What do docs care most about: You or their income?

[SnoreNoMore2005]

A question was rasied on a previous post about whether docs will take you off anti-depressants, anti-anxiety meds, or sleep meds and/or stop seeing you even if doing so means they will lose the income you generate for them. While most of us have met caring and compassionate docs (and who hasn't watched a heart-warming medical show on TV), I contend the majority of the docs are in business to make a "healthy" profit (no pun intended) .

My contention is you must take control of your own healthcare instead of completely relying on docs who will lose income if you stop seeing them. I realize some people will consider this blasphemy as they look at their docs as God's little helpers who would never, never, ever give you advice or have you take unnecessary medical tests that would increase their income. Those people can tell me I'm all wet, or at least give everyone the benefit of their opinions on why you should listen to your docs and never stop following their instructions.

SnoreNoMore2005

[Swordz]

I think people are quite nieve to believe that all people in healthcare are to help the good of people. That's just not so, and its not just that line of work. People exploit and seek to make money off others everyday in many careers.

My docs are geniune and honest, becuase if they weren't, I'd see another. My sleep doctor is another story, as he's uncaring and doesn't checkup with my health status at all.

Docs are just 1 part of this society that make me sick. (Unless you're a good one!) People have to be open to the idea that others are out to take advantage of you. Of course you balance that out that if you don't trust anyone, your life will be spent lonely and miserable.

Good docs great, crappy, for the money docs suck.

[Pad A Cheek]

Many caring people are out there trying to help patients like you and me. Sometimes they have to learn by experience. I have agreat doctor that is not the money grubbing kind. If anything my doc tries to solve as much as he can with a personal phone call. FREE I might add, he considers it part of an ongoing relationship with his patients. I wish the same for all of you out there.

[Jere]

My contention is you must take control of your own healthcare instead of completely relying on docs who will lose income if you stop seeing them.

Yes. The answer is yes. But there are so many variables that come into play, besides just greed. Many doctors wish they could spend more time with patients, but are prevented from doing so by rules mandated by the HMOs or the insurance companies. Also, some doctors just never develop a bedside manner (i.e. they are jerks).

In order to take control over my healthcare, I have chosen some doctors that have come highly recommended but do not participate in my insurance plan (or any plan). In the case of my primary care doctor, I have always been willing to pay more to get better care.

My sleep doc, fortunately, is in my plan.

If you want some real fun - try to get the doctors to talk to each other!

[Grabraham]

My contention is you must take control of your own healthcare instead of completely relying on docs who will lose income if you stop seeing them.

I see that as the key No matter what you think of your Doctor.

[Guest]

Okay....disclaimer here. I'm married to an ENT doctor.

Try to keep patients around to make money off of them? Are you NUTS? There are hundreds more patients where you came from, lined up to get in. DESPERATELY trying to get an appointment. If you actually know a doctor doing this...get another doc, because the good ones are so busy they are looking for ways to see FEWER patients not more.

Making money off of patients? Well, some types of treatments are profitable, yes. But many, many of my DH's patients don't pay at ALL. They have nasty, nasty head and neck cancers from years of self-abuse, they take hours and hours and hours of care, most of which cannot be billed to anyone (post-op care, etc., which can take MONTHS in the worst cases), plus phone calls made to the best doctors nationally to determine the absolute best, cutting-edge treatment for these people to give them the best possible remaining life. So you want to know HOW many patients do not pay at ALL? Now mind you almost every time they have ignored their health so badly they are desperately ill and take LOADS of time...about one in seven? One in eight? No Medicaid. No Medicare. Nothing. And they receive the same care as everybody else. Same as a millionaire. Because the goal is the same...make them better. A patient is a patient is a patient. And the ones with insurance help pay for the care of the patients without. Still and all..the patients get the treatments they NEED, and only that.

Keeping people on meds just to keep them coming in? How does that work exactly? I'm on about 6 meds myself...normally I only see my internal med doc once a year (this was a strange year--lots of minor problems popped up, including the need for surgery and CPAP), but normally only once a year. Any problems with the meds are handled with a phone call to the nurse. That makes her (my doc) money HOW? It only COSTS her in overhead. She cannot charge my insurance company for writing a script for meds and there are no kickbacks by the drug companies, I promise you. Yes, there are drug reps knocking on the door, but most doctors hate them and don't take the time to even SEE them. Don't have the time to see them if they wanted to. Also most doctors find it disgusting that a 20-30 year old sales rep with a 4-year college degree is trying to tell THEM what meds to prescribe? After all, did they go to med school? Are they actual pharmacists? What the heck do they know but the company propaganda? They are usually treated like the annoyances they are.

Most doctors do not make money by ordering tests either. Most tests are outsourced, the doctors have no financial interest. In the last six months, I've had six sets of bloodwork, three x-rays, an EEG, an ultrasound, a mammogram, hmmm, there is something else as well...oh, the sleep study. No prescribing doctor made a dime on any of those tests. All outsourced. A couple of the doctors didn't even make money on my followup doctor visit...they were considered post-surgical and included in the surgical fees. In fact many insurance companies now audit the doctors on how many tests they order and there are financial consequences for ordering too many. SOME doctors have invested in surgery centers, sleep centers, what have you...yes, they will make some money off their investment, but what drove them to do it was the incompetence of the hospital run programs and the inconveniences to both the doctors and the patients. They are striving to deliver medical care more efficiently which benefits everybody.

And yes, of course I know a couple of cynical docs who hate what they do. But basically, the vast majority of them are in it because they love what they do and are trying to help people. It makes the long hours they work more palatable. And basically it is like every profession...do what you love to do and the money will come.

Sorry, this topic came up while DH was on call. Since Friday morning he has had about 10 hours of sleep total...not because of sleep disorders either. He's only been home that long...the rest was covering patients from three hospitals, doing about 8 emergency surgeries, talking to emotionally overwrought families, telling people they are dying of cancer.....oh yeah, and you think inbetween it all he is prescribing meds just to get you back in the office next year???????????????? Oh, by the way, he gets off call 8 am Monday morning, just in time to start a 12-hour work day in his own practice, ready to play mind-games and cheat a whole new set of patients to pad his wallet. Yeah right.

Oh, and he is doing all this with a very, very severe cold, he has lost his voice, etc. So will he be taking a day off now to recover? Noooo, there are patients who made their appointments months ago and are worried sick about their conditions. They need to see him. They want and need answers. In 25 years of marriage he has taken ONE day off because of illness. I truly don't know any doctors who take off for being sick. Not only will it inconvenience the patients, but other doctors will notice the lack of dedication and refuse to refer patients to a slacker. It will ruin their entire reputation, both in the community and within the medical field.

My apologies. As I said, the timing on this thread was really bad. I tried to stay away from it, I really did......please forgive me if I stepped on a few toes. If you know a lousy doctor, please just change doctors. And realize that does not mean all doctors are lousy. If all they are doing is trying to make money, there are easier ways to do it, I assure you. By the way, no, I'm not in the least bit naive.

Jan

[Boomer]

I agree with most of what has been said, to this point. I have been through quite a few various docs over the years, various HMO's and traditional plans. I think I finally did find a good one. He has been my GP for the last 10 years.

He is also unique, he is an MD as well as a Chiropractor, and a homeopath. If he has the option, he would rather give me a list of supplements to take care of an ailment, rather than a prescription, as long as the supplements will do the job. If need be, he will prescribe whatever is needed.

I walked in one day, limping, from a severely irritated sciatic nerve, he gave me a few injections, anti-inflammatory, did a few chiro. adjustments, and I walked out of there, pain-free, in less than 30 minutes! Hasn't bothered me since.

Another example, I developed a loss of muscle control on the left side of my face, couldn't even close my eye. This was on a Sunday afternoon. Called his office, got his answering service, his nurse called me back in less than 10 minutes, told me he was out of town for the weekend, that I should go to urgent care. She said it sounded like Bells Palsy, but was best to get it checked out. It was Belles. Urgent Care told me to follow up with my regular doc in a few days. I did that, when I saw him, first thing he said to me was to apologize for not being available when I called, on Sunday! This may sound a little strange, but he also said there was really nothing that could be done for Belles, that it would have to run its course. He said, I love ya, but I can't help you with this, I'm sorry".

He has also calls, if I have not seen him for a while, just to see if everything is ok. That just blows me away. He is an awesome doc.

I think there are way too many docs out there, that are in the biz for reasons other than caring for other people, kinda sad really, but I think I'm pretty lucky to have found "one of the good ones".

Boomer

[Jan in Colo.]

I'm sorry, the least I can do before writing a rather heated post is to sign in. That Guest was me, Jan in Colo. I confess.

And now that I've vented and am all cooled down...the original poster made an excellent point. Yes of course you should be an active partner in your health care, be informed, and work with your doctor. No, none of them are perfect, none of them are saints. If you recall my story...I "prescribed" my own sleep study after having been DISCHARGED from the hospital with just a shrug about my oxygen saturation levels dropping to the 50's and 60's every night. I had to call my primary care doc and ask for a sleep study, because I didn't happen to think it was a shrugging matter.

Was the shrugger a bad doctor or uncaring? No, just out of his field. He had just done a rather complicated, very major surgery on me that took a LOT more knowledge and skill than a sleep study. He's a fine doctor and I'd recommend him to anybody...just stay in his field of study, lol.

Another example in the millions out there that yes, definitely direct your own health care in conjunction with your doctor. Listen carefully to what he says, ask questions, make suggestions, ask for second opinions.

Jan in Colo.

[neversleeps]

Thank you, Jan, for your intelligent, thoughtful and informed reply.

A question was rasied on a previous post about whether docs will take you off anti-depressants, anti-anxiety meds, or sleep meds and/or stop seeing you even if doing so means they will lose the income you generate for them.

Yes, SnoreNoMore2005, you raised this same question on a previous post. My opinion remains the same as it did in my reply to you then: To suggest that one must take the initiative to stop taking medications without a doctor's supervision under the pretense that the doc is only continuing to prescribe them as a money-making venture is stupid and dangerous.

By all means, as Jan said,

...definitely direct your own health care in conjunction with your doctor. Listen carefully to what he says, ask questions, make suggestions, ask for second opinions.

But your contention that the majority of docs are keeping patients medicated to line their own pockets is cynical at best; paranoid at worst. As Jan pointed out, the doc is not making money by prescribing medication!!!!!

[Janelle]

I'm one of the lucky ones with several great, really great Drs, a cutting edge GP who actually reads all the journals and is looking for more to learn about conditions her patients have and is a fantastic diagnostician --who would have known that my chronic bronchitis was caused by allergies when I had no allergic rhinitis, etc? My orthopedist is considered one of the best in the area, my Spine and Pain Dr., has saved me from surgery numerous times and has total control of any pain meds I'm prescribed. My Sleep Dr. is also a highly trained Neurologist and very up-to-date on OSA treatments, even if he doesn't like my 420E because he feels it is too aggressive. He prefers the Resmed, but he is very pro APAP, although he'll prescribe a BiPap or even an ST if he feels a patient needs it. The thing is he KNOWS what you need for your condition, and mine has challenged him and his Nurse Practioner more times than I can count with my insomnia, my lack of deep sleep even after trying two medications, my disturbing number of Central Apneas (he thinks they are probably pressure induced) and he/she listen to my request to keep my dosage at a level where I feel comfortable even if it is not where they would *like* me to be. I take them a readout for the last 96 hours each time I go in, which is about every 3 months, which they look over and then put in my file. I'm given the results of whatever test they have recently done and a copy for me to take home. I've had MRIs of my brain, EEGs to figure out why I basically passed out when I had my wreck without feeling drowsy, and am on medication for that which they feel was some kind of seizures. They are worried about my 33 pound weight loss and say if I lose much more they will have to change my deep sleep medication again. Told them if I got much below a size 10 I'd consider it, but my weight seems to have leveled off for the time being, while I was losing 2 pounds a week, which is slow and I feel better than I have in ages.

But when I go in next time, I'll have to confess that I don't think I'm dreaming (another problem, no REM sleep), so they might change the medication or insist I up the dosage. But the point is they care.

I have a friend on CPAP for almost as long as I have, a bit less than a year. I asked if he had been retitrated and he said he hadn't even seen his sleep doctor for 2 years, which I guess means he seen the NP. He's on a CPAP set at 17, and even after all those months hasn't lost a pound. I told him he should have if he is getting correct sleep, but he doesn't seem to care. He has heart problems, diabetes and high cholesterol. I have given him medical papers copied off the internet which show that CPAP will reverse the cholesterol and diabetes, and his wife says the Diabetes Dr. said no it won't. I told her, read the papers, and she said she did, but she felt they held out false hope. I told her many people had been able to lower their dosage and get entirely off it, but she still doesn't believe me. I've told both of them about this forum, and they haven't even taken a look. How can people go along like this. He's even had the same mask for nearly a year. I told him to call his insurance to see if they would pay for a replacement, and he hasn't. I hate to hound him all the time, but to me he is really pretty much killing himself by not getting correct treatment.

[Swordz]

Makes you have a new perspective once you hear from some1 that is affected by it everyday. Your perspective is well appreciated Janelle.

I think everyone also needs to realize that doctors, and yes even lawyers (!), are people when they come home. They are our friends, family, etc.

Plainly put, if you've got a good doc, keep them! If you got a bad one, get rid of them, find a new one, and make sure everyone knows about that bad doc.

Keep on truckin Jan!

[Oh 2 breathe]

Here in Canada its not so much that they are money grubbing as they just don't have enough time to do their jobs thoroughly or to keep up with all the latest treatments. I know a few doctors and psychiatrists who are literally run off their feet and would never want to trade jobs with them even though their incomes are much higher than mine.

I agree with others who have posted above that ultimately the only solution is to take charge of our own health care and seek out as much information on our own as possible. Sites like this one are invaluable! I've learned way more here than a doctor would ever have the time to tell me.

~ OTB

[Colorado Jan]

I agree with others who have posted above that ultimately the only solution is to take charge of our own health care and seek out as much information on our own as possible. Sites like this one are invaluable! I've learned way more here than a doctor would ever have the time to tell me.
________________________________________

Yes, this site is an excellent source of information and you DO get more information than a doctor could tell you!

In my case, my internal medicine doctor ordered the sleep study for me. I met with her to go over the results, and she was surprised that SHE was supposed to write the prescription for CPAP, but that was what I had been told by the sleep center. So I told her exactly what she needed to write down, based on what I had read on this site, lol. "Make sure you specify heated humidifier and you have to write down how much pressure I'll need and see? It's written right here on the sleep study...." I'm not sure she had ever done it before!

Couldn't haev done it without CPAP.com.....

Jan in Colo.