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The Water Cooler
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Opioid Crisis in OK; Who’s to Blame?
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<blockquote data-quote="tRidiot" data-source="post: 3250088" data-attributes="member: 9374"><p>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</p><p></p><p>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.</p><p></p><p>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, [USER=43724]@Tanis143[/USER], 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.</p><p></p><p>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. </p><p></p><p>And guess what I get out of this, [USER=43724]@Tanis143[/USER]? 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?</p><p></p><p>More samples.</p><p></p><p>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.</p><p></p><p>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?</p><p></p><p>Just stop and think about it for a minute.</p><p></p><p>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.</p></blockquote><p></p>
[QUOTE="tRidiot, post: 3250088, member: 9374"] 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, [USER=43724]@Tanis143[/USER], 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, [USER=43724]@Tanis143[/USER]? 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. [/QUOTE]
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