#017–Who is really in charge of a patient’s health: the doctor, insurance, or Big Pharma?

Photo credit: Bill Brooks/Creative Commons

I remember the first time I saw a prescription medication advertised on the t.v. It was either for Celebrex or Claritin, and at first I didn’t pay much attention–I just thought it was a new drug to see in the store. Then they said the magic words: “Ask your doctor.”

That was around 2000, and since then have been hundreds of other ads, some for syndromes and conditions I’d never heard of before with somewhat vague and non-specific symptoms (probably why WebMD got a great start–seriously, is there anything LESS reassuring than looking at about 50 mild symptoms that go along with a condition that if you look hard enough, you might find yourself fitting by chance, or is that just me?) Here’s a great bit from NPR about health care getting so high.

Guess this question’s on my mind because I’m a bit ill. Had a bad throat yesterday and a full-blown cold hit last night, but I didn’t go running to the doctor. I’m sick of being told to get this, this, this, or that by doctors, so for the longest time I quit. Plus, as long as I get hot liquids and don’t blow my brains out through my nose or ears (and sleep soon), I should be alright.

It’s no secret that we’ve been bitching and moaning about our healthcare/sick-care system for decades, and then of course the Affordable Care Act, the hikes in prescription drug costs, repeal–it’s becoming a national obsession! As much as pharmaceutical companies moan and groan about patents, research and development, and keeping in business, there’s one thing they’re not going to trim anytime soon but should.

If they really wanna keep the money in house and do us all a favor, they sure as hell should cut advertising to the basic consumers. That would save billions in the combined budget of big pharma.

I despise drug advertising on t.v. It’s one thing if it’s over the counter medication, but anything telling me “hey, do you feel like ______. Well, there’s help. Ask your doctor about ______”?

…yeah, that doesn’t fly with me. Who is really in charge of a patient’s health care: the doctor, or the pharmaceutical companies?  Or wait, what about the insurance companies?

I could call myself a young geezer and complain about how healthcare used to be, but I wasn’t terribly sick as a kid–just the run of the mill stuff that I usually got over. Then I got a stepmom and anytime we had a fever, us kids were whisked to the doctor to get antibiotics. My doctor knew I didn’t make a fuss, so he didn’t go crazy on the antibiotics and was very careful about them (or course, that was back when Actifed with Codeine was still good–yuck, but it worked like a charm).


(from voluntary benefits magazine online…creepy, huh?)

I saw another side to healthcare when I worked in a pharmacy. I found it dismaying how many prescriptions were coming through the door for little kids, I was about 18 and I bet I could still take the amoxicillin if I needed antibiotics–you know, the bubble-gum tasting stuff–and be okay. I saw prescriptions for 7 year olds for Zithromax (which was the most powerful antibiotic on the market then). It shocked me, and some of these were repeat customers who would get antibiotics for every little illness, and the ante was upped quite a bit.

With so many doctor’s offices in my town, you know the drug reps were around. In our pharmacy, we had drawers full of pens, notepads, fridge clips, koozies, etc. that they gave us when they stopped in, at least 1 or 2 a month.

I do wonder about the power struggle in the health/sick care industry. I mean, doctors are supposed to help the patients to the best of their ability, to use their knowledge and expertise to diagnose and help treat a human being coming to them for that purpose. The drug companies have their own agenda, trying to get doctors to write scripts for a certain drug.

But with advertising directly to the public, the drug companies put ideas into people’s heads and have them demand the doctor give them a prescription for this medicine they saw on t.v. And when they can’t get it, I guess they go looking for a doctor who’ll do it, or find some other means.

670062fc02901f82c3840849ea20c121I know the past decade there’s been a so-called “pharm party” scare in the news, where kids would raid the medicine cabinets and bring ’em to someone’s house, throw ’em in a bowl to mix and take what they wanted. I think that’s a bit far-fetched, and the stats on the actual parties themselves aren’t there. But there is a trend where thanks to these commercials, people are willing to self-diagnose far easier than they used to. Teens and college-age young adults I’ve bumped into (after I left that pharmacy job) actually said they’d pop a pill to stay up all night and study, or to get some sleep.

Where were they getting the meds? Swipe a pill or two from dad’s medicine cabinet. It’s not an “epidemic” the way the media wanted to push it, but is a concern because there’s a reason those drugs ARE prescription. It’s called “drug interaction warnings.” Certain prescription drugs will react negatively with other ones. Those side effects they tell in the commercials in rapid pace aren’t all of them by a long shot, it’s just the basic worst of the list that’s said. They don’t talk much about all the drugs that may interact negatively.

Also, with plenty of people taking multivitamins and other supplements over the counter, there’s a reason to talk to and listen to your doctor. Some supplements can create a bad reaction with prescriptions. The doc is supposed to be able to advise you on what to cut or try instead.

Of course, when you finally get to talk with the doc and a script is filled, there’s a chance insurance won’t pay for it. So, the doctor has to go back and find something they will pay for that may not work as well but is more affordable. So, the system’s rigged again.

In all seriousness, I don’t mind the idea of pharmaceutical companies advertising to doctors–as long as it’s informed decisions and not wining and dining incentives (which it often is). Give them good information to work with and publish in medical journals (instead of waiting room magazines), and that’s good to me. Tech and treatments change, and docs need to be aware of what’s around the corner.

It’s a shame that the health/sick care system is a business all the way around, the business of getting people in the door and out again with a shopping cart full of prescriptions, and if they don’t work, bring ’em back in again. I pondered this with someone yesterday and they told me their girlfriend worked in a hospital and the first four years it was all about helping the patients. But the longer you’re in the system, you realize it’s all a business.

So, in this trifecta-from-hell, who really is in charge of the patient’s health care: the doctor, insurance companies, or the pharmaceutical companies?

Perhaps it was too simplistic a spin, but if anybody’s got any other great info to share to educate us all (preferably not brought to us by a certain drug company, insurance company, or malpractice group), then I’d love to learn more.

4 thoughts on “#017–Who is really in charge of a patient’s health: the doctor, insurance, or Big Pharma?

  1. Andrew says:

    I hated taking anti-biotics when I was younger (still hate to take them) because they always made me feel worse somewhere else (use your imagination). I just got over a cold, still have the stupid cough, but I’m not going to the doctors office. Partly because I know they can’t help and partly because I know they might try to help and prescribe meds that I don’t need. Who’s in charge? Well, I think all are in charge depending on where you are in the cycle. Pharma is big business and like the oil companies, have lobbies in all parts of government. When I do have to take meds, I refuse to take “name brand” and will insist on generic. If there isn’t a generic for what is being prescribed, I ask if its really necessary. Only once did the doctor tell me it was necessary.

    I don’t see the stupid pharma ads on television anymore because I stream everything now. I never watched them when I did have cable as I’d always record and watch later (to fast forward the commercials). It’s all a racket that makes people richer in my opinion.


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