[Justputt]

Doctors are not pharmacists. While they are usually aware in a general sense of drug interactions and side effects for many meds, there are a continuing stream of new meds on the market and doctors are busy enough keeping up with changes in medicine, standards of care, techniques, etc. The pharmacist is REQUIRED to offer information, especially when you receive a new prescription unless you decline it. Behind the scenes your pharmacist is looking at EVERY prescription to determine if it is correct for your medical condition, conflicts with other meds you take, etc. Over the years, our PharmD daughter had caught many errors from providers that selected the wrong med, didn't know about contraindications, etc. When a pharmacist or pharmacy tech asks if you have any questions, that's more than just a superficial question. Our daughter has gone through our meds and told us things like "don't take these at the same time, do one morning and one afternoon/evening", "don't take this with grapefruit juice, use water", etc. So, in short, ask questions about when to take, take with what or what to avoid, some meds make you more sensitive to sun exposure, etc. Ask questions!

I recently found using the AI in one of my health Apps that I should NOT have been taking certain vitamins/supplements at all with my meds. So, when the doctors ask you what you are taking, that includes vitamins. In my case, the B-Complex was a no-no.

[PLedoux]

Personally, I don’t expect my doctor to tell me what a drug costs. There are too many variables to that answer and I don’t want him spending time on that. I appreciate it if he says something like, this might be expensive and we can discuss other alternatives if necessary. But cost research is on me. What is expensive to me might not be to others and whether I am willing to sacrifice other things for my health is my decision.
I DO expect him/her to discuss side effects, especially if it involves interactions with other drugs I am taking. I believe that is in the scope of his job. And I have never had an experience when that was not discussed.

[SHIBUMI]

Great to hear from personal experience...

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kindle is the cheapest way to go, otherwise get the full edition paperback.

Hey, I mentioned price, lol, enjoy the read...........

Originally Posted by golfing eagles

Sometimes. For example, generics tend to be cheap. I knew some drugs that would tend to be expensive, but no idea to what extent insurance would cover the cost. My job was to choose the best possible treatment for the patient to lead to the best possible outcome. I did not sell drugs, I was not an insurer, nor was I an accountant. If a patient came back and stated they could not afford a drug, we would work to find the next best alternative. But to know the bottom-line cost for all patients, all drugs, and all insurers would not be possible

[Justputt]

Originally Posted by SHIBUMI

the 1,000$ an hour, 250 for 15 minutes Doctor has not enough time to investigate the drug he is giving you?

He just picks one out of a hat.......and lets the 20$ an hour pharmacy attendee explain it to you. Something wrong with that picture.

LOL, $1000/hr? What's billed and what's collected is FAR from the same! When it comes to time, between peer-to-peer calls with insurance companies that don't want to pay for anything more than the basic, dictating patient notes for new patient visits, follow-ups, patients on-treatment, patient treatments, billing, consulting with referring physicians, required staff meetings, tumor board, etc. most physicians I know were there before anyone else and worked when others were leaving for the day on most days. Then there's the continuing education for MOC, keeping up with current journal publications for treatments, etc. I only worked in radiation oncology and radiology as the chief medical physicist, but I can tell you I wouldn't want their jobs even if they made twice what I did!!

"...20$ an hour pharmacy attendee explain it to you..." That's not how it works. If you have questions, the pharmacy tech gets the board-certified Pharmacist to answer the questions! Pharmacy techs don't have the knowledge base to answer questions.

[DAVES]

Originally Posted by SHIBUMI

When a doctor prescribes a medication, how come they are not required to tell you what it costs and what the side effects are?

This seems to me to be the ethical thing to do. The patient should not have to ask for this info, many just accept it.

I'm not a doctor. Imagine what medical care has become. Most is paid for by the government or insurance, and they figure four patients an hour-15 minutes each. A check up or a new issue. Prescribing a new drug? If not mentioned ask cost and side effects. All drugs have side effects.

Business. Imagine a business where the government or insurance tells you what you can charge? Oh and attorneys drooling screaming call Shyster, Shyster and Shyster

We seek PERFECT. PERFECT does not exist.

[Driller703]

Originally Posted by OrangeBlossomBaby

Here's the PDR listing of side effects for one of them meds I take.

Severe

heart failure / Delayed / Incidence not known
cardiac arrest / Early / Incidence not known
arrhythmia exacerbation / Early / Incidence not known
atrial fibrillation / Early / Incidence not known
epiphyseal closure / Delayed / Incidence not known
craniosynostosis / Delayed / Incidence not known
increased intracranial pressure / Early / Incidence not known
seizures / Delayed / Incidence not known
angioedema / Rapid / Incidence not known
serum sickness / Delayed / Incidence not known
Moderate

infertility / Delayed / Incidence not known
thyrotoxicosis / Delayed / Incidence not known
hyperthyroidism / Delayed / Incidence not known
elevated hepatic enzymes / Delayed / Incidence not known
heat intolerance / Early / Incidence not known
dyspnea / Early / Incidence not known
peripheral edema / Delayed / Incidence not known
angina / Early / Incidence not known
palpitations / Early / Incidence not known
hypertension / Early / Incidence not known
sinus tachycardia / Rapid / Incidence not known
growth inhibition / Delayed / Incidence not known
pseudotumor cerebri / Delayed / Incidence not known
osteopenia / Delayed / Incidence not known
osteoporosis / Delayed / Incidence not known
wheezing / Rapid / Incidence not known
Mild

alopecia / Delayed / Incidence not known
flushing / Rapid / Incidence not known
hyperactivity / Early / Incidence not known
irritability / Delayed / Incidence not known
diarrhea / Early / Incidence not known
anxiety / Delayed / Incidence not known
appetite stimulation / Delayed / Incidence not known
weakness / Early / Incidence not known
headache / Early / Incidence not known
nausea / Early / Incidence not known
vomiting / Early / Incidence not known
fatigue / Early / Incidence not known
anorexia / Delayed / Incidence not known
menstrual irregularity / Delayed / Incidence not known
weight loss / Delayed / Incidence not known
emotional lability / Early / Incidence not known
abdominal pain / Early / Incidence not known
amenorrhea / Delayed / Incidence not known
fever / Early / Incidence not known
tremor / Early / Incidence not known
muscle cramps / Delayed / Incidence not known
insomnia / Early / Incidence not known
hyperhidrosis / Delayed / Incidence not known
pruritus / Rapid / Incidence not known
rash / Early / Incidence not known
urticaria / Rapid / Incidence not known
arthralgia / Delayed / Incidence not known

If my doctor tried to TELL me all of this, it'd freak me out. If he printed it out and gave it to me, I'd read the top 5 results and freak out.

Good thing he simply told me that the med is just synthetic thyroid to replace the hormone that no longer gets produced, since I had a thyroidectomy in 1990.

That's JUST the list of potential side effects, of a prescription product that's just a synthetic version of a hormone a healthy body produces naturally. I didn't even look at the contraindication (drug-drug) risks.

The drug interactions category for levothyroxine is insane. If it was printed out, it'd be around 8-10 pages long, starting with alendronate and ending with warfarin.

Everyone has access to the PDR. You have access to it too. In fact, if you were AT the Doctor's office, and he recommended a prescription, and you had to just wait to confirm that the prescription was sent to your pharmacy so you could pick it up - you could look up the drug on the PDR while you're still in the doctor's office and read the whole thing all by yourself.

However, the PDR doesn't list prices. Know why? Here's why: Because THE DOCTOR DOESN'T SELL PRESCRIPTION DRUGS. That is not his job. If you want the prices, you can run an online search. You can check with your health insurance. You can check with GoodRx or Optum or whatever other med discount programs are available. You can check your preferred pharmacy. Those are the places to find prices on prescription meds.

Sadly, this litigious society in which we live requires the drug company to list any possible side effect that has been encountered by anyone of whom they have been made aware, up to and including death! If the warnings did not mention tooth abscess for example, and someone developed a tooth abscess, that’s a law suit that will be settled out of court, just to make it go away.
That’s just the way it is, even though the benefits more often than not, far outweigh the potential risks.

[Dlpdo]

Originally Posted by SHIBUMI

Doctors should know how much your medications cost!....... they prescribe enough of them!
There is a general price for a drug, forget the pharmacy, won't change that much.

They dont talk about costs so they can over bill medicaid. No where do they list their fees!
And they do that so they can over bill medicaid as well.

Smarten up. This is not ethical behavior.

More importantly as mentioned, side effects. You're telling me a doctor does not know the side effects of a drug they have prescribed. dah! Yea, let's just blame the pharmacies. If you knew the side effects you may have refused the drug. '
Naivete'.

You are correct that doctors should be explaining side effects of the drugs that they prescribe.
You are wrong in that they should give you the price of the drugs. They might have a general idea but that could be off by tens if not hundreds of dollars depending on your pharmacy and insurance provider. Just because they prescribe a drug doesn't mean they know the cost of thousands of different drugs. That is the patients responsibility to get that info.
You are also wrong about their own costs. if they work for a hospital system or corporation they may have no idea what an office visit cost as they are not in control and probably have never seen a pricing sheet. BUT someone in the office should have that information to give to you. You have a legal right to that information. Same for hospital cost. All hospitals are legally suppose the have pricing info online.
As far as the overbilling. Medicare/mMedicaid pay a fixed amount for things such as office visits. Doesn't matter if doc bills medicare $1000 for visit they will only pay whatever they their coding says they pay.

[blueash]

No the doctor does not pull a drug out of a hat. But the doctor absolutely should advise about any common and serious side effects, meaning both are present. But no doctor is going to tell you every side effect or every rare side effect. If I give you augmentin I will mention diarrhea, common and can be substantial. It also saves me a phone call later about diarrhea or a claim of a drug allergy because of diarrhea.

But I don't know exactly when a drug goes generic nor how much if any it saves the patient. Example... Doxycyline been around for decades. Generic for decades. In the 80s and 90s it was so cheap it was on the free list of my local grocery store pharmacy. In the 2011 - 2014 time range its cost went up 8000 percent. Since then it has come down in cost.

I only have a very general idea of cheap vs expensive based partly on patient feedback, and partly on what drug ads I am seeing (more expensive). But now that almost everyone with insurance has a drug plan that is all out the window. With some policies a generic can cost more than a preferred brand name.

How much of my allotted 15 minutes per visit including charting time do you really want me to spend listing every side effect and speculating on cost when I don't know the cost. How far behind schedule do you want me to be because the patient before you insisted I talk about ALL the side effects and I look up the cost for that patient before he'd accept the script?

[DAVES]

Originally Posted by Johnsocat

Im sorry, but I disagree. Drs.
Have access to ypu records and every one of them requires you list your current meds and allergies on your intake form, so they can be aware of any contraindications on any drug they prescribe. There is also a desk reference made for doctors called the "Physician's Desk Reference " (PDR) that is published so they can look up any drug, it's generic name as well and who makes it. Also listed are side effects.
Any good doctor will tell the patient what common side effects to look out for when they prescribe. And they will check to ensure it does not interfere with their current meds before they do so.

Should be vs REALITY. Not here and a long time ago. I picked up a regular prescription. It didn't look right. It was actually 100x stronger. Took it back to the pharmacy and pharmacist said he didn't even know it was made that strong. Spooky it went through ALL the people supposed to check from receiving on.

[retiredguy123]

As I understand it, the ACA law was supposed to create a universal electronic medicel record system that any doctor could access that would contain all pertinent medical information about the patient. Can someone comment about whether this is true and why it never happened?

[Rwirish]

The doctors office is not a pharmacy. Why would the doctor know the cost of the drug and the specifics of your medical plan?

The patent needs to do his/her homework.

[Justputt]

Originally Posted by retiredguy123

As I understand it, the ACA law was supposed to create a universal electronic medicel record system that any doctor could access that would contain all pertinent medical information about the patient. Can someone comment about whether this is true and why it never happened?

There's a push for all to have an EMR, but there are/were exceptions for remote and small practices. The EMRs are not all connected. The EMRs like Epic, Meditech, Cerner, athenahealth, etc. are not nearly similar enough to share data. The data structures, types of discrete data, etc. are very different and some systems like Meditech are pretty closed systems that don't interface to much of anything. When I was in NY, I think we (as patients) were offered the opportunity to share selected data through a common system that I think was the State's.

The short answer is unless there are interoperability networks, etc. between hospitals, the information is not automatically available across hospital/clinic/doctor offices.

[SHIBUMI]

If the doctor is administering the shot with the medicine in it, there is no pharmacy.
And there in lies the cost knowledge and side effects knowledge responsibility.

And that is the thrust of this whole conversation............

Originally Posted by Rwirish

The doctors office is not a pharmacy. Why would the doctor know the cost of the drug and the specifics of your medical plan?

The patent needs to do his/her homework.