How Do You Trust Your Provider, When The Waiting Room Is A Display Case?

A common complaint by providers these days (in America that is) is that they aren't making as much money as they used to. (Aaawwww and here we thought the idea was to help people.)

Medicare has cut back payments, Insurers hassle them more, they have to improve their documenting by implementing electronic medical records. Equipment is getting more complex and expensive, rents are going up, the patients expect to be able to watch Fox news in the waiting room and cable is expensive. The Jaguar needs new rims, the new girlfriend on the side needs new breasts...What is a provider to do?

Well it seems the solution that many providers are using is to supplement their income by prescribing "nutraceuticals" to their patients and then selling them right in the practice.

The waiting rooms look like you are walking into a local GNC.

I have several problems with this.

1) Patients trust their doctors. (or at least we were brought up to believe we could)

2) Some of the supplements make spurious claims that have not been proven by trusted studies. (When it loudly proclaims on the label that the supplement contains Acai berry extract, your woo alarms should be going off like crazy.)

3) It states right on the supplements that the FDA has verified these claims. (this one always gets me, neutraceuticals are given the same classification as dietary supplements which is what they are. The only thing the FDA does is to make sure you aren't being given cyanide instead of what's on the ingredient lsit and to make sure rats aren't runnning around the warehouse where the ingredients are stored)

4) They are exorbitantly expensive. (usually at least 100% higher in price than vitamins sold at the local groccery)

5) The "nutraceutical" companies working their way into doctor's offices have complex multi-level marketing schemes where doctors get territories and when they bring other doctors on board they get a cut of the action. (but don't mention that dirty "pyramid" word. The pharmaceutical companies themselves should be in an uproar because they are banned from doing this very thing.)

Now I can't mention the name of one particular company due to my involvement with practices that have been sucked into this, But I can't keep biting my tongue about this any longer.

It is ethically wrong to fleece your patients with overpriced supplements, especially those patients on a fixed income by taking advantage of the doctor-patient bond. Your patient trusts that your recommendations are for the betterment of their health, not to fatten your wallet. Doctors should not, must not benefit directly from prescriptions written for patients. Aaah, but they don't write prescriptions they recommend. There is a difference right? They should explain that to the patients. Better off, remove the display cases from the office. While they're at it take down all of the pharmaceutical advertising too.

And while I'm at it, turn off the Fox News in the waiting room and let 'em watch reruns on the Game Show Network it will do less damage to their brains.

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Replies to This Discussion

Permalink Reply by NoSacredCow on September 8, 2010 at 12:35pm

Then you'll probably want to join the Fox News Boycott (if you haven't already)

Permalink Reply by Sydni Moser on September 8, 2010 at 1:13pm

Without a doubt this is unethical... It's a racket and trusting patients will abide by their doctor's advice, and rarely if ever question their motives. I think you should write an article on this topic, perhaps under a pseudonym and try to get it published on The Alternet, or Huffington Post? Or maybe just some 'letters to the editor' in your hometown newspapers, or the NY Times for that matter...

Since I don't often go to the doctor (tsk, tsk) I haven't noticed this practice going on. What galls me is the 5 minute limit of their time and attention to my medical issues... Many are seeing upwards of 70 patients a day, because they still have a mortgage on that vacation house and couple of kids in college to support... This is the way that I see most doctors making up for the fact that their payments from insurance companies aren't enough to pay for their extravagant life styles... If the government helped pay for medical school, or forgave some of the huge loans that med students begin their career with, some of this money frenzy wouldn't be so acute.

Permalink Reply by Sydni Moser on September 9, 2010 at 1:47am

GREAT advice Jean Marie, I will definitely look out for a better doctor in my new hometown. I had limited choices of local doctors on Long Island, so I went with the doctor my friend recommended. The two of them seemed to have a great rapport, but I wasn't chosen to be one of her favorite patients. I ALWAYS had to wait over an hour past my appointment to have just a few spare moments of her time. By the time I finally got to see her, I was so angry that all I wanted to do myself was get out as quick as possible...

And to beat all, I received a phone call one day from a company she hired to do a poll of her current patients to see whether we would be interested in becoming private clientele. It would mean that she would provide considerably more personal time and attention to a selected group of patients who would be willing to pay an annual 'members' fee, plus pay out of pocket for office visits, tests and any other necessary treatment needed. She would no longer be accepting any health insurance policies, just cash, check or card transactions.... Ever hear of this up and coming trend that some doctors are adopting? These doctors would only be serving the upper echelon of their patients, those who can afford to pay up for this privileged medical care. I wanted to really strangle her then! And I'm sure she thought she was offering a great service by wanting to change over her practice to this formula....

Permalink Reply by NoSacredCow on September 9, 2010 at 8:07am

Ah yes "boutique" practices are all the rage these days. They don't accept insurance, it's an annual cash fee and depending on the specialty runs about 3-5 thousand per year.
This provides you with unlimited visits to the provider and "personal" care.

Some family practioners make it more "reasonable". $2500 per adult and $1500 per kid.

This doesn't cover emergency care, hospital care, tests etc.

This is the kind of healthcare system the GOP is pushing towards.

I'm also seeing more and more "anti-aging" practices that are cash only too. Basically they prescribe hormone injections and write you a script you get it filled and then you come back and they shoot you up with it all for only $250 a visit.

Permalink Reply by NoSacredCow on September 9, 2010 at 10:06am

Well it is Florida, the medicare con capital of America.
Any wonder it's also a bible state?

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