lpnmajor Loc: Arkansas

There is a difference............a BIG difference.........yet most people wouldn't recognize either one. I was seeing a pain management Doctor, because AR law said I had to, trying to control the drug addicts don't you know. This Doctor had me coming in every two months, stating that the law required it - but - he forgot I was "in the biz" and knew better. The law required no such thing, in fact, the law allowed for 4 months of prescriptions for my medicine. This was HIS policy - because Medicare asked no questions and just paid him...for a 2 minute "exam" every two months. It took me longer to park my truck than he spent with me at each visit. I fired him, and the new prescriber gives me a 4 month prescription, saving Medicare $300...just on me....for that one medicine. Imagine 100 million people on Medicare, each being treated like a cash cow by each prescriber. My example could save Medicare 30 billion dollars a year .....for one drug. I reported this to Medicare..........who hasn't said a word.

We're spending all our time, energy and effort, talking about how to pay for shit, and no time thinking about WHAT we're paying FOR. Hospitals/clinics price treatments according to the patients pay source - not by what the treatment is actually worth. Pharma companies set prices based on the length of the patent/copyright, how much was invested, and how much profit the shareholders demand - not on what the drug is actually worth. Who sets the fees charged by specialists? I'll give you one guess.

I do case management ( by referral only ) for free, where I examine the patients history, current medications ( including OTC ) and treatments. I do NOT look at the patients pay source. 9 times out of 10, I find duplicate medications ( two BP pills from 2 different Dr.s ), medications that react with another medication ( pharmacies are SUPPOSED to catch these ), patients taking OTC's that counteract their prescription medicines ( Doctors are SUPPOSED to catch these ) and treatments that do not match the patients diagnosis. I find that fully 1/3 of the Doctors visits are not medically necessary, 1/4 of the medications are unnecessary and 3/4 of the ER visits by these patients are caused by medication/treatment errors. That's a hell of a lot of wasted money, not to mention being potentially deadly.

The reality today is, if the patient is not knowledgeable enough to be their own advocate, they HAVE no advocate, and are at the mercy of someone else's bad hair day. Nurses are supposed to be the patients advocate, but have become part of the problem....more concerned with correct billing than correct patient care. 4 years ago I was hospitalized due to a heart attack, I checked myself out "against medical advice" the very next day - because - my Nurses made 2 medication errors ( trying to give me an ACE inhibitor and a Beta blocker when my BP was 54/46 - twice ), the admitting Dr. refused to order my routine medications putting me in serious pain and the attending Dr. made rounds while I was asleep and didn't wake me. This was absolute bullshit. How many patients die as a result of this kind of crap? Giving someone a medication that will lower their blood pressure - when their blood pressure is danger low already - guarantees a code blue.

We are STILL looking at the wrong problems and asking the wrong questions. Old school doctoring and nursing could cut the Nations healthcare bill in half, at least, and make for a much healthier, happier and more productive citizenry. Wouldn't that be worth considering instead of who's gonna pay, to whom and how much?