Health and Medical News and Resources

General interest items edited by Janice Flahiff

4 reasons why doctors should be outraged

From the 7 December 2012 article at KevinMD.com

4 reasons why doctors should be outraged

Outrage #1: Wasting time of skilled caregivers. Everyday skilled nurses and physicians’ assistants waste hours of time on the telephone either getting approval for medications that we prescribe for our patients or trying to fight a rejection for a medication we requested.

Outrage #2: Choosing a medication for cost, not effectiveness. A child cannot breathe because the acid and other nasty stomach contents come up from the stomach and inflame the airways without the right treatment. Although many of them might respond to one “preferred” drug, not all of them do. And, guess what? There is another “non-preferred” drug to which more of them will respond, but it is not allowed as a first line treatment, even in this critical airway situation. When there is an airway problem and the infant is choking, coughing, turning blue and not sleeping, or the airway is becoming progressively narrower, wouldn’t you want your child to have the medication that works more often? I know I would. The insurance companies call their approach “best practices” because most, but not more, might respond.

Outrage #3: Pretending we are giving care when we are not. So the one “preferred” (i.e. less expensive) medication also tastes really nasty. Many kids won’t take it at all no matter what flavor is used. So then families are told to mix it with their formula or juice or some other food and this dilutes its effects because it won’t work in that preparation.

Outrage #4: Pretending that patient diversity doesn’t exist. Different people respond to medication differently (? pharmaco-genetics). You know that’s true just from the way some of us fall asleep after one dose of Benadryl and others of us don’t get knocked out even with a whopping dose of morphine. We are in a real quandary when we have to fight (sometimes for weeks or months) to try another medication because the one we are allowed (first tier) doesn’t work. And then on the second or third tier, the family cannot afford it, doesn’t get the medication, and the child might go untreated. We have wasted money, time and have put the child in harm’s way….

….

Yes, I am angry about this. Very angry and very frustrated. I am tired of being told what medications to use, what tests I can order and even what surgeries to perform. I am “appealing” to one insurance company to be paid for an operation they said was not proven effective in children. Were they faced with the anatomy that I encountered and knew was the cause of the problem and required a different operation than planned? Another has denied payment for an assistant surgeon which I needed because we performed a difficult airway case!….

December 15, 2012 - Posted by | health care | , ,

No comments yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: