Concerns About Medical Practices When Prescribing ... - Page 3

Tinkrbl44 · ‎08-23-2010

@Nightowlz wrote:
It's a bunch of BS IMO.
They change what the normal should be so they can put more people on Big Pharma Drugs.
I have already told my doctor I'm going by what the levels on blood pressure, cholesterol etc used to be not by the changes they keep making.
I'm the patient I have a right to decide if I want to take what you are prescribing. Just because the doctor says I need it does mean I have to take it.
All I can say is good luck telling your doctor you won't take it. I have had doctors tell me to find a new doctor because I won't do as they say.
It's my body.
IMO the more Big Pharma drugs you take the more you will have to take & the more problems you have had. I have seen it.
I'm hypothyroid so I take NP Thyroid. If I did not have that I would never go to the doctor.
By the way all these doctors prescribe the new drugs which cost a lot more money. All you have to do if you need the drug is tell your doctor you will take a drug that has been out on the market for years with a history plus a lower price tag. Don't let them tell you there is not such drug. Most likely there is.

@Nightowlz @jubilant

Of course it's your body, and you don't need to take what your MD says you need.

Unfortunately, there's a serious malpractice consideration most people chose to ignore.

Example --- A person dies from some affliction, and a family member consults with a medical lawsuit attorney. Attorney says person would have lived IF the doc had prescribed XYZ Drug, so they sue for malpractice. Suddenly it's the doctor's fault that the patient wouldn't take the medication ..... and the family wants money.

Happens all the time, unfortunately, which is probably why they tell you to go to another doctor. They shouldn't be held legally liable if a patient is uncooperative! JMO

Doctors are "dammed if they do, and dammed if they don't" prescribe. (Misspelling intentional to avoid censorship, lol)

sfnative · ‎03-10-2010

@jubilant

Referring to your 50 y.o. friend, are you aware of her entire medical history? Having "normal" TOTAL cholesterol is not the end-all. I have "normal" total cholesterol (178), but my ratio is off. And, since I'm a chronic kidney patient, my nephhrologist has placed me on a minimum 2.5mg tab of Lipitor/day, which she indicated she now does with all of her patients in my basket. There has been research to back up her new protocol of prescribing this minimum amount per day.

I'll also add that I "got the gene" from one side or other side of my family, as my cholesterold went ape in 1999 out of the blue. That's when my Internist indicated I must have inherited a gene and it finally chose to kick in. I worked on my food plan and activity level like heck to get my numbers down, only to have my ratio remain an issue.

One of the lessons here is that you just never know through casual conversation what's behind a physician's reasoning in prescribing any drug, even given normal labs, as you state. Were all lab values in the last 5 years consistently the same? Were or are there clinical factors known only to the physician, which he/she failed to share with the patient? Also, understand that many people would rather da_n the medical and pharmaceutical profession, rather that speak truth about their own status.

My 2 cents worth, after a career in healthcare...

Tinkrbl44 · ‎08-23-2010

@Sooner wrote:
Medicine is a business. Once you get old enough and you have ANY sympton you are immediately a patient: On the treadmill until you die or they kill you.

@Sooner

Really? Pretty much everything is a business ..... at least all products and services, but obviously there is a lot more. So what? That's the global economy.

A LOT of medications now improve our quality of life.

That shouldn't make one suspicious. If you don't want to take a prescribed medication, don't take it. The next person may be very grateful for relief received from that prescribed medication, and not see it as a treadmill at all. Some people actually care a great deal about maintaining good health, and work with their doctors to do so.

Nightowlz · ‎03-11-2010

@Tinkrbl44 wrote:
@Nightowlz wrote:
It's a bunch of BS IMO.
They change what the normal should be so they can put more people on Big Pharma Drugs.
I have already told my doctor I'm going by what the levels on blood pressure, cholesterol etc used to be not by the changes they keep making.
I'm the patient I have a right to decide if I want to take what you are prescribing. Just because the doctor says I need it does mean I have to take it.
All I can say is good luck telling your doctor you won't take it. I have had doctors tell me to find a new doctor because I won't do as they say.
It's my body.
IMO the more Big Pharma drugs you take the more you will have to take & the more problems you have had. I have seen it.
I'm hypothyroid so I take NP Thyroid. If I did not have that I would never go to the doctor.
By the way all these doctors prescribe the new drugs which cost a lot more money. All you have to do if you need the drug is tell your doctor you will take a drug that has been out on the market for years with a history plus a lower price tag. Don't let them tell you there is not such drug. Most likely there is.

@Nightowlz @jubilant

Of course it's your body, and you don't need to take what your MD says you need.

Unfortunately, there's a serious malpractice consideration most people chose to ignore.

Example --- A person dies from some affliction, and a family member consults with a medical lawsuit attorney. Attorney says person would have lived IF the doc had prescribed XYZ Drug, so they sue for malpractice. Suddenly it's the doctor's fault that the patient wouldn't take the medication ..... and the family wants money.

Happens all the time, unfortunately, which is probably why they tell you to go to another doctor. They shouldn't be held legally liable if a patient is uncooperative! JMO

Doctors are "dammed if they do, and dammed if they don't" prescribe. (Misspelling intentional to avoid censorship, lol)

@Tinkrbl44

Well I still need a doctor to prescribe my thyroid medication.

Wish I did not have to take it because I would never go to the doctor.

I don't need them telling me I need this test or that test or this medication or that one.

They prescribe one only to cause other problems so they can prescribe another one & so on & so on. I'm not playing that game.

If I'm having a problem then we will discuss medication.

If I'm not having any problems & my labs are within range to my satisfaction don't try to push Big Pharma Drugs on me.

If my doctor had his way I would be taking high blood pressure medication plus statins. I don't need either one IMO.

If the doctor needs me to sign some paper saying I refuse xyz drugs/tests I will sign it.

My doctor is half my age & I feel he's a little intimidated by me.

At least this post reminded me I need to cancel that appt they made for me next month. I told him I'm only coming in 1 time per year.

jubilant · ‎06-10-2010

@sfnative

Yes, I think you make some good points. Maybe I shouldn't have said what I did about the pharmacueticals but I am not as trusting as I used to be.

I didn't tell the woman I was speaking to not to take the medicine. Your right, I don't know her history. I myself tried 5 different statins years ago and know that some people can take one of them and not the other. That was not true for me. My cholesterol has been (as my doctors say), "sky high". My triglycerides are pretty high, too and my good cholesterol is rarely over 30. It is hereditary. Both my parents had the same problem. Guess what, Mom will be 89 in Oct. and Dad passed away about a year ago at 89.

proudlyfromNJ · ‎05-01-2010

@jubilant wrote:
@proudlyfromNJ

Actually, I have had 3 medical people tell me this. My cardiologist, the PA in my cardiologist office (at my last visit) and my family doctor. I don't mind them stressing the importance of how they feel about it and even thanked them for their care and concern. I also explained to them that they haven't walked a mile in my shoes. I have other issues in my body....some stemming from other major surgeries and another that I have had since I was 18. I also told them that if I live to be 78, I will consider that pretty good. I think some people can't wrap their minds around that kind of thinking .....especially a doctor. One of them looked at me kind of speechless when I told him that so I said to him...."I bet I know what your thinking..I bet your thinking, this woman doesn't have a very strong will to live". He came back at me with...
"Yes, that is what I was thinking"...then he said "if you were my mother, I'd tell you to take this medicine". That made it really hard for me to tell him, no and I did feel sorry for him and told him how much I appreciated his concern. He put his hand on my arm and said, I don't mean to argue with you, but we will have to have this talk again in the future. I like him very much and I know he thinks that's what's best for me and that is why he is so adamant. He's doing his job and I'm making my choice.

@jubilant. I know this isn't going to sound right, but if your beliefs are this stong with everything you have posted, why see a Doctor at all? It sounds like you would be happier without the aggravation.

caw · ‎12-22-2015

I am a practing pharmacist of 32 years and just wanted to weigh in. Jubilant, you are absolutely correct that no one can make anyone else take a medication. Your relationship with your doctor should be a partnership, not a dictatorship. Just remember though that you pay your doctor to share his/her expertise.

I would like to address the situation of the friend who was asked to take a cholesterol medication even though her "numbers were in the normal range". When we treat to lower someones cholesterol, we treat to the patients RISK. Numbers are now a secondary endpoint. For example, if a person is a diabetic they are 2 to 4 times more likely to have a stroke or heart attack. This increased risk exists even in diabetics with "normal" cholesterol numbers. In diabetics the "sugar" is in the blood vessels instead of in the cells where it should be. The excess sugar causes inflammation in the blood vessel lining. Diabetes also changes the ability of the blood vessels to dilate and this affects blood flow to the organs.

Statin medications help to reduce the inflammation and restore the ability of the vessels to dilate and therefore allow blood to flow freely. Statin medications also stabalize cholesterol plaques. (even people with "normal" numbers can have plaque, diabetic or not). When a cholesterol plaque breaks off from the blood vessel wall, a clot forms around the plaque. The clot can stop the blood flow inside the vessel, and it can travel to the heart , brian or lungs. This is why we treat diabetics ith "normal" numbers with "statins"--simply put , it reduces risk and this is done by mechanisms other than changing the numbers.

If someone has high blood pressure , or if they smoke, or if they have a strong family history , they re also at increased risk of a stroke or heart attack.

The controversy around statins is how to calculate who is at a high enough risk to warrant taking one, it is not whether statins lower risk. Some people believe that for some groups, we overestimate the risk, and statins should not be prescribed.

If we go back to diabetes though, having diabetes a major factor for cardiovascular disease and whether or not your diabetes is controlled and whether your numbers are "good" or not, you are considered high risk and a candidate for "statins".

No other meds, not fish oil, not Niacin, not fibrates have any studies to show they reduce the risk of a stoke or heart attack. Remember, big pharma sells two prescription fish oil products and a prescription Niacin product. There are no commercials because there are no studies (and plenty of drug companies have tried) to show they reduce risk. Fish oil can change your numbers, and we use it to lower the chance of pancreatitis due to high triglycerides, but it does not reduce your risk of stroke/heart attack. This goes back to all the ancillary effects statins provide.

When someone only looks only at numbers I think they short change themselves. We changed to using risk as a reason to determine statin use because of the number of people with "good" numbers who were having strokes and heart attacks. Treating to risk is endorsed by the American College of Cardiology, the American Heart Asscociation and the American Diabetes Association (to name a few).

Lifestyle changes, ie diet and exercise should always be the first step in ANY treatment plan.

Always partner with a doctor you trust and who will listen to your concerns. There are many factors that go into determining "risk" and your doctor should be explaining this to you and discussing this WITH you. The decision for any treatment rests in the hands of the patient (as it should).

Continued health

Addie2118 · ‎11-05-2017

The only comment I have is why aren't doctors more educated when it comes to vitamins and other supplements? I have repeated asked for a list of supplements that would be beneficial to me. They just shake their heads.

hckynut · ‎03-10-2010

Hi @jubilant

I am not sure of your point here, so I won't say a thing.

hckynut(john)

q-girl · ‎10-05-2011

@phoenixbrd wrote:
All prescribed meds have side effects....was consistently in the ER years ago due to the blood pressure med Lisinopril. Now I always investigate and review alternatives and my lifestyle before turning to any medication suggested. Just like finances, I don't care how credentialed the financial planner or MD, we must be our own advocates.

Yesterday I attended a class on weight management at Kaiser. I was horrified at the information given by the registered dietitian and her constant proclamation that this is "based on scientific evidence" (maybe 50 years ago and very biased). What a hoot and pathetic.

Please, @phoenixbrd, if you will, what types of problems did Lisinopril cause for you? I am currently on that med for my BP, and would just like to compare symptoms. Thanks much.

Hugs . . . Beth

Life is tough, but I am tougher!!