Perhaps this is true for some. For me even in my telepsych job for patients that miss appts they only get enough meds till they can schedule with me and i make them come in and get checked by a clinical nurse and the whole encounter is documented. There is 0 financial incentive for me in this.
Also, is there any other business or profession where you can get a service ( in this case a refill which may i add comes with liability) without paying for it? Would a mechanic, dentist, plumber, lawyer, accountant ever provide service to ANY extent where their professional service was required with liability and do it for free? Medicine is a business first and foremost in this country.
The beauty is everyone else in the game is always taking advantage of doctors in any and every way possible and using guilt primarily to do it while they make the real money in healthcare. If physicians unionized from the beginning in this country the profits insurance companies get would be ours and the balance of where money in healthcare should be would be skewed to those making the actual clinical decisions.
eh, in primary care a stable patient on anti-HTN meds, and a whole host of other stuff, much of which I think may actually be more dangerous than say, SSRIs (but also may be quite dangerous to run out of) can get a year's worth of refills without being seen again, and it's NBD
granted, what you're using the SSRIs for very often warrants more f/u than this by virtue of what you're treating, perhaps
I imagine it may be more an issue of liability to not want to refill a psych patient's meds sight unseen, especially if there's been recent changes, especially someone who's having a hard time following up (might suggest social issues that would impact tx)
OTOH if my pt is a just a general ponyshow about getting in for refills on their metoprolol, whatever that might say about their mental health doesn't necessarily mean I'm doing wrong by refilling it after a cancellation, so it is a different beast
it's a different game, but I give people until their next scheduled appt, and then if they cancel, until the one after that, and I warn them at that point that 3 mos is the maximum time I'll give them to get in and get refills. I feel like with good documentation that stepwise way to go is justifiable, but then again, it depends on how risky the condition and the medication vs sudden d/c as well.
Lastly, professionals, when you look at what it means to be a professional by definition, do plenty of things to carry out their duties that aren't billed directly, and it is just sorta part of the service. I've had mechanics, dentists, lawyers, and accountants all work this way.
I get it that psych is sorta special with liability and f/u, and that the amount of "long distance medicine" that could in theory be practiced safely, isn't because liability is a real concern.
