Comments on: You Want to Know Why Medical Care Is So Expensive?

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By: marvel

marvel — Fri, 18 Sep 2009 17:19:08 +0000

Dr. T: I, too, would prefer far fewer restrictions and mandates. Don’t get me started on what we were required to do for well child-care checks to get reimbursed for Medicaid patients. (The patient has poorly controlled asthma, allergies, is prediabetic and failing the 4th grade for the second time and I can’t get paid for this visit unless I do an (unnecessary) hearing exam? Please, can I spend time on what the patient needs? Pretty please?)

What do you mean with the advent of ObamaCare we’ll be lucky to avoid government servitude? I don’t think there’s anyway to avoid government servitude with ObamaCare–government servitude of both patients and doctors is the point of the whole enterprise.

By: Dr. T

Dr. T — Fri, 18 Sep 2009 00:16:36 +0000

Give me a break. Optometrists are not part of the medical profession. They’re just technicians trained to measure vision defects. Ophthalmologists are eye doctors. They diagnose and treat eye diseases such as retinal detachment and glaucoma. They aren’t responsible for the idiotic state law that makes you get your eye prescriptions confirmed annually.

Some of us in the medical profession prefer fewer restrictions: many prescription drugs should be converted to over-the-counter drugs, physician assistants and nurse practitioners should be allowed to practice independently, patients should be able to request lab tests, etc. Of course, with the advent of ObamaCare, we’ll be lucky to avoid government servitude.

By: marvel

marvel — Thu, 17 Sep 2009 22:56:02 +0000

I agree with Dan Smith re physicians keeping patients on short leases b/c potential liability issues. As a patient, I hate it. As a doctor, I do it all the time.

By: Bob Smith

Bob Smith — Wed, 16 Sep 2009 22:22:38 +0000

I can now buy some types of insulin over the counter without a prescription along with the syringes

Oddly, you can’t buy metering strips without a prescription, at least around here. I’m not saying you should need a prescription for insulin, but if you’re going to control distribution of anything, why require a prescription for harmless paper strips yet allow the far more dangerous insulin to be purchased OTC?

By: Jerry

Jerry — Wed, 16 Sep 2009 12:53:42 +0000

I too can’t stand the contacts thing, I have worn contacts since 1991 and have recently moved (stocked up on contacts but now running out) and going to the eye doctor, they don’t want to give me my prescription until I try out a pair of contacts and see if I like them. If I don’t I’ll buy a different kind to try. What a pain in the ass.

By: Dan Smith

Dan Smith — Wed, 16 Sep 2009 11:52:28 +0000

I can’t speak for ophthamologists, because I am in Famil Practice, one one big reason doctors are being so hard nosed about requiring visits for things like medication refills is the decline in payments from third party payers and the simultaneous insistence on meeting “quality guidelines” issued by the same group. The guidelines generally mandate that doctors and patients go one on one to discuss chronic diseases. Here is an anectdote from my practice: we hired a nurse and trained her in how to advise diabetic patients about managing their blood sugars, diet, foot checks, etc. She made frequent phone calls to the patients and they loved her. Unfortunately, Medicare did not accept any billings that she submitted. We lost money every time we had her see a patient. So we had to let her go, much to the dismay of her patients.
The other major factor in forcing reluctant patients to come in is so that we are not in court one day listening to a plaintiff attorney tell the jury: “Can you believe that this arrogant physician prescribed “X” drug without seeing my poor disabled client and monitoring him/her for side effects. Please award him/her one million dollars.

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