[queasy27]

Originally Posted by JoMar

My view is that you have the right to fire the doctor if you don't feel he is doing what is in your personal view, what's best for you. He also has the right to fire you if he doesn't feel you are doing what is in his personal view, what's best for you.

I truly do sympathize with the doctor's side of things, but I'd also expect a bit of forebearance on their part.

The difficulty is that "not forcing me to take medication" isn't a good way to find doctors. This is my 5th internist in 9 years -- three of them left TV and one I left because of excessive wait times and error-prone office staff. I'd hope to find something who's willing to work with me as I try to take back some control over my health care after a couple of stressful years on the medical merry go round. I'm tired of the paperwork and repeat testing and having to start over and explain everything again with someone new.

I absolutely dread going to the doctor these days and get quite anxious (blood pressure up!).

United Healthcare even contacted my danged pharmacy and had them call me to say I needed to take statins. Like, really?

[queasy27]

Originally Posted by mills3186

At the HMO I worked at, we were given benchmarks to meet and part of our pay was docked if not. So was it my fault my patients chose to continue to be morbidly obese?

That's horrible!! I swear.

I appreciate the insight.

What's kind of ironic is that a couple of friends referred me to this doctor because they said this person doesn't nag. I didn't think it through, but the reason they don't get any pushback is because they're both fairly healthy and do what they're told. D'oh!

[graciegirl]

I believe that Statins are the number one reason we have had a huge drop in death from cardiovascular disease in the last thirty years. An ounce of prevention is worth a pound of cure. I have heard others say that statins caused pain in their arms and legs. I wonder what your side effects are? Sometimes the benefit outweighs the side effects, but that is for each to choose.

[thetruth]

Originally Posted by retiredguy123

Huh??? This make no sense to me. If the doctor prescribes a drug and the patient doesn't take it, it is not the doctor's fault. Are you saying that someone who is 100 pounds overweight should not get medical treatment because they just eat too much? Is that the doctor's fault?

You choose a doctor because you believe they are qualified but perhaps more because you approve of their personality-bedside manner. Obviously, it is a two way street.

You mention 100 lbs overweight. If, that is your issue. If, it is getting worse. It is fairly easy to take weight off. The hard part, where most people fail is keeping it off. In any case, as frustrating as it is. it is also frustrating for a doctor. If, it is bad enough the doctor might well prefer you left.

Where we used to live-pre Villages. I, my sister and my niece all used the same doctor. I had used him for many years. He was sort of a friend and a bit of a gossip. I had serious issues with my sister due to my niece. The doctor knew as we would discuss it. Perhaps, inappropriately he once told me that my sister and my niece were his patients and that they had left.
His comment was he is glad they both left. My sister-I do not regularly talk to her. As a patient, as a human being, she is the type that refuses to listen to a different opinion than her own.
She is, or was several hundred pounds overweight. Her extra weight kept her from exercise so of course it got worse.

She has been going through chemo. I don't think her weight caused her cancer but I do know her weight makes her care, her options etc more difficult.

[Brandigirl]

Mills3186, great insight into how you actually experienced it. Doctors are under a lot of pressure to follow these guidelines. Who would want to have part of their pay taken away because they can't convince someone to follow the advice of the benchmarks and best practices! The patients should have the right to make an informed decision regarding their healthcare. The only thing the doctor should do is document the non-compliance with the " Benchmark or Best Practice" and that should be the end of it, but unfortunately it is not. To Queasy27: I know that with certain insurance companies, you are "flagged" by the insurance company by some circumstances. I am not sure what exactly sets off the flag but it could be something like multiple ER visits for high blood sugar or high blood pressure. The insurance company sees these claims when submitted and they feel you, for some reason, cannot keep your blood sugar or blood pressure under control. They will send you a letter stating that they recommend you start a medication or have a "Nurse Navigator" help you manage your health care. They work with you over the phone to try and prevent you from continually going to the ER. So when a medical practice sees that you have gone to the ER, they want you to come back for a follow up appt to try and educate you, review your medications and try and prevent it from happening again. ER visits are very expensive and some insurance companies give a medical practice a certain amount of money to manage a certain number of patients. So if the medical practice goes over that amount, it comes out of their pocket. That is where the "Best Practices" come into play.

[trichard]

You can always refuse treatment, but the physician does not need to retain you as his or her patient. It’s their prerogative. Nothing wrong with that.

[John_W]

...

[John_W]

PS - if you're with Villages Health, ask for Dr. Raquet at Brownwood. He's my doctor and he definitely knows what an allergy to cholesterol drugs is all about after I taught him.

Originally Posted by Brandigirl

Mills3186, great insight into how you actually experienced it. Doctors are under a lot of pressure to follow these guidelines. Who would want to have part of their pay taken away because they can't convince someone to follow the advice of the benchmarks and best practices! The patients should have the right to make an informed decision regarding their healthcare. The only thing the doctor should do is document the non-compliance with the " Benchmark or Best Practice" and that should be the end of it, but unfortunately it is not. To Queasy27: I know that with certain insurance companies, you are "flagged" by the insurance company by some circumstances. I am not sure what exactly sets off the flag but it could be something like multiple ER visits for high blood sugar or high blood pressure. The insurance company sees these claims when submitted and they feel you, for some reason, cannot keep your blood sugar or blood pressure under control. They will send you a letter stating that they recommend you start a medication or have a "Nurse Navigator" help you manage your health care. They work with you over the phone to try and prevent you from continually going to the ER. So when a medical practice sees that you have gone to the ER, they want you to come back for a follow up appt to try and educate you, review your medications and try and prevent it from happening again. ER visits are very expensive and some insurance companies give a medical practice a certain amount of money to manage a certain number of patients. So if the medical practice goes over that amount, it comes out of their pocket. That is where the "Best Practices" come into play.

Thanks to you and Mills3186 for some very interesting information.

[Brawnwy123]

Originally Posted by queasy27

Without getting too specific, one of my doctors said they would have to discharge me as a patient if I wasn't wiling to take a cholesterol medication. My objection was that I had taken them for 15+ years but had developed side effects that I am no long willing to tolerate. During that time, my cholesterol was never reduced to recommended levels, anyway.

I confess I don't really understand the doctor's position. Am I not allowed as a patient to refuse treatment? Should doctors have the right to only treat obedient patients who do everything they say?

I don't know the answers. I'm not trying to be stubborn or willfully noncompliant but do feel strongly about this particular issue. I'm curious to hear other opinions from both sides.

RESPONSE: We have found the doctors here are a long way from the quality we found in other states. Yep, some real surprises here, but then I cannot tell it all here. So, our opinion is CHANGE DOCTORS NOW. THAT MAY WORK?? We have two neighbors who go for their medical in the state they moved from, a long way, but it is understandable. They have an unending line of folks here to bring in the money so it seems ($$$$) GOOD LUCK.

[queasy27]

The doctor who discharged me for refusing statins did so based on the labs below. They don't meet the recommended standards but they're not horrible. She would not budge. But it was only my second visit with her so it's not like she and I had any history.

Total: 212
LDL: 126
HDL: 59


If physicians can be penalized when their patients don't meet certain guidelines for best practices, do they also get bonuses when they prescribe certain meds?

[maggie1]

Originally Posted by graciegirl

I believe that Statins are the number one reason we have had a huge drop in death from cardiovascular disease in the last thirty years. An ounce of prevention is worth a pound of cure. I have heard others say that statins caused pain in their arms and legs. I wonder what your side effects are? Sometimes the benefit outweighs the side effects, but that is for each to choose.

I have RLS (restless leg syndrome), and the statins I've been prescribed aggravate the condition. I currently take Ropinirole, which seems to keep my RLS in check, but if I take a statin too, the effects of the Ropinirole is greatly reduced, and I end up getting no sleep. I wouldn't wish this condition on anyone!

[J1ceasar]

Originally Posted by queasy27

Without getting too specific, one of my doctors said they would have to discharge me as a patient if I wasn't wiling to take a cholesterol medication. My objection was that I had taken them for 15+ years but had developed side effects that I am no long willing to tolerate. During that time, my cholesterol was never reduced to recommended levels, anyway.

I confess I don't really understand the doctor's position. Am I not allowed as a patient to refuse treatment? Should doctors have the right to only treat obedient patients who do everything they say?

I don't know the answers. I'm not trying to be stubborn or willfully noncompliant but do feel strongly about this particular issue. I'm curious to hear other opinions from both sides.

Find another doctor, there are plenty of other pills you can try, as well as diet and exercise

[ts12755]

12 years ago my Doctor told me the same thing. 6 months later they took the cholesterol medicine he prescribed off the market because it caused heart problems. I'm still not on any cholesterol meds and my reading is what its been for 35 years, 220. Find a better doc, he probably owns stock in the pharmaceutical company or the Rep has him eating out of her hand.

[maggie1]

[QUOTE=John_W;1623780]I just posted this on another thread, so I'll repost here since I'm allergic to statins and I had to find out the hard way.

In 2012 I had an attack of psoriatic arthritis and my legs swelled so much, I couldn't tell where my knees were, I gained 15 pounds overnight. I went to the VA ER at Gainesville and they gave me an IV of prednisone and then 144 prednisone pills to take over the next 30 days. I recovered in two weeks but when the pills ran out, my condition returned, but in a different way. I had psoriasis so bad I looked like a snowman flaking all over the place. I went back to the ER and they admitted to the hospital for 3 days and gave me a lot of predisone again. As it turned out, the VA never found what caused my reaction, I discovered it on my own while experimenting with my prescription drugs. I was allergic to statins, because I took avorstatin for cholesterol.

I have both a VA doctor and a Villages doctor with medicare. Jump ahead a year and my Villages doctor retired and I'm given a new doctor. He prescribed a drug and I made a big mistake, I trusted him and didn't read what it was, it was Crestor. I got red blotches all over, I called him and he said, it's just a small 5 mg dose, I said, I'm allergic to statins. He apparently had never encountered that before.

Anyway, I've been without taking statins now for a couple of years and my HDL is right about 210, which worries him. Six months ago he told me he has patients that are dropping 40 points using this natural drug, Cholestoff Plus. I started taking two a day about five months ago and I'll have a blood test in March and I'll find out if it's working.

It's $15 for 105 pills at Walmart and $30 at Walgreens. The way it's suppose to work is it stops the body from making cholesterol. My VA doctor once had told me to try the nutrient Red Yeast Rice, and when I did I broke out in blotches. After I researched it, I found that Red Yeast Rice is is a blend of 5 statins, so don't take that either.

If this reduces cholesterol without the side effects of statins, then I'm headed to WalMart as we speak. Thank you for the "heads up".