[golfing eagles]

Originally Posted by kendi

I don’t need hands on examining for my doctor to discuss and show me the results of my MRI.

But you may need him to do EXACTLY that to determine if you actually need an MRI.

[RoboVil]

Originally Posted by golfing eagles

Yes, which is why I know that post is, well to put it politely, untrue.

Love to hear an example where a physician puts a patient on "unnecessary" medication.

I addressed testing in a previous post, as well as the obvious solution (other than kill all the lawyers)

Docs are not the problem. The insurance companies are the problem, not just the prior approval scam, but also in their denial of payment to healthcare providers.

By the way, anyone wondering about their treatment for their diagnosis - plenty of clinical guidelines out there for you to read. The American Diabetes Association for example publishes yearly updates, and free to anyone who wants to read them.

[golfing eagles]

Originally Posted by RoboVil

Docs are not the problem. The insurance companies are the problem, not just the prior approval scam, but also in their denial of payment to healthcare providers.

By the way, anyone wondering about their treatment for their diagnosis - plenty of clinical guidelines out there for you to read. The American Diabetes Association for example publishes yearly updates, and free to anyone who wants to read them.

Unfortunately, there are way more than "plenty" of medical references out there, but unfortunately, I would say the majority are either wrong, half-truths, pushing an agenda or a product, or beyond the understanding of the non-professional. The problem is the internet information leads to the attitude of "I'm in charge", or "I can debate this with the doctor". WRONG!!! You can choose among reasonable options offered by a professional as well as his opinion as to which is best. But don't ever delude yourself into thinking you're on some kind of knowledge and experience parity with the physician. I wish I had a dollar for every time a patient brought in some nonsensical printout from the internet and handed it to me---those went straight in the garbage. (The printout, not the patient)

[JRcorvette]

On my last Medicare summary there was a $6000 bill from a Village doctor that I have never seen. It was for medical equipment out to NC of all places. I contacted Medicare right away to report it. Apparently the doctor in the Villages had all my information. Medicare had prior complaints about this guy. I read on Nextdoor or here that recently people showed up at his office and it was locked and he was gone without notifying any patients. There is a lot of Fraud in Medicare… go get them DOGE.

[blueash]

Originally Posted by golfing eagles

Love to hear an example where a physician puts a patient on "unnecessary" medication.

As much as half of the Rx's for antibiotics are unnecessary. So often I have been told by neighbors that they are on a "strong" antibiotic because they have a "bad" virus.

ADD/ADHD medications to not just help kids who actually have those disorders. Adderall helps anyone concentrate a bit better. I am very aware of a high performing school in my home town where the expression was "There are two kinds of students, those who get straight A's and those who get medication" And yes, parents from that school would request drugs to help their kid's GPA even if they were simply B students if the meds might make them A students.

Do you want more examples? How about all those Vit B shots to those who do not have pernicious anemia. How about PPIs for everyone with any GI symptoms and SSRIs for anyone with the sadness or Thyroxine for subclinical hypothyroidism. Or while we are on unnecessary... bioidentical hormones, chelation products etc.

So sadly, the medical profession has a lot to answer for reaching for a prescription pad, ok now a keyboard. And I hadn't mentioned opioids which are both over and under used.

[golfing eagles]

Originally Posted by blueash

As much as half of the Rx's for antibiotics are unnecessary. So often I have been told by neighbors that they are on a "strong" antibiotic because they have a "bad" virus.

ADD/ADHD medications to not just help kids who actually have those disorders. Adderall helps anyone concentrate a bit better. I am very aware of a high performing school in my home town where the expression was "There are two kinds of students, those who get straight A's and those who get medication" And yes, parents from that school would request drugs to help their kid's GPA even if they were simply B students if the meds might make them A students.

Do you want more examples? How about all those Vit B shots to those who do not have pernicious anemia. How about PPIs for everyone with any GI symptoms and SSRIs for anyone with the sadness or Thyroxine for subclinical hypothyroidism. Or while we are on unnecessary... bioidentical hormones, chelation products etc.

So sadly, the medical profession has a lot to answer for reaching for a prescription pad, ok now a keyboard. And I hadn't mentioned opioids which are both over and under used.

Perhaps I wasn't clear. My intention was to call out an example of a physician prescribing an "unnecessary" medication for the purpose of making a profit for himself or a pharmaceutical company, which seemed to be what the post I was responding to implied. Of course there are weak physicians who prescribe antibiotics for viruses and long term PPIs for a little indigestion. They are usually DO's with a 2 year "family practice" residency at a DO hospital. Thyroxine is a little more gray zone. And those chelation products are usually prescribed by those "holistic" and "alternative medicine" quacks.

[blueash]

Originally Posted by JRcorvette

There is a lot of Fraud in Medicare… go get them DOGE.

Who do you think is going to find this fraud? It is the inspectors. It is the guys and gals who sit in front of a computer and look for patterns of suspicious claims. It is the person who was at the other end of your complaint who entered it into the system. If you called in your complaint it was a human who answered, and is on the chopping block now. It is what you would call the bureaucrats. And guess who is getting fired? Yes you might hear there is less fraud next year, because nobody is looking anymore. Kind of like firing all the cops and the crime arrest rate drops.

The answer to Medicare/Medicaid fraud is more people not fewer. Spending billions to upgrade computer systems will save 100's of billions.

[ithos]

My biggest issue with our healthcare system is that it does not inform patients that most diseases and ailments are caused by or excaberated by poor diets and lack of exercise. Even most genetic predispositions can be overcomed. "Genes are not your destiny"
https://www.youtube.com/watch?v=qvGOXCiTPKc&t=110s
There are populations today and in history that have far lower incidences of cancer, diabetes, automimmune diseases , etc because diet and lifestyle are the biggest factors for health.
https://www.bluezones.com/
True North Center takes in patients that conventional medical care has failed.
https://www.youtube.com/watch?v=qrFbGyQG070 (28:14)
Most challenging patient. https://www.youtube.com/watch?v=qrFbGyQG070 (22:40)

[PugMom]

Originally Posted by golfing eagles

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

Bingo! someone finally said it

[blueash]

Originally Posted by golfing eagles

Perhaps I wasn't clear. My intention was to call out an example of a physician prescribing an "unnecessary" medication for the purpose of making a profit for himself or a pharmaceutical company, which seemed to be what the post I was responding to implied.

I agree that prescribing to benefit a pharmaceutical company must be exceedingly rare. Writing a script to benefit Lilly makes no sense. I suppose there might occasionally be some tendency to choose a med from the company that has a nice rep or fed your employees when the med is one a several equal options.

But, when you give that worthless B12 shot and the patient has to come back every few weeks for another one you are increasing your profit. When you give the patient an antibiotic shot in the office for his viral sore throat or even documented strep, you are increasing your own profit. And yes I understand there are rare situations where strep might be treated with a shot... patient vomiting, history of not taking meds etc.

Friend went to an urgent care/freestanding ER here and diagnosed with a UTI. No vomiting, not dehydrated, not unable to take oral meds, not when pharmacies were closed. But in addition to the Rx for an appropriate oral antibiotic he was given a very expensive IM antibiotic to "get him started" Patient thought it was great that they did the shot, I think it was for profit.

By the way, my experience with DOs is that they are just as well, or poorly, trained as MDs.

[blueash]

Originally Posted by PugMom

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

Bingo! someone finally said it

So all the times I was awakened by a phone call from a parent to help with a sick child at 2 AM I was NOT practicing medicine. PERIOD. All those calls from hospital floors reporting on the lab results or updating me, I was not practicing medicine PERIOD. The over 100 calls on a weekend during flu season to evaluate and advise was a waste of my time and useless or even dangerous as I wasn't hands on. Good to know. Wish I had just not answered my pager as there was nothing useful I could provide. PERIOD.

[62SkiDoo]

Originally Posted by PugMom

Bingo! someone finally said it

Yep

Telehealth has already been fingered for leaking personal health information to 3rd parties.

The whole premise is absurd in any case. No competent physician could ever reliably diagnose a patient through a remote app. (Any medical doctors here should chime in.)

It's another example of "technology" out of control, technology that continues to depersonalize us and remove us from any common sense or reason. And you can bet that the driving motivation is cheaper cost for providers while at the same time never translating into anything but higher costs for patients.

I was recently offered a Telehealth physical therapy evaluation for an injury I suffered doing yard work. I said, "no, no, no, I don't Telehealth any more." And so I did my evaluation at the facility instead.

Good grief! Anyway, that's my Saturday soapbox.

[Dexterconfetti]

Look it up!

[kkingston57]

Originally Posted by gatorbill1

United healthcare has been excellent for me

That is how they get away with it.

[RoboVil]

Originally Posted by golfing eagles

Unfortunately, there are way more than "plenty" of medical references out there, but unfortunately, I would say the majority are either wrong, half-truths, pushing an agenda or a product, or beyond the understanding of the non-professional. The problem is the internet information leads to the attitude of "I'm in charge", or "I can debate this with the doctor". WRONG!!! You can choose among reasonable options offered by a professional as well as his opinion as to which is best. But don't ever delude yourself into thinking you're on some kind of knowledge and experience parity with the physician. I wish I had a dollar for every time a patient brought in some nonsensical printout from the internet and handed it to me---those went straight in the garbage. (The printout, not the patient)

The clinical guidelines are the clinical guidelines. If you are practicing outside the clinical guidelines then you better document your reasoning. Don't try to say the clinical guidelines are "nonsensical" internet garbage. Scary you would try to discourage patients from looking at the clinical guidelines from the medical associations.