a established history it might be acceptable for some to self medicate, but with depression you want monitoring and the like to be sure of effecacy and to keep an eye on suicidal thoughts.

 

[ponderingturtle]

As far as medical prescriptions go, a good example is contact lenses. You can save a lot of money by ordering them through the mail, but a prescription is required. My prescription has been the same for 15+ years, but the requirement for a prescription (and the eye exam required to get it) adds much cost. For someone like me who's been wearing contacts for over 30 years I'll know when my lenses are no longer doing the job, all the doctor's exam does is raise my costs.

But you get more at an eye doctor than just a new perscription for your contacts. They also check your eyes for other problems.

This is like saying that a yearly checkup is an unnessacary expense if you feel healthy.

 

[fls]

My understanding is that there are good reasons to not make anti Depressents OTC. This is that you do not want people with real serious depression not going to a doctor and just taking OTC medication. For individuals with a established history it might be acceptable for some to self medicate, but with depression you want monitoring and the like to be sure of effecacy and to keep an eye on suicidal thoughts.

Admittedly insight is going to be more of an issue when you are talking about mental illness, but let's assume we are talking about an individual with an established history (since the recommendations for OTC anti-depressant use would include "do not use without an established diagnosis of depression"). Much of the efficacy and side effects could be assessed by the individual (it is their mood, after all). The suicide issue is tricky. Outcomes depend upon access to care. While access to mental health services (a bit of a catch-all) reduces completed suicides, medication alone may not. If the reason to self-medicate is to save money, the benefits we can expect to see from increased medication use will be offset by the reduction in benefits from decreased use of mental health services. I don't know how that would balance out, and I suspect that it wouldn't be in favour of self-medication.

I'm not sure how much of a difference interventions based on monitoring for suicidal thoughts make to the whole process. Providers don't seem to act differently until after a gesture or attempt has been made, anyway. (Take this with a grain of salt...it is not my area of practice).

I'm not really advocating for any of this. It makes more sense to me to advocate for access to good quality care for everyone, than to attempt to maximize solutions for those who don't have access.

Linda

 

[fls]

But you get more at an eye doctor than just a new perscription for your contacts. They also check your eyes for other problems.

This is like saying that a yearly checkup is an unnessacary expense if you feel healthy.

To be honest, that part is true. If you are an otherwise healthy adult male between the ages of 21 and 50 (maybe even 64), you don't need a yearly check-up if there is no reason to think there's a change in your health. You should be screened for some risk factors (like cholesterol levels), but you don't need that every year. Most of the interventions that have been demonstrated to be beneficial during that age range are related to advice about health-related behaviours (regular activity, smoking cessation, etc.) - stuff you can read about on your own.

Linda

 

[The Atheist]

Sorry I couldn't make this thread more interesting, The Atheist. I am waiting, however, for responses to your question.

So am I.

Funny that.

Maybe everyone has me on ignore (strongly possible), so it might be worth your while asking the same question. I think it's pretty relevant and I know it's analogous.

 

[gdnp]

Well, immensely boring topic so far, so I'll try to liven it up a bit, having given the matter a little critical evaluation.

Beacuse this is about legal drugs, I wondered how illegal drugs fit into the equation.

I believe there should be no illegal drugs; heroin, meth, LSD, salvia, the lot, should all be quite able to be grown/produced and sold as any other commodity.

So, why should medical drugs differ?

To my mind, they shouldn't. If I see a world where a person can legally buy heroin, why would I discriminate against diazepam or romicin?

Would those opposing self-prescription just quickly note their attitde to illegal drugs, because my experience is that quite a heavy majority of skeptics favour no drug laws, yet most of the skeptics here seem to be against Richard writing his own scripts.

I used to be against anti-drug laws, but I changed my mind as I saw the consequences of drug use were not limited to the users. There was one episode in particular where a man on PCP whipped his stepdaughter to death with an electrical cord. My high school chemistry lab partner raped and killed his 80 year old neighbor while high on something. So I advocate maintaining at least some prohibitions against recreational drugs. Some are just too dangerous.

 

[The Atheist]

I used to be against anti-drug laws, but I changed my mind as I saw the consequences of drug use were not limited to the users. There was one episode in particular where a man on PCP whipped his stepdaughter to death with an electrical cord. My high school chemistry lab partner raped and killed his 80 year old neighbor while high on something. So I advocate maintaining at least some prohibitions against recreational drugs. Some are just too dangerous.

And yet those things happened while drugs are illegal.