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(Medical Daily)   American doctors prescribe the strongest drug 60% of the time. The other 40% of the time they prescribe the one that has the cutest pharmaceutical representative   (medicaldaily.com) divider line 23
    More: Interesting, antibiotic overuse, Physicians Prescribe, U.S., Americans, ear infections, antibiotics, University of Utah  
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859 clicks; posted to Business » on 12 Aug 2013 at 8:41 AM (49 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



23 Comments   (+0 »)
   
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2013-08-12 08:57:27 AM
This is your chance farkers.
 
2013-08-12 09:03:46 AM
[Image Related]
medicinemaniac.weebly.com
 
2013-08-12 09:06:53 AM
Ah pharmaceutical reps, the job the 90 IQ hottest girl in high school can have for 11 years after which she ends up on the pole for the next 20.
 
2013-08-12 09:12:23 AM
I think 40% is on the low side.
 
2013-08-12 09:15:39 AM
60% of the time, those drugs work all the time.
 
2013-08-12 09:26:00 AM

HotIgneous Intruder: This is your chance farkers.


I'll start, with low-hanging fruit.

Diana Chafair

www.playerwives.com


coedmagazine.files.wordpress.com
 
2013-08-12 09:33:12 AM
They need to start making sure that docs know that "no script" is an option, even for stuff that a pill might make easier or shorter. Sure, you can knock out a cold in 20 hours with a fever reducer and a decongestant, but you're still able to transmit it to someone else during that time, and is it really worth incremental damage to liver/kidneys (like mileage on a car) to be healed 12 hours faster?

// that's but one example
// not applicable to all conditions/illnesses
 
2013-08-12 09:34:31 AM
How come they send female reps to female doctors too?  I saw a guy once but it was almost all women...  the doctors were married to men so I'm assuming they're not lesbians...
 
2013-08-12 09:40:30 AM
My best friend is a physician. She's also a Super-Mega-Butch-Dyke. The first set of pharmaceutical reps that visited her were handsome-ish. Every drug company rep she's seen since then has been an attractive female.
 
2013-08-12 09:51:27 AM
Those doctors should be prescribing the strongest drug all the time.  When you hang a picture on the wall do you tap the nail in?  Hell no, you take a full swing with the biggest hammer you can find.  If they can prescribe 20 mg they can just as easily write for 400 mg.  But their business is in keeping you sick, or at least teetering on the edge.  They don't make any money from healthy patients.
 
2013-08-12 09:59:24 AM
It's not so much the hotness of the rep, it's the quality of the catering she brings with her every Tuesday.
 
2013-08-12 10:12:12 AM

Dr Dreidel: They need to start making sure that docs know that "no script" is an option, even for stuff that a pill might make easier or shorter. Sure, you can knock out a cold in 20 hours with a fever reducer and a decongestant, but you're still able to transmit it to someone else during that time, and is it really worth incremental damage to liver/kidneys (like mileage on a car) to be healed 12 hours faster?

// that's but one example
// not applicable to all conditions/illnesses


Yes and no.  There are multiple irons in the fire in this case.

The patient believes they "deserve" whatever the best antibiotics are for their case - most don't realize the difference between viruses and bacteria, and so don't understand that the likely have no need whatsoever for any antibiotics at all.  Additionally, if they do have a bacterial infection, they want (understandably so), the "very best" antibiotics available.  This I understand - most people would want the best available, especially if their insurance is going to cover it, and they don't understand the differences between "broad-spectrum" and "narrow-spectrum", AND, "I have insurance, so why won't my doctor give me the 'expensive' medication?"

Its also complicated from the physician's perspective.  We have to balance the risks and benefits of the patient's case - do I really think its viral?  Am I willing to risk discharging them home (I'm an ER-doc), only to have them get worse, bounce-back septic and need admission and a much higher level of care?  Even when I think/suspect/know its bacterial, which antibiotic do I give them?  The one that is "proven" to kill almost everything, or the one that has about a 70% of being effective, but is cheaper and they are possibly more likely to take it?

Finally, though I am generally a supporter of "Obamacare", there are aspects for which physicians are likely to feel very conflicted.  For example, hospital/physician reimbursement will now be tied to patient satisfaction.  Although this is proven to actually cause worse morbidity and mortality, if the patient doesn't rate the experience as "excellent" on the phone survey they will get, the hospital and/or physician stands to lose 2% of the money they have  already spent on the patient's care due to the patient's perception that the care wasn't the best.

So, anyway, its not that simple as "no script" vs. "script", in any case...
 
2013-08-12 10:15:22 AM
For your further entertainment:  http://www.cafepharma.com/boards/
 
2013-08-12 10:24:03 AM

PatoDeAgua: So, anyway, its not that simple as "no script" vs. "script", in any case...


To be sure.

There's a bit of choice fallacy I've noticed with docs (used to work at a psych facility, and it's definitely more common there), that "patient presents with symptoms X, Y and Z, so I must prescribe something that vigorously attacks all 3 without too much disruption" (though sometimes, a little disruption might be desirable). In the acute-care psych world, I don't think they let you stay without having at least some kind of cocktail.

That, to me, is slightly farked up, and necessarily means overprescription. I happen to think we overprescribe (or are too quick to prescribe) for mental health anyway, but the rise of antibiotic-resistant bugs can be tied to overprescribing broad-spectrum antibiotics for anything and everything.
 
2013-08-12 10:24:41 AM
I should also add that IANAD.
 
2013-08-12 10:27:48 AM
www.popsci.com


There's more prescription drug overdoses than there are car fatalities in America now.

But we keep trying to solve everything with the STRONGEST MAGIC PILL possible.

Typical, lazy attitude to life.
 
2013-08-12 10:53:57 AM
Dr Dreidel:

I happen to think we overprescribe (or are too quick to prescribe) for mental health anyway, but the rise of antibiotic-resistant bugs can be tied to overprescribing broad-spectrum antibiotics for anything and everything.

Well, I'm quite inclined to agree with you there.  We definitely over-prescribe, in all areas of medicine.  As I said before, its a multiple-edged sword.  And I'm not a psychiatrist, so I can't really speak to the practices you mentioned, but it happens in almost all of medicine.  From an ED-standpoint, we try to hit the infection as hard as we can out front, and then let the antibiotic "de-escalation" begin in the ICU, or inpatient, once they more closely ID the bug in question.
 
2013-08-12 11:23:47 AM

PatoDeAgua: Finally, though I am generally a supporter of "Obamacare", there are aspects for which physicians are likely to feel very conflicted. For example, hospital/physician reimbursement will now be tied to patient satisfaction. Although this is proven to actually cause worse morbidity and mortality, if the patient doesn't rate the experience as "excellent" on the phone survey they will get, the hospital and/or physician stands to lose 2% of the money they have already spent on the patient's care due to the patient's perception that the care wasn't the best.


Wow, that's really dumb.  People already think they know better than doctors, now doctors have to listen to a patient's suggestion about their health to get paid in full?  Why even have doctors then?  Just let patients self diagnose and prescribe the medication they think is best.
 
2013-08-12 12:23:21 PM

Farnn: PatoDeAgua: Finally, though I am generally a supporter of "Obamacare", there are aspects for which physicians are likely to feel very conflicted. For example, hospital/physician reimbursement will now be tied to patient satisfaction. Although this is proven to actually cause worse morbidity and mortality, if the patient doesn't rate the experience as "excellent" on the phone survey they will get, the hospital and/or physician stands to lose 2% of the money they have already spent on the patient's care due to the patient's perception that the care wasn't the best.

Wow, that's really dumb.  People already think they know better than doctors, now doctors have to listen to a patient's suggestion about their health to get paid in full?  Why even have doctors then?  Just let patients self diagnose and prescribe the medication they think is best.


Fortunately, its not entirely in that direction, but if, for example, I offer decongestants and fever-reducers for that annoying cold you have instead of a prescription, AND you happen to not have insurance, you might perceive that I am treating you inferiorly compared to someone who does have insurance.  This perception, whether right or wrong, will affect your rating, and will subsequently affect my "percentile ranking" compared to my peers.

Its not a physician's number one goal, and don't get me wrong, patient's should feel that they've been treated well, but it can weigh on the mind of a doc who has challenging patients.
 
2013-08-12 02:56:51 PM
Not my doctor. I'm on the oldest, cheapest blood pressure med in existence.
 
2013-08-12 03:24:45 PM
I've been workign in a doctor's office the past 8-9 months. It has been disturbing to see the sausage made, but hot drug reps have not been a reality here.
 
2013-08-12 06:53:20 PM
Sprain your wrist? Yeah, oxy 15mg tab 1t po q6 prn.

You'll be fine, precious.
 
2013-08-12 09:18:53 PM

NostroZ: There's more prescription drug overdoses than there are car fatalities in America now.

But we keep trying to solve everything with the STRONGEST MAGIC PILL possible.


Well the article is about antibiotics so first off, you're an idiot.  You can't overdose on a course of oral antibiotics.

But note the majority of those cases are "unintentional self harm".  This means the idiot who thinks that if one ibuprofen every four hours relieves a bit of pain, then four every two hours will be super awesome.  This is the idiot who doesn't read the information that comes with the medication, even if it's only a couple of lines, and whine that they "didn't know" that eating grapefruit would cause a toxic load of buspar.

If you are taking a medication it is your responsibility to make sure you take in the appropriate dose and avoid possible interactions.  There was a time in my life I was taking 9 medications at a time and over a period of a year had tried around 30 different ones.  I researched every single one of them.  You don't get to blame the doctor because YOU are an irresponsible moron.
 
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