The Role of Doctors in Weight Loss
Replies
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There are big signs in most doctor's offices here that they don't prescribe opiates. So it's right out there in case the patient was hoping to score. I think the most shameful drug promotion/shelf pull lately is the Oxycontin brou-ha-ha. It was first touted as a non-addictive replacement for morphine, but guess what. It creates addicts. Prescribed addicts. Made that way through professional care. Our government finally responded by yanking the drug from the market, which created desperate addicts. Here in Canada after Oxycontin was pulled we saw a sudden rise in heroin use. All caused by first approving a drug that shouldn't, and then yanking it thoughtlessly with no suitable replacement.0
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tincanonastring wrote: »the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
My insurance will not cover medications if there is an over the counter equivalent, not even generics. For example, I have to take a daily double dose of the OTC omeprazole (Prilosec). There's a presecription time release, but because of the OTC version, I can't get it covered. I end up paying nearly 4x as much because a) I'm taking twice as much as the normal OTC dose, and b) I lose out on the insurance negotiated generic pricing.
I've gotten Omeprazole covered under insurance for some of my patients by having the doctor write a letter of medical necessity. Maybe you can try that?0 -
I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.0 -
Coolhandkid wrote: »I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.
give him a good rating on rate my doctor .com or whatever the site is.0 -
My sister when she was a resident, spent some time in a large chain clinic. She was reprimanded for coding one visit to the equivalent of a "nothing". As in, there was nothing wrong with the patient. Doctors aren't compensated for "nothing". She never used that code again.0
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EatCoolhandkid wrote: »I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.
give him a good rating on rate my doctor .com or whatever the site is.
Ratemydong.com
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tincanonastring wrote: »the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
My insurance will not cover medications if there is an over the counter equivalent, not even generics. For example, I have to take a daily double dose of the OTC omeprazole (Prilosec). There's a presecription time release, but because of the OTC version, I can't get it covered. I end up paying nearly 4x as much because a) I'm taking twice as much as the normal OTC dose, and b) I lose out on the insurance negotiated generic pricing.
Costco is pretty well known for having good policies, and in this case, they do almost the exact opposite. If you can get your doctor to prescribe something they sell a Kirkland generic of (such as Claritin), it's free.
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My sister when she was a resident, spent some time in a large chain clinic. She was reprimanded for coding one visit to the equivalent of a "nothing". As in, there was nothing wrong with the patient. Doctors aren't compensated for "nothing". She never used that code again.
I wonder if that's why my doctor is always confused during my physical. He is always like "but what's wrong" and I always say nothing, I'm just here for me APE. I get a discount on my health insurance through work by getting my APE and annual lab work completed.0 -
tincanonastring wrote: »EatCoolhandkid wrote: »I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.
give him a good rating on rate my doctor .com or whatever the site is.
Ratemydong.com
some drs are dongs, but i'm not sure that's it (could be wrong though)0 -
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
Yes, we do.
Honestly, we don't have as big a problem with safety protocols stopping that should continue as getting outdated and proven ineffective (or even misleading) regulations removed and instating effective ones. It's the time delay. I imagine it's a problem in any sizable health care system regardless of country. Bureaucracies just are not good at staying updated.0 -
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
Yes, we do.
Honestly, we don't have as big a problem with safety protocols stopping that should continue as getting outdated and proven ineffective (or even misleading) regulations removed and instating effective ones. It's the time delay. I imagine it's a problem in any sizable health care system regardless of country. Bureaucracies just are not good at staying updated.
Did you file the blue update form or the green update form?0 -
tincanonastring wrote: »EatCoolhandkid wrote: »I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.
give him a good rating on rate my doctor .com or whatever the site is.
Ratemydong.com
some drs are dongs, but i'm not sure that's it (could be wrong though)
Obscure reference five!
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the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
We have the exact issue in the US and since physicians will not prescribe opiates due to the increased scrutiny, this is one of the primary reasons for the resurgence of heroin.0 -
Having served in the military and moved several times I have come to believe that just because someone has "MD" after their name is no guarantee that they are competent. I have seen some outstanding AF Medics/Navy Corpsmen/Civilian PA's, etc. that hands down are better than some doctors I have seen. And you can't always go by word of mouth; you may have to "shop around" for someone that knows what they are doing. I consistently get sinus infections (if I'm not careful) because some "MD" kept telling me (for over two weeks) I had a cold (and I knew better); I finally went to a PA (retired Navy Corpsman); I had a sinus infection that was so imbedded it took me six weeks to get rid of it
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griffinca2 wrote: »Having served in the military and moved several times I have come to believe that just because someone has "MD" after their name is no guarantee that they are competent. I have seen some outstanding AF Medics/Navy Corpsmen/Civilian PA's, etc. that hands down are better than some doctors I have seen. And you can't always go by word of mouth; you may have to "shop around" for someone that knows what they are doing. I consistently get sinus infections (if I'm not careful) because some "MD" kept telling me (for over two weeks) I had a cold (and I knew better); I finally went to a PA (retired Navy Corpsman); I had a sinus infection that was so imbedded it took me six weeks to get rid of it .
I refer to these and "People with letters behind their name".
As a former Navy Corpsman I agree with all of this
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tincanonastring wrote: »the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
Yes, we do.
Honestly, we don't have as big a problem with safety protocols stopping that should continue as getting outdated and proven ineffective (or even misleading) regulations removed and instating effective ones. It's the time delay. I imagine it's a problem in any sizable health care system regardless of country. Bureaucracies just are not good at staying updated.
Did you file the blue update form or the green update form?
Both. In triplicate.
But then I was told that I'd submitted the forms exactly 30 secs after the required due date (noted solely in CFR 45 Part 23, section 181, subsection Z, part 1.4.51.678.2(b)) and I'd need to start over using the grey, yellow, and red forms that had been approved as a prequel to the blue and green update forms last week.
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We have the exact issue in the US and since physicians will not prescribe opiates due to the increased scrutiny, this is one of the primary reasons for the resurgence of heroin.
That, and suddenly taking Ocycontin off the market, as I mentioned above. <-- so grateful my disabilities have all been fairly pain-free.0 -
We have the exact issue in the US and since physicians will not prescribe opiates due to the increased scrutiny, this is one of the primary reasons for the resurgence of heroin.
That, and suddenly taking Ocycontin off the market, as I mentioned above. <-- so grateful my disabilities have all been fairly pain-free.
As someone who needs pain meds, I'm glad that Vicodin is still available. Although I did have to sign a lengthy agreement with my GP to get a prescription for it. (She's a good GP)0 -
tincanonastring wrote: »tincanonastring wrote: »EatCoolhandkid wrote: »I had my annual physical with my Dr who I genuinely liked. He took WAY too much time with me (like 80 min instead of 30). The nurse was IRATE. He explained the risks I was placing on myself with my weight, and did it in a respectful fashion. He was supportive and I really give him credit for starting me down the right path.
Less than a month later I called to schedule a follow up with him and he had been terminated. Apparently, keeping people fat and in need of health care is preferable to a Dr who genuinely helps people transform their lives. I'm still sickened when I think about it.
give him a good rating on rate my doctor .com or whatever the site is.
Ratemydong.com
some drs are dongs, but i'm not sure that's it (could be wrong though)
Obscure reference five!
oh jeez lol
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griffinca2 wrote: »Having served in the military and moved several times I have come to believe that just because someone has "MD" after their name is no guarantee that they are competent. I have seen some outstanding AF Medics/Navy Corpsmen/Civilian PA's, etc. that hands down are better than some doctors I have seen. And you can't always go by word of mouth; you may have to "shop around" for someone that knows what they are doing. I consistently get sinus infections (if I'm not careful) because some "MD" kept telling me (for over two weeks) I had a cold (and I knew better); I finally went to a PA (retired Navy Corpsman); I had a sinus infection that was so imbedded it took me six weeks to get rid of it .
I had this happen to me when I went to the free university clinic. I had a GP in the area, but I was a broke college student. I was told I had whatever virus was going around. Two weeks of green snot later, I finally sucked it up, was told I had (surprise) a sinus infection. I took some antibiotics and it went away!
Sinus infections are the only thing I ever seem to get. I know when I have one... I was just cheap.
Consequently, this same GP has never mentioned my weight but seems pleased that I have lost it and taken up running.
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