Opioid Crisis in OK; Who’s to Blame?

[tRidiot]

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.

So what we're talking about now are:

Your bad doctor who didn't listen to his patients and didn't prescribe medicine with appropriate consideration for side effects. - Nothing to do with kickbacks, or are you claiming that, too?

Doctors who actively consipired, committed fraud and falsified records. Ok... yes, I'll give you that. And you can find the same thing in every single industry out there - construction, contracting, finance, education, politics (national, state and local). In fact, I'd hazard a guess that doctors and pharmaceuticals probably have less graft going on than many of these other industries, due to the massive regulation involved. But the way you talk about it, this is a widespread practice in the industry. I mean, honestly, you keep bringing it up like it is all over the place. I'm telling it's not. But hey, who knows, right? The media knows. lol.

I'm sorry your wife had a ****** doctor. Truly, I am. But lumping every doc in with bad apples you find in every field does nothing to help the problem, it only fuels the mistrust and continues dividing people. Like the people I see every week who won't take my advice because they don't trust doctors - because we're all in collusion with the drug companies. Ok... but they'll believe anything the cannabis and CBD pushers tell them, or the $10/hr high school grads at the health food store who don't know **** about what they're selling. lol

Anyways, good luck to your wife, really. And I hope you have better experiences going forward, but it's obvious to me your opinion has been unjustly and incorrectly colored by some bad experiences with one individual in the past.

 

[Tanis143]

I'm sorry your wife had a ****** doctor. Truly, I am. But lumping every doc in with bad apples you find in every field does nothing to help the problem, it only fuels the mistrust and continues dividing people. Like the people I see every week who won't take my advice because they don't trust doctors - because we're all in collusion with the drug companies. Ok... but they'll believe anything the cannabis and CBD pushers tell them, or the $10/hr high school grads at the health food store who don't know **** about what they're selling. lol

Anyways, good luck to your wife, really. And I hope you have better experiences going forward, but it's obvious to me your opinion has been unjustly and incorrectly colored by some bad experiences with one individual in the past.

Please point me where I said all doctors are like that? The original post I said on this topic was about how SOME doctors get kickbacks for prescribing more of x medication. You came back with that it doesn't happen. I provided proof it does. But I never said it was all doctors. My wife's experience also highlights how some doctors do not listen to patients concerns. This was all to refute that the opioid problem is 100% on the patient. Again, you are taking my points as absolutes when I am showing there are many shades of grey involved.

And we now have a very good doc for my wife (and me as well). He listens, explains, and is willing to work with us when we have concerns over medication.

 

[DavidMcmillan]

It's way too easy to make blanket statements, about doctors, lawyers, preachers, and Indian chiefs. We do the same thing with industries, networks, and sports teams.

I chose to think the best about all, until an individual disappoints me, and then my opinion drops for that individual, not every group they may be a part of.

 

[CHenry]

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.

Interesting debate coming from a MD who openly complained about the entire medical field and wasn't making ends meet about 2 years ago. Now they are all angels and unicorns just frolicking in the green fields...
Don't I recall you quit the practice to go to a 9 to 5 job with less stress and more income?
SMFH...

 

[CHenry]

It's way too easy to make blanket statements, about doctors, lawyers, preachers, and Indian chiefs. We do the same thing with industries, networks, and sports teams.

I chose to think the best about all, until an individual disappoints me, and then my opinion drops for that individual, not every group they may be a part of.

I've been through about 8-10 completely worthless MDs to maybe 3 good ones (thats a conservative ratio) in the last 2 years. Almost died before I found the good ones.
I have a new lower respect for our healthcare system in America.

 

[DavidMcmillan]

That's a shame. Fortunately that is not the case for most people.

 

[Aries]

I have diabetes and good insurance, so I have a doctor for just about each body part. All of them are pretty good to one degree or another. My GP is 70 and I'm not looking forward to trying to find one as good as he is when he retires, and I'm glad my endocrinologist and dermatologist are significantly younger than me, as I NEVER want to have to find others to replace them.

 

[druryj]

OMG.
I'm gonna sit out of this particular one.

Changed your mind huh? Or was it that you saw an opening and just couldn't help yourself?

Hey, on a serious note: I didn't start this thread so we could take jabs at each other, so...please, let's not. And Chenry and Tanis143, I respect your opinions (even though you're wr... uh, never mind).

I was asking because I'm curious what this small sample of public opinion thinks and also because it looks like tomorrow, Johnson & Johnson is going to make a motion to just dismiss or drop the suit against them. If they do, and the judge rules in their favor on the motion, the trial is over and Att'ny General Mike Hunter loses the suit he filed. This case has nationwide implications, If Oklahoma wins, it sets the stage for other states to follow. If Oklahoma loses, it sends a message too. I've stated what I think, and some others have varying opinions. This could be a big deal. It will be interesting to see how it plays out. One thing; if J&J loses and takes a really hefty hit in the pocketbook, I betcha one thing we'll see is a rise in price for baby powder and stuff like that real quick!

 

[DRC458]

I have diabetes and good insurance, so I have a doctor for just about each body part. All of them are pretty good to one degree or another. My GP is 70 and I'm not looking forward to trying to find one as good as he is when he retires, and I'm glad my endocrinologist and dermatologist are significantly younger than me, as I NEVER want to have to find others to replace them.

Amen on the docs. My PCP, cardiologist, pain doc, and even my dentist are all probably 20 to 30 years younger than me, and I am very happy with them. Now, if they don't decide to leave me, I've got it made.

 

[DRC458]

Don't I recall you quit the practice to go to a 9 to 5 job with less stress and more income?

As I recall, it was substantially less income, but a lot more time with his family.