Re: Canadian doctors coming to the US

From: dahmd (dahmd_at_cfl.rr.com)
Date: 09/06/04 

Date: Mon, 06 Sep 2004 00:32:09 GMT

"George Conklin" <nilknoc@earthlink.net> wrote in message
news:c1M_c.7373$Wv5.2280@newsread3.news.atl.earthlink.net...
>
> "dahmd" <dahmd@cfl.rr.com> wrote in message
> news:51H_c.15386$Of3.6663@tornado.tampabay.rr.com...
> >
> > "Founding Father" <ff@qwest.net> wrote in message
> > news:BLo_c.28$0P5.5692@news.uswest.net...
> > >
> > > "dahmd" <dahmd@cfl.rr.com> wrote in message
> > > news:7iPWc.47629$4s6.35165@tornado.tampabay.rr.com...
> > > >
> > > > "George Conklin" <nilknoc@earthlink.net> wrote in message
> > > > news:UdlWc.1231$Y%3.494@newsread2.news.atl.earthlink.net...
> > > > >
> > > > > Good. Would you support laws which allow pharmacists to
> substitute
> > > if
> > > > > the patient wants a generic and that little box on the
prescription
> > pad
> > > is
> > > > > not checked?
> > > > >
> > > >
> > > > No problem.
> > >
> > > But I bet there WILL be a problem if the patient has a bad outcome
with
> > the
> > > generic and sues the doctor - even if the problem isn't even directly
> > > related to the generic. If it is, he should, of course, sue the
> > pharmacist,
> > > but you know THAT won't happen - deep pockets and all that (just ask
> John
> > > Edwards).
> > >
> > > > To my knowledge that's how it's done in Florida.
> > > > Alternatively, I receive faxes from insurers every day that request
> > > > substitution of a name-brand to a generic, or from one type of
> > medication
> > > to
> > > > a similar, less expensive medication. I review these and, almost
> > always,
> > > > auathorize the change. Note that I receive no compensation for this
> > > > service, which does not benefit me in any way. Further, you might
be
> > > > interested to know that patients (not physicians) are the driving
> force
> > > > behing requests for name-brand prescriptions. Most patients want
"the
> > > very
> > > > best" and are unhappy about receiving generics. Ask any pharmacist.
> > They
> > > > want the name-brand, because they "are paying good money for
> insurance."
> > >
> > > There's that damned insurance problem again. People always want the
> most
> > > expensive when someone else is paying for it.
> >
> > Absolutely. It's human nature. Very few of us are altruistic enough to
> > reject "the best" care for the second-tier care, even if it's almost as
> > good. If an x-ray can diagnose the problem 97% of the time but a CT
scan,
> > which is about 10 times more expensive, can make the diagnosis 98% of
the
> > time, people are going to want the CT scan.
>
> Such scans are pushed by the medical-industrial complex. Stop blaming
> the public if they bought into the propagana machine that 'we have the
best
> medicine in the world.' That mantra demands that people ask for 'the
best,'
> not second best. As for 'people.' Are you saying everyone? Or just those
> who think we get the best medical care in the world? I know we do NOT,
and
> do not ask for tests.
>

For certain medical therapies, such as pharmaceutical agents, I would agree
with you. However, who "pushes" CT scans?! Doctors get nothing out of
ordering them. I can't recall ever seeing an ad for a CT scan, although
there are a few ads out there for "open MRI" machines. It's possible that
physicians in part are to blame for overstating our ability to diagnose and
cure illnesses, but I thought those days were gone. If anything, physicians
are so paranoid about lawsuits that they understate the potential for cure,
so that patients don't get their hopes falsely elevated. After all, if you
expect the procedure to have problems, and problems occur, you theoretically
are less likely to sue. I have not heard a physician say that a treatment
is "a piece of cake" in many years. Rather, when I hear informed consent
conversations, they usually involve a detailed discussion (in part) of all
the bad things that could happen if you choose that therapy. I stand by my
original comments: one of the reasons we have costly health care is that
patients are pseudo-consumers. They want the best available, regardless of
cost, but don't have to pay for it directly. When was the last time you
went into a store and bought something without knowing how much it cost?
Medical consumers frequently demand expensive tests or medications, and
don't even know the cost differential between that therapy and less
expensive ones.

Ashley

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