Health care frustrations lead to adverse reactionsWritten by Barbara Goodman Shovers | | firstname.lastname@example.org
I spent several hours in my doctor’s reception room last week. There were nine pastel-jacketed women filing, phoning, and chatting behind the counter, but only three doctors were seeing patients.
As I read magazines, four drug company reps – ”detailers,” as they’re obliquely titled – stopped by to drop off samples, display baby pictures, and ”check the doctors’ lunch schedules.” Patients waited patiently, but the detailers walked through like they owned the place.
I was at the office to discuss my cholesterol. This could have been done by phone. In Germany, where I used to live, that’s how my physician conveyed test results. She charged for the phone consult, but the fee was minimal.
Despite wasted time on the part of patients and rushed-ness of on the part of physicians, face-on appointments remain the norm here. That might be because my German doc had one office helper while the Americans have their phalanx: all these people need paychecks. And with insurers and drug companies mostly running the show, that’s not going to change soon.
Still, in the way we hate the sin yet love the sinner – or hate the war but love our soldiers – I like my doc. She’s a reasonable woman. But we disagree on the course she wants me to follow.
My cholesterol count is marginally above current acceptable levels. So the doc wants me on a statin to bring it down. Acceptable levels have dropped from 240 to 200 in recent years. Dare I suggest what great news that must have been to Big Pharma. Dare I suggest they were involved in the studies that recommended the change.
With the exception of sleeping tabs I’ve never been a pill popper. So the prospect of long-term meds concerns me. Also, my drug coverage stinks: I’ve paid an out-of-pocket average of $60 for each of the last four prescriptions I’ve taken to Rite-Aid. My insurer only covers ”generics” but the detailers do their darndest convincing docs to prescribe proprietary treatments.
I told this to my doc, and because she’s reasonable she agreed to start me with a generic. But when we discussed renewing my sleeping med, she suggested I try instead an herbal supplement chased by an antidepressant. ”But I’m not depressed,” I said. ”I just can’t sleep.” ”That’s not the point,” she replied. Sleeping pills are ”controlled substances Antidepressants are not.
Nor are they generic. I can get 30 old line sleeping tabs for under 10 bucks. Since I split each in quarters, that’s $30 bucks annually and not a lot of dope ingested. Antidepresssants are hardly as divisible or economical.
But docs continue recommending them, maybe cause detailers keep dropping off samples; about 140 millions scrips were written last year. Are there that many ”depressed” Americans?
Maybe, I think, they’re prescribed prophylactically: When I checked out, one of the pastel-jacketed women handed me a bill for $185 dollars. Though I’m personally responsible for only $20, my mood fell and blood pressure karoomed.
So what comes first? Meds to cure ailments or ailments created by the cost and inconvenience of our health care industry?
I am not, of course, the first patient to seethe about long waits and outrageous health care costs. Docs are angry at the system, too. They hate the head-counts required by insurers and the lack of flexibility in treating patients (though, financially, they still make nice incomes off it).
Here’s my solution: cut the insurance guys out of the equation. Get the detailers out of the office. Make medicine one-on-one between doctors and patients. We dismiss socialized medicine as Old European, but in my experience both docs and patients are happier with their relationships.
Being reasonable myself, I told my doc I’d give her suggestions a try. But the plan may be backfiring: The crankiness of this column is probably the result of too many sleepless nights. As with all meds or lack of them, be aware of adverse reactions.