drug abuse and or over-prescribing

[dr of rx]

Advertisement - Members don't see this ad

My wife went to her local MD with complaints of neck pain and constant headaches. On the advice of her PT sister, she was seeking a referral for physical therapy. The Dr's answer was Lexapro for the headaches and nothing more. (This is the 2nd Dr that wanted to throw an SSRI at her spinal/muscle issue). My wife flatly rejected the rx and after some time the MD agreed to physical therapy.

After only minutes with the therapist, he found displaced vertebrae (correct term?) and muscle spasm on the left side of her neck/back. But if she was like most of the public, she would have begun a lifetime of SSRI use (not to mention what other drugs they would try).

Is it just me, or is there an epidemic of drug over-prescribing? Why would any ethical, knowledgeable doctor treat a mechanical problem with Lexapro? The vertebrae were so out of line and the muscle was so tight that the therapist saw the problem as soon as my wife turned around. Would a doctor not even look at the problem area?

"Just start Lexapro 10mg daily for the headaches. Come back in 2 weeks." I guess that is the easier, revenue generating answer.

The public wants a quick fix for their problems. Also, going to see a doctor = getting a script EVERYTIME. But why does it have to be that way?

How many of the scripts that you fill are not necessary? And if so, is it unethical for us to fill them?

Seeing how many people get unnecessary Z-Paks, SSRI's given out like candy, and the gratuitous PenVK 250 BID rx, I would guess that at least 15-20% of my work is not necessary.

Doing the math, that means 600/rx per week or 31200/rx per year at my store alone are not necessary. Imagine the insurance savings to everyone if the scripts and ER visits were cut accordingly.

I understand our salary comes from rx's we fill, but is it right to sell someone something they don't even need???


ok, I feel better now.....rant off..

 

[WVUPharm2007]

SSRIs are the jack of all trades for neurological probs, so I'm not convinced they are overused, per se. There are about a bazillion indications for them, including migraine, which the physician may be thinking is the root cause for everything, I dunno. I'm not sure why the physician would chose that first for what (I assume) he wants to use to treat neuropathic pain, though.

 

[spacecowgirl]

The public wants a quick fix for their problems. Also, going to see a doctor = getting a script EVERYTIME. But why does it have to be that way?

I think you hit the nail on the head here. People are dissatisfied if they leave the doctor's office without an Rx. No mother wants to be told that her kid's OM will clear up just fine without antibiotics and in virtually the same amount of time. Doctors are running a business too and depend on customer satisfaction. I'm not saying it's right or defending those practices, but I think the pressure comes from the public and DTC ads and drug reps more than it does from MD laziness or negligence. I don't know how we can change this attitude, but I do think it would be a very uphill battle.

I do cringe with every Z-pak Rx, I can't lie. And I have told people not to fill one of the zillion stupid Rx cold preps that can be found for much cheaper OTC.

 

[MountainPharmD]

One thing I know for sure...You can't save people from themselves. If they are bound and determined to take a pill to cure all lifes ills I say let them.... Job security, besides who are we to decide what they "need". I believe that is the Docs job.....

 

[ZpackSux]

One thing I know for sure...You can't save people from themselves. If they are bound and determined to take a pill to cure all lifes ills I say let them.... Job security, besides who are we to decide what they "need". I believe that is the Docs job.....

Well said.

 

[dr of rx]

One thing I know for sure...You can't save people from themselves. If they are bound and determined to take a pill to cure all lifes ills I say let them.... Job security, besides who are we to decide what they "need". I believe that is the Docs job.....

It should be...but what if they are not doing their jobs? we all suffer. Their hand is forced by the publics expectations and the desire to run a business.

"you had a runny nose for the last 20 minutes? sure....take a Z-Pak."

"so you say there are pulled muscles and displaced vertebrea? Lexapro will fix you right up. If that does not work, you can be sure we'll try Effexor, Wellbutrin and Elavil. And mabye if you're lucky we'll chase it all with a life long addiction to Xanax."

 

[blueclassring]

Unfortunately, that is part of the latent function of visiting a doctor. No one is satisfied unless they receive something for their co-pay. If not, the patient feels ripped-off.

 

[MountainPharmD]

It should be...but what if they are not doing their jobs? we all suffer. Their hand is forced by the publics expectations and the desire to run a business.

"you had a runny nose for the last 20 minutes? sure....take a Z-Pak."

"so you say there are pulled muscles and displaced vertebrea? Lexapro will fix you right up. If that does not work, you can be sure we'll try Effexor, Wellbutrin and Elavil. And mabye if you're lucky we'll chase it all with a life long addiction to Xanax."

I am not trying to sound condescending but...Welcome to the world of modern day medicine. A prescription for everything, real or imagined, thats the deal.

In retail pharmacy we have a buisiness to run a well. If you owned your own independant pharmacy, how many people would you turn away because you perceived they were getting a prescription they did not "need".

 

[dr of rx]

I am not trying to sound condescending but...Welcome to the world of modern day medicine. A prescription for everything, real or imagined, thats the deal.

In retail pharmacy we have a buisiness to run a well. If you owned your own independant pharmacy, how many people would you turn away because you perceived they were getting a prescription they did not "need".

thats what I am saying...

I don't "turn anyone away" now. (other than the refill too soon Oxycontin cash paying dope-heads)

Oh well, screw it. I'll keep filling scrpits until my eyes pop out. How else will I get to retire early?

there is a new M3 coming out soon. I hope the ER is full of runny noses tomorrow! $$$

 

[meg]

My great grandmother's hip screws had come loose and her doctor just said she had arthritis and prescribed her Celebrex so yes I think it happens a lot!