My Doctor Quit
I am a type1 Diabetic.. So, it is pretty important for me to have a reasonably good relationship with my Endo. For the last 18 months I have been pretty much running on auto pilot while taking part in a fairly big drug study for Lilly. I figured there would be no problem as my endo was one of the doctors on the study, the facility is even an extension of the clinic I go to.. Its even just downstairs. But, last fall I had sort of noticed that my usual endo was not really around and I was only ever seeing the other guy. Again, I was running on autopilot so I didn't really think too much about it. Now, as part of the study, I was not on the test insulin this time ( I was a control ) but, Lilly provided 100% of everything. Every 3 months I would haul home a crate of insulin pens, tips, test strips, glucose tabs, sharps containers.. Pretty much any supply I could imagine needing, and some that I didnt.. Yesterday, the study ended so I knew I would be needing to update my actual scripts and stop at the pharmacy. This is when I discovered a few things. First, apparently last fall my regular Endo suddenly retired. Apparently, it was a very sudden retirement.. Odd since he is probably in his mid 50's and _very_ damm good at his job.. While I had been thinking that the health care act was causing retirements, I had never actually thought that it would hit me so fast. As it turns out this is a huge problem now since< apparently it is against the law out here to write an insulin script if the doctor has not actually seen me in the last 12 months. So, now I need a new endo and to top it off the clock is ticking as my emergency supply drains away.. The good news for me is that I have pretty stellar, and mostly unused insurance.. So, I will do my part to help make things more of a mess by using an urgent care to get new scripts. Yes, this might mean that someone with a more immediate issue gets to wait a bit longer.. But at the same time I will only last about 40 hours after the last of the emergency supply runs out. So, I would describe this as a fairly urgent problem.. Of course this whole mess got me thinking back to the days when Insulin was technically an OTC med. In fact for most of my life a bottle on insulin was about 25 bucks and I did not need a script to buy it. The pharmacy folks would occasionally give me crap for not seeing an Endo.. But back in my 20's I did not have insurance as it was way outside of my price range, and I was already pretty good at being a type 1. That all changed with the latest generation in insulins. The FDA has classified them as being too dangerous to be OTC and as it turns out there is a reason. Apparently its the Doctors that don't want us to be able to just go out and buy insulin. They prefer to force us into making an office visit every 6 months so we can see them for about 90 seconds and then get our script updates phoned in by the assistant.
So, my to big lessons on this are that Dr's are in fact going galt.. Also, they were busy cutting their own throats..
So, my to big lessons on this are that Dr's are in fact going galt.. Also, they were busy cutting their own throats..
http://www.diabetesmine.com/2012/06/fda-...
As for these stories.. Yes, I expect it.. While the Endo's association might have pulled an Orren Boyle there are plenty of good Doctors out there that would prefer to be good Doctors instead of O'care stool pigeons or insurance accountants...
That reminds me, my previous Endo.. He was running his own private clinic. One doctor a Nurse/Diabetes Educator a lab person, and 4 billing specialists. He is also retired now..
I think that I will reply to both threads here.
I like money. I would like to have more money. I would like to not have to scrimp and scrape to make ends meet. But money is not the reason that I work, and work hard. There is more allure in the challenge of making the world a different place, of changing things, than there is in money. In spite of the lampreys attached to and feeding off of my company, I will continue to try to make it grow and flourish - because we have already changed healthcare in some small ways, and are capable of doing more. That is why it is worthwhile for me to work hard...and why it is worthwhile for doctors to continue in their practices. The people they care for are real.
Yes, trying to provide good medicine or trying to do something better than anyone else can do it with the current regulatory restrictions is like trying to swim the English channel with an anvil tied to your ankle. Yes, we could all do better jobs without this additional burden. But in the meantime, there are people all over the world receiving better healthcare because of my efforts. There are friends and neighbors receiving essential health care because doctors are still working, because doctors have not given up - yet.
If I knew a better country to go to where we could work more effectively, I would be going head-to-head with the president and co-founder of my company over moving there. But there is no such country; I peruse the net regularly to check on this datum. The US is still the best place to be.
Sucks.
Jan
I feel for your situation. But everyone has a different breaking point. For many many doctors that have put up with becoming paper pushers and accountants for insurance, becoming a robot and mouthpiece of government health distribution is a step too far.
The government is too big and has gone too far. I am hopeful that most great doctors understand this and are making the point clear. I also hope that under a freer system, many will return. See off shore hospital ships below.
You are not quite there. If you can fight to swim with an anvil on you, all you do is ask them to add more weight. These looters will only stop when the economy collapses. They rely on the best among us to find a way. As long as we keep finding a way to survive, we only feed their power and need for more.
Once you learn that our constant ability to navigate and find a way is the source of their power, you understand why so many want to stop feeding the machine.
One of the distinctions we have to make as practical futurists is the one between a technological solution to a problem and a social solution. (Can you tell I am a geek?) Malthus thought that the geometric expansion of population would outpace the arithmatic expansion of food. This did not happen, for two reasons (a) he had no evidence for his theory...it was just a thought problem, (b) technology provided the solution to both points of his hypothesis. Even given that his thought problem would have proven correct in a world of level technology, that is not our world - the agricultural revolution and the existence of birth control has stood his theory on its metaphorical head.
This can happen in other venues as well. What happens when a significant portion of healthcare is taken out of the hands of the healthcare industry and put into the hands of the casual user? What happens when the working class is almost entirely robotic and there is affluence without need or possibility of work for 90%+ of the population?
It is possible that the solution to social and political problems is to make them irrelevant. My company is a small company, but we are still swimming.
Jan
Jan
Another closed his practice to work in a research clinic where his new position isolates him from the Feds (for now).
My current family practitioner is going to retire early (he is in mid-50s) and close his office this year because he has had to hire an extra employee to transcribe his "paper charting" to conform to the electronic medical record requirements. This added burden was his personal "last straw".
These men and other physicians I know are knowledgeable thinkers, diagnosticians and practitioners of the art and science of Medicine. They are most reluctant to become slaves of protocols and other forms of "cookie cutter medicine" that politicians and bureaucrats are so eager to impose on then.
Back in the 60s when Medicare was being debated AR wrote an article entitled "The Forgotten Man in Medicine". As we look at the gutting of sound medical practice today we can see that she could not have been more prophetic.
I knew a Doctor that gave up and now runs two McDonald's. Irony not withstanding.
I RARELY hear any of them speak of the joy of practicing medicine anymore. .
The comment I am responding to is spot on.
He will probably be very unhappy.
Finding a new doc whom you can trust is a tough thing to do. Best of luck & hope you don't have to spend a lot of time either.
I have been moving into biomaterials and tissue engineering the last couple of years. I know there are people out there working on an artificial pancreas. Would you like me to find out more on this for you?
If you can help find me adequate non-mooching and non-looting sponsorship, I would be happy to move my tissue scaffolding work toward pancreatic tissue engineering. Are there any Midas Mulligans in the Gulch with severe diabetes problems? Maybe I can help.
Regarding insulin, there are a few types of insulin that one can get without a prescription, but the newer brands (the ones that work better) are almost all prescription-only - thus the quandary posed by iroseland. And just as clarification, insulin is not interchangeable. It takes several weeks to several months to adjust to a new type of insulin, during which one's bloodsugar is in flux. Extremely low blood sugar (<80) can lead to blackouts and even death, while extremely high blood sugar (>400) leads to long-term problems such as kidney failure, glaucoma, and more, so staying on one's insulin regime is very important for both short-term and long-term health.
It is very frustrating that it takes so long for insulin to be approved for over-the-counter sales. Some part is the pharmaceutical company trying to recoup research and development costs - which I don't really object to. Another part is just FDA bureaucratic red tape, which is frustrating.
What is of more concern to me in this case was the hand-off of patient care, which was by this account lackadaisical. I would have expected a letter of retirement by the doctor or at very least a letter of explanation from the new doctor as well as a follow-up visit or call for all transitioning patients. I can see many opportunities for the market to offer impetus that are currently frustrated by government regulations, etc.
But otherwise, we're happy to take responsibility for all the other problems in the world.
If our benevolent government wanted to impact health care costs and at the same time cure a lot of people, it seems to me they would fund medical schools all over the country and open the flood gates to create many, many more Doctors. You see, in Columbus Ohio there are barber shops all over the place. and you can get a hair cut at Saturday's for $9.95. Grooming a toy poodle is different, Groomers are hard to find, good groomers even more so..grooming a toy poodle is at least a $50 deal. The analogy is this. If doctors, hospitals and clinics were like barbers and barbershops, the cost of medical care would go way down. IMHO we have a market distortion caused by insurance companies and made worse by government intervention. We should someday have an interest in insuring catastophes, and getting the government and insurance companies out of the Doctor's office.
And I'm so frustrated with my neighbors who continue to push for more government money - Pell Grants, scholarships, low interest loans, etc. in order to pay for college. If these fools would just open their eyes they'd see that these are the things that are causing the costs to rise in the first place. That, and the blatant redistribution of wealth system that is called "scholarships."
I can relate to what you say about seeing a doctor for 90 seconds just to get a script. during one of my visits, I asked my ex-GP a question about headaches and she actually said, "my alloted time with you has run out. you'll have to make another appointment." I asked her to repeat herself to make sure I understood her...she said the purpose of that particular visit was just to check on my levels, not bring up a new issue. I was very angry. I asked for my file and said I'd be leaving the practice. I went home and did my research. I now see a doctor that is part of a private practice. it was work to find a good doctor around here, but I'm glad I have one now. it is getting increasingly difficult to find doctors that are good, treat causes instead of symptoms, and treat you like a human being with worth. I am not looking forward to what's in store in the medical community in the upcoming decade. I don't blame doctors for going galt--not at all.
let us know how everything works out, rose. I wish you the best.
I too have run into situations similar to your experience. I accompany my sister (75) and a family friend (86) to their doctor and was exposed to their lack of professionalism. I advised them to retain a new doctor that didn't have that sort of attitude. My advice to anyone experiencing these types of situations is to immediately leave that practice and expose those doctors for the negligent and unprofessional conduct.
Sadly, doctors are no different than many other people in having lost all understanding of work ethics and an understanding of their professional responsibilities.
Fred Speckmann
commonsenseforamericans@yahoo.com
A compromise between right and wrong, is always evil.
Is it the doctors' fault? I personally don't think so. They are unfortunately caught in the pinch, and I don't blame the ones who are saying "screw it"...
I'd go more in depth but I haven't seen you post anything else here and as far as I know you just walked in the room called everyone crazy and walked out.