Making the patient come back also manages the Dr’s time more efficiently. If you build in enough time to handle everything, the Dr’s time is wasted if the checkup turns out uncomplicated.
Your pony needs to manage it’s time more efficiently.
Not necessarily. The instruction is for the patient not to bring up any issues. If a doctor does a thorough job he will ask a question (or maybe it will be on a form that you fill out) that will likely elicit whatever problem you are having. At that point it’s either charge more to deal with it or come back the next day.
Again, do not construe above to be a defense of the status quo.
https://twitter.com/Robinstigator/status/1527356888928915458
https://twitter.com/Robinstigator/status/1527356890551930880
https://twitter.com/Robinstigator/status/1527356891826835473
Absolutely fucking infuriating.
On a much less impactful note, I’m on my 5th different brand of ritalin. Each one shittier than the last. Until they finally landed on the shittiest one, and there it’s been stuck for years.
The difference in strength and in time to act between brands can be up to double. The pharmacy and my psych both swear that’s not possible. Apparently our pharma quality control is as corrupt as our healthcare billing systems.
it means you’re less likely to come back and complain about something that is going to cost the insurance company money
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I’m gonna need you to connect the dots on this one. The pharma company with the deepest pockets will likely be the one who originally brought the drug to market. Their incentive is to prevent others from making generics. So the effects of corruption should go the other way. Basically everyone who already has an approved drug will be incentivized to stop yet another version of that drug coming out, shitty or not.
At least, that’s how I see it. I’m not saying there aren’t other ways this could play out. There absolutely could be and I guess I can imagine some. I’m just curious at how you arrived at your conclusion.
I have no idea. I just know that the range between brands is gigantic - like on the level of buying coke on the street - except for the risk of getting total bunk.
I saved the strong stuff for hiking or working out when I need an energy boost. Half of one of the strong ones is like a full weak one (the only one I can get now). One strong one takes an hour to kick in, the other a half hour.
Methylphenidate (Ritalin) is super cheap so there must be a lot of generic manufacturers.
Why not just assume incompetence rather than corruption?
Well either way there should be much better quality control. Also it seems suspicious that the pharmacy landed on the weakest (presumably cheapest) brand after changing every year before that.
And we know regulatory capture by pharma companies is strong. See the senators who all quit to work for the pharma industry immediately after passing Medicare Pt. D.
My guess is that the FDA drug oversight that’s supposed to monitor these things is poorly funded and has weak enforcement powers - by design. Call that whatever you want.
One of these days the NYT or WaPo may print a big expose on lack of standards control in the drug industry. And everyone will be SHOCKED that the FDA rubber stamp isn’t working.
It’s also possible that my brand has the right amount of the drug, and the previous companies were goosing it to try to become popular and get customers to ask for it.
I hadn’t seen a primary care doc in pretty much my whole adult life until my early 30s. His advice was about every 3-5 yrs unless, of course, something comes up. I’m lucky in that I can get into specialists easily with my coverage. I also get my cholesterol checked on my own a bit more frequently than is recommended. If you haven’t had that done in 10yrs, that’s probably a leak.
Sounds closer to incompetence than corruption based on that.
Really not an important distinction to me at all. The corruption could have been in the drug companies successfully lobbying for the 80-125% equivalent, even knowing for some drugs it’s way too wide of a range.
Maybe not to you, but calling someone dumb and calling someone dishonest really are two different things.
I understand that either way you get shitty drugs, so your view makes sense. It’s just not the default assumption that most people would make.
The scenario that you are talking about and the one that victor is talking about are entirely different.
Also, I think your example is unlikely to be true. I realize you probably weren’t going for realism and just picked two random symptoms. However, a urinary tract infection could definitely cause someone to be fatigued. Probably an advanced bladder cancer could cause both things too.
Edit: I see you added some stuff. I fully accept that if the doc makes some sort of calculation that they are separate problems, then he might make the patient come back to deal with the less pressing one.
The corruption comes in the form of regulatory capture, not in envelopes of cash handed under the table.
I don’t know what this means.
It means the pharma industry owns congress and gets laws like this passed that allow them to legally push crappy drugs on people.
“Owning congress” sounds a lot cash under the table, or a cushy job, or campaign contributions or whatever. So I see no distinction between “regulatory capture” and “cash under the table”.
So either you agree the system is corrupt, or you disagree that regulatory capture has happened with the drug industry.