Opioid Crisis in OK; Who’s to Blame?

[Tanis143]

Please share more about the perks and kickbacks the doctors are getting. Really - specific examples would be helpful. I'm curious, because I am unaware of a single perk or kickback ANY physician receives for the prescribing of ANY particular drug. So, since you have definite and specific knowledge of these things (having made these claims multiple times), I would like to know more about it. I think the public deserves to know, don't you?

Thanks.

How about looking up doctors in your area to see how much they have been paid by pharmaceutical companies?

https://openpaymentsdata.cms.gov/

Doctors have been paid to promote (note: not prescribe) drugs for a long time. The problem is that some doctors "promote" by telling a patient that x drug will solve their problems but fail to mention that there are other, sometimes safer and sometimes cheaper, drugs that will do the same the same thing. So please tell me that's false. One of the few things I did like about the ACA is that now any and all payments from pharma companies to doctors over $10 must be reported and with the above website you can look up doctors in your area to see how much they get.

That's not to mention how many doctors have stocks in pharma companies, which is totally legal.

 

[druryj]

I looked up my Primary Care Doctor and see that he got a blazing $1,241.89. Another Physician that I know here in OK got $766. Guess I need to tell my doctor at the Pain Clinic I go to about this, it shows he didn't get anything. I also don't see any evidence that this is either illegal or unethical. It's not under the table or slipped to them for promoting a certain drug, it's right there in the open.

I'd like to see who, among doctors, hospitals, and clinics in Oklahoma is really raking in the bucks with this scheme. Just from this very cursory search, this doesn't look like it really carries much influence as far as contributing to the opioid crisis, at least not as pertains to the Doctors who write prescriptions for me.

My question in the beginning was about responsibility for the opioid crisis. I fail to see how minor amounts like this have anything to do with it, but I have an open mind.

 

[tRidiot]

How about looking up doctors in your area to see how much they have been paid by pharmaceutical companies?

https://openpaymentsdata.cms.gov/

Doctors have been paid to promote (note: not prescribe) drugs for a long time. The problem is that some doctors "promote" by telling a patient that x drug will solve their problems but fail to mention that there are other, sometimes safer and sometimes cheaper, drugs that will do the same the same thing. So please tell me that's false. One of the few things I did like about the ACA is that now any and all payments from pharma companies to doctors over $10 must be reported and with the above website you can look up doctors in your area to see how much they get.

That's not to mention how many doctors have stocks in pharma companies, which is totally legal.

Seriously? lol Ok, man. Speaking at a professional gathering on behalf of a pharmaceutical company is far far far from "receiving kickbacks under the table, as you claimed." lol

If you'd ever been to one of these speaking engagements, you'd know without a doubt how ludicrous that claim is. And I mean absolutely ludicrous. Every single one of those presentations is meticulously researched, full of legalese and warnings about side effects, interactions, etc., and every single claim or word or Powerpoint slide has to be approved before they can use it. They are forbidden from talking about any kind of ongoing research, any off-label uses, and honestly every provider there knows it's a sales pitch AND knows to take it all with a grain of salt.

They HAVE to pay specialists to give these talks, because that's the only way to get their message out directly to the clinicians. I can tell you, I have made a special effort to attend a number of these talks over the last 12 months specifically to learn about some of the new medications out there, having been in ER for 8 years previously. I didn't know much about how they worked, and while I could read all about them in the advertising literature, nothing beats speaking directly with a specialist who uses them 10x a day - like a headache specialty neurologist from Norman, or endocrinologists and cardiologists from Tulsa and Wichita - people I would never meet, never talk on the phone with and would be lucky to get a generic note describing a patient's appointment if I referred them there. You have literally no idea what a huge BONUS it is to have these very busy specialists come to my town to deliver information and experience directly to the people taking care of people like YOU and TONY and JOEL on the front lines every single day. I'm not kidding. I don't know how much money they make, but I DO know how much money they LOSE when they have to cancel their clinic for a day to go deliver such talks, and it's not minor. Do you know? Tell me, @Tanis143, what is your solution to help get these experienced specialists out to help deliver the word on these important lifesaving medications directly to primary care providers in rural areas? Seriously.... what's your solution that would be better than this? I want to hear it, I really do.

Look... most primary care providers know to take all the stuff the drug reps say with a grain of salt, and we know how to wade through a lot of the BS on the printed materials they leave with us. We give out some of the samples they leave, judiciously, mainly to people we know have private insurance and are going to possibly be able to get the medicine once the samples run out - that is, once we jump through the hoops of their insurance prior auth requests, and quantity limits, and denials and appeals due to cost - so the patients can get a very important medicine that can drastically improve their lives and survival. I'm not kidding. These are things we think about every. single. day. It's a headache. I spend 20 minutes talking to someone about a new medicine, trying to describe how it works, discuss side effects, talk to them about using insurance co-payment assistance cards, recommending techniques to get which pharmacy to actually accept the card (all information passed on by those evil drug reps), and then sometimes actually calling the reps back to get their help, doing online and fax prior auths, doing peer-to-peer phone calls to appeal a decision by the insurance company, etc.

And guess what I get out of this, @Tanis143? Seriously. Guess. What did I personally get as any kind of "reward" or "kickback under the table" from the pharmaceutical company or representative? You wanna know? Do you REALLY want to know what I got?

More samples.

Yup. More samples to give away for FREE to some more of my patients. I give away hundreds of dollars worth of insulin a week, maybe thousands. But no littel trinkets, no pens or notepads, no Caribbean vacations (ha! as I type this from my own self-paid Caribbean vacation), no rounds of golf, no massages, no nothing. I got I think one steak dinner last month from a dinner I went to. And that was to listen to a headache specialist neurologist from NORMAN who drove 3 hours to talk to us, and we could pick his brain about new headache medicines. Do you KNOW how many people I see every week who have problems with chronic migraines? Do you KNOW how frustrated they are (and I am!) at my inability to help them control their migraines? And yet... these new medicines are a GODSEND to some of these people, we just have to figure out how we can get them to people, how we can get them paid for, and which patient population is a candidate - guess who helps us make all those decisions??? That's right... that specialist who took off 2 half days of clinic so he could come up and talk to us. Should he do that for free? Wait, how about we pay him... oh, $100 pus dinner. Sound good? Sure... I'm sure that guy who spent 15 years training in his field and how has a backlog in his clinic for several months trying to get new patients in for management is going to drive halfway across Oklahoma to talk to us for that. Wouldn't you??? Not to mention losing 20 patient visits in his clinic? Although remember... even if he isn't there generating income, his staff still is, the lights are still on, the computers and phones are still running and using electricity, he's still paying rent and insurance. But he's not producing revenue to keep those lights on, that staff paid and that staff's insurance and benefits.

It's not so simple, man. Yes, some people who are experts in the use of these medicines and techniques get paid to come deliver these talks. How much does Obama or Clinton charge these days for a 20 minute speech? And how much expertise are they delivering for that fee that is changing the lives of the people around them for the better?

Just stop and think about it for a minute.

Oh, and get back to me about those "kickbacks under the table". I'm still waiting for those to kick in, I've been waiting for 20+ years now.

 

[stick4]

I looked up an urologist I used to go to who collected upwards of $60K over 2 years. Pretty sure the payments were related to some kind of drug study he was conducting.

 

[DavidMcmillan]

The pharmacutical industry is not an organized crime entity. Billions of dollars are spent every year, developing, testing, meeting government requirements, etc. Yes, revenues are large, compared to my income, but profits on that revenue are a small percentage. It takes years to develop a new med, requiring many high priced researchers, doctors, and so forth. Then more years of required testing and trials. Then only a few years to recover the expenses of that development and testing, before the drug goes generic and greatly reduces the profitability of hat drug.

These companies are in business to make a profit. Yes, I'm sure there are physicians that own stock in pharma companies, the same as your 401k or retirement accounts.

Consider all the advancements in health care that we enjoy today and compare that to what we know about health care even 25 years ago. "Big Pharma" is an easy target for those that want to complain. The Left has made them a target and way too many folks have jumped into that parade.

There are bad docs, and bad cops and teachers and preachers and auto mechanics and store clerks, AND bad patients.

 

[tRidiot]

I just looked up all of my partners... I am the only one who got zero in 2018. Everyone else got a reported few hundred dollars - I guarantee you that wasn't cash payments. Those are benefits reported from something else, I don't know what. 3 of my partners do Hospice and Nursing Home work, which I am going to start doing next month, as well. Hell, several of my partners don't even allow drug reps in their clinics, so I find it hard to believe they're accepting some kind of kickbacks. lol

 

[tRidiot]

Hell, I wish I could buy into some of the pharmaceutical companies' stock. Why? Because Americans have ****** health and ****** lifestyles and investing in healthcare-related fields is a GUARANTEED money maker. Healthcare is an industry you will almost always be able to find work in America. If we invested 1/4 of the time, effort and money in being healthy that we invest in leisure, laziness and gluttony, the healthcare industry would shrink. But we have over 50% of our adult population in the "obese" classification.

I'm proud to say, for the first time in my adult life I finally fell out of that category last month... my BMI dropped below 30. And I still have a ways to go, but I'm working on it. My A1c plummeted (with the help of some of those "evil" meds!) and I've lost almost 40 pounds. But it took self-discipline, too... there is no "magic pill".

 

[Tanis143]

Hell, I wish I could buy into some of the pharmaceutical companies' stock. Why? Because Americans have ****** health and ****** lifestyles and investing in healthcare-related fields is a GUARANTEED money maker. Healthcare is an industry you will almost always be able to find work in America. If we invested 1/4 of the time, effort and money in being healthy that we invest in leisure, laziness and gluttony, the healthcare industry would shrink. But we have over 50% of our adult population in the "obese" classification.

I'm proud to say, for the first time in my adult life I finally fell out of that category last month... my BMI dropped below 30. And I still have a ways to go, but I'm working on it. My A1c plummeted (with the help of some of those "evil" meds!) and I've lost almost 40 pounds. But it took self-discipline, too... there is no "magic pill".

That's great. My wife was the exact opposite. Those meds her first doctor gave her robbed her of her strength and balance, then packed 60 lbs back on in less than 4 months. He told her to take a medication that said if you are over 40 consult your doc and if you are of japanese descent do not take, he told her to take it anyway. Why would a doctor do all of that? Why would he keep her on medication that prevented her from working out AND caused weight gain. These medications were for her blood sugar, cholesterol and blood pressure. It got so bad she could barely walk, couldn't open simple stuff like bottled water, and no matter what she did she still put on weight. She doesn't eat much and she was making sure to limit her carbs. The doc just told her to quit stuffing her mouth (she was eating less than 1500 calories a day, and at that point cut out all junk food, soda and for a while even tea). She got to the point were she was only eating one meal a day and it wasn't even a full meal. This doc almost caused my wife to get hospitalized. We finally left him and got with a different doc and he changed her meds. Its been several years now but her weight is starting to come back down. Her strength and balance? Still gone. But she is now at least eating healthier albeit less than she should. But everytime she gets a bad glucose reading she ends up psyching herself out and doesn't eat.

And I can't remember the full details, but there was a nursing home here in Tulsa that the in house doctor was prescribing medication and charging it to medicare when the patients didn't need it.

You may be a doctor with integrity and do not do these things. But are you going to honestly tell me that every doctor out there is the same? You might not be getting kickbacks, doesn't mean others are not.

https://www.nytimes.com/2018/03/16/nyregion/fentanyl-subsys-drug-kickbacks.html

https://www.justice.gov/opa/pr/new-...g-bribes-and-kickbacks-pharmaceutical-company

https://www.cbc.ca/news/health/opioid-fentanyl-drug-company-conviction-insys-1.5121088

Those were found with just a simple google search and are pretty recent. I bet if I spent more time I could dig back further and find more examples.

 

[Okie4570]

I searched the couple dozen docs I know/know of from neuro, gastro, ortho, ER, general and one that's a general in an Indian health clinic. Three are notorious pill pushers, one on the verge of loosing their license. The Indian health clinic doc's payment was just over $8. One the general doc's $2100. The three pill pushers were between $300-$500.

 

[druryj]

Sorry to hear that some feel that the medical profession is so corrupt. Try getting the same quality of care in many other countries. We all know that some do abuse the system, Doctors , drug reps, Pharma companies, patients, hospital and clinic administrators, etc. but in general, I trust them to do me right in terms of my healthcare. And I’m smart enough to choose wisely.

It’s kind of like choosing between cable tv or streaming Netflix and sling: somebody is making money off of me and I just know it! Can’t fool me, nosirree. Why, I betcha somebody even gets a bonus if they talk me into HBO and Showtime! How dare they push that on me for their own financial gain! Me, the poor dumb consumer, being taken advantage of at every turn, forced to gulp opioids and binge while old tv shows I’ve become addicted to in an endless, mind-numbing cycle. And it’s not my fault!

(PS: Safety Tip: I’m not picking on anybody here but if this fits you, and this is just an observation, so take it like you will, but if I was telling the world about my wife’s weight problem and she found out, I’d NEED more opioids for damn sure to combat the severe, long term pain I’d probably be in. So, maybe think about that and don’t become a statistic okay? Just sayin’...).


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