insurance

0

Do some people become doctors just to earn a lot of money?  Yes.

Sigmund FreudDo some of them find out that it’s not as lucrative as portrayed in the media (based upon stereotypes at least 40 years out of date)? Hell Yes!

Psychiatrists are not normally schizophrenic — however there are two types.  One is the media stereotype “Talk Therapy” doctor.  These are nearly extinct. They exist mainly in Woody Allen movies and old TV series.  In fact, most of those are psychologists — not psychiatrists (but who knows the difference and who cares?).

The other type is what you chiefly find today — Pill Pushers.  Insurance and

Read more on Where Have All the Psychiatrists Gone?…

Filed under Psychiatrists by on . Comment#

0

Sure, the malpractice system is broken.  And there are lots of suboptimal doctors out there.

I have told some what the correct diagnosis is and they have ignored me.  Some are too busy to take phone calls from me.  Institutions have refused to order tests that I’ve requested.

On the other hand, I have been lectured about the necessity for “cover your ass” medicine.  I could not practice it if I wanted to.  Nobody would pay for it.  In my specialty, I am always told to look for ways to cut costs while some patients cry to me they cannot afford their medicine.  We do our best. Read more on Capping Malpractice Damage Awards…

Filed under Diagnosis, medicine by on . Comment#

0

Wait a second here.  President Obama did not “mandate” compulsory birth control.  As the headline plainly states, this is a mandate for insurance coverage for birth control.

Nobody is going to drag a young — or older — woman kicking and screaming into a gynecologist’s office and force her to take pills or injections or put anything into another orifice.

People are complaining that the President did not consult with people like Catholic religious groups.  The Republicans especially do not like this.  This is not surprising as they do not seem to like anything President Obama does — include breathe.

The Republicans — well, their opposition is supported by the part of the nation that seems to have chosen to “stupid up” its politics –left and right, liberal and conservative, yes and no. Read more on Contraception and Birth Control…

Filed under Contraception, News, politics by on . Comment#

0

Most people don’t seem to understand how disability benefits work – and that includes doctors as well as patients.  There’s a very good reason for that. The system is screwy.

Thinking that your own regular doctor might be prejudiced and just dish out disability benefits ad infinitum so you never have to go to work (Gee – where did the government get that idea?) the patient is sent to an outside doctor to do an evaluation.

I’ve done plenty of those in my day. I’ve done them for veterans and for Social Security and for worker’s comp and even such exotic things as employee plans for large corporations (such as GM and Ford) and unions (like the Railroad Workers). Read more on Diagnosing For Dollars…

Filed under Diagnosis, News by on . Comment#

0

Why would a pharmaceutical manufacturer want to change a drug from prescription to over the counter (OTC)?

Well, one thing I’ve learned in my lifetime is – When the Question is “WHY?” then the answer is “MONEY.”

Prescription Drugs Go Over The CounterIn this case, the most obvious reason is more money for pharmaceutical companies.  I certainly cannot think of anything — I mean any way shape or form — that can benefit patients.

Oh, sure – in our economically-ignorant country, many people think – “Whee!  I can buy any drug I want without spending money on a doctor’s appointment and without having to get a prescription! ”

These people are prime candidates for the Darwin Awards.

Yes, believe it or not, the “RX to OTC Switch” can actually HURT patients.

Drug patents expire relatively quickly, competitors are waiting at the gates with generic equivalents, and when a drug becomes OTC, there is a chance that insurance does not cover it.

This makes insurance companies and government programs (Medicare, Medicaid/Medi-Cal, etc.) very happy.  They are so strapped for cash that even paying for a cheaper generic is a strain on the budget.  When this kind of money is involved, you can bet that lobbyists are pressuring the government to ease their restrictions so that drugs once considered risky enough to warrant a prescription so that not just anybody can have access will be available to anyone who can walk into a drug store or click on a shopping cart on the web.

Patients will have to pay for OTC meds in cash money and doctors usually do not bother prescribing an equivalent drug.  If they do not already know of an equivalent, they will probably — and generally do — just tell a patient to go buy it over the counter.

A patient who cannot afford the drug will go off it.

OK – so what’s the big deal if a cold medicine, allergy remedy or hair-restoring pill is no longer a prescription drug?

Read more on When Prescription Drugs Go Over-The-Counter…

Filed under prescription drugs by on . Comment#

0

One of my Frequently Asked Questions is “why do you hate prescription drugs so much?”

And the answer is, I DON’T.  Not at all.  I have used, and will continue to use, prescription drugs whenever they are the best treatment for an individual.

What I DO hate is the way they are mis-used, and the way some companies push their drugs for inappropriate purposes, or in dosages that are harmful when they could be helpful in (usually lower) doses. Read more on A Remarkable Medicine And Its Champion…

Filed under prescription drugs by on . Comment#

0

THE PLACE: Medical school, France
THE TIME: 1975

I have survived the “concours,” a competitive examination that I would compare to an intellectual equivalent of “American Gladiators” and through human dissection, the anatomical study of a human who previously walked the Earth.

An Accurate Diagnosis Is The Basis Of All Treatment

An Accurate Diagnosis Is The Basis Of All Treatment

Now our class is now going to start doing medicine with real, live people.
The excitement is great on our first day of an immense multispecialty class that will take the year, called “Semiologie.” The best English equivalent I can think of is “diagnostic signs.” We each receive notebooks and documents throughout the year that are signed off on by professorial-level clinical teachers who are doctors and have practices.

Read more on Nothing Happens If The Diagnosis Is Wrong…

Filed under Diagnosis by on . Comment#

0

“Innovative Health Care Programs?”

This seems to be the era of backwards-definitions.  “No Child Left Behind” means a diminished budget and fewer programs for child education. “Compassionate Conservatism” means cutting programs for the unemployed, the medical indigent and the hungry. “Strategic Defense” means a full-speed-ahead attack.

The “Innovative Programs” article talks about are mostly supplied by The Greenfield group, where improved medical care is provided if people  fork in some cash to get it.  Also “Harvard Vanguard,” who loves to be the first to do things.

Since there is nothing but Harvard hospitals on the reality TV show  Boston Med, I wonder if the Harvard Public relations people have descended to some all-invasive biological state, to infiltrate all media, and to try to get us to believe that they do things medically and surgically that are more advanced than other providers.  Read more on Walls and Barriers To Providing Health Care…

Filed under Healthcare reform, politics by on . Comment#

0

I’m often asked for my opinion of and reaction to our new healthcare reform.

My immediate reaction is to correct the concept that this legislation has anything to do with healthcare. It is more properly insurance reform.
I stopped accepting insurance payments in 1996. In the intervening years, I’ve successfully operated a cash-only practice and in the past few years have been drawn into coaching other doctors in how to operate such a practice and consulting with people who are tired of insurance tyranny.
The term bandied about in the recent debates about healthcare reform is “access.”

Can't Wait For Healthcare

The talking heads — both media and governmental — claimed a large number of people were uninsured. I recall numbers in the range of 40 million, and I’ve heard such numbers debunked.
Read more on Access Is A Null And Void Concept…

Filed under Healthcare reform by on . Comment#

0
I have assisted several people in changing gender. Most of them have been middle-aged. To me, it is simply a sort of birth defect.  Sometimes the chromosomal sex does not match the brain for a variety of very specific reasons, some of which we know something about, some of which we do not.
Milton Berle In Drag

Milton Berle In Drag

I am now far less involved with these folks.  Not that I do not venerate them and respect their struggle.  Rather, the condition of being a person requiring transgendering is so mainstream, that plenty of types of medical insurance pay for this.

Then again, several do not.  In fact, I had two patients in one year who worked for a major international conglomorate, and the sexual reassignment surgery was covered by their company benefits.  Let’s see if Obamacare is going to take that into consideration.

Read more on Sex Changes Are Confusing Enough When You Have Accurate Information…

Filed under big pharma by on . Comment#