What do you think about this problem?

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orchidd

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The FDA is considering expanding the number of prescription drugs it converts to over-the-counter status. This may include birth control pills and antibiotics. So are you supporting or against this issue? so what is your opinion on this?

Thanks!

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I'm against it.

First of all, antiobiotics seem to be overly used even as a prescription drug, which has led to some of the resistant strains we are now seeing. By placing them over the counter then patients will self medicate when they do not need an antiobiotic. Also, which antibiotic would they choose? Different drugs treat different bacteria.

As for BCP, again, so many varieties which are hit and miss even when you see a doctor, but would be even more so with the patient trying to selct for themselves.

Also, like some other meds that have gone OTC, most insurance then will no longer cover the cost. So, I;m sure the insurance compnaies have their hand in this as well.
 
against!!!!!

antibiotics: b/c resistance and everything else

BCP: b/c there could be problems and the woman should have a pelvic done!

There is no way MDs would be for this... has the AMA issued anything yet?
 
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Totally against both.

I had a hard enough time with infectious disease in therapeutics. I'm sure the average Joe wouldn't have a clue what antibiotic to choose. They'd also start them for viral infections, stop taking them too early, etc.

For BC, how would a person know to adjust her progestin content on her BC if she had some breakthrough bleeding on day 8 of her cycle? That's insane.
 
"This may include birth control pills and antibiotics."

I'd be really interested to know which antibiotics would be the frontrunners.

But I agree with everyone else, seems like a dumb idea.
 
orchidd said:
The FDA is considering expanding the number of prescription drugs it converts to over-the-counter status. This may include birth control pills and antibiotics. So are you supporting or against this issue? so what is your opinion on this?

Thanks!
I doubt those products will ever make it to OTC...and they shouldn't.
 
bananaface said:
For BC there are studies showing that a pelvic is not necessary prior to starting, but that a careful verbal medical history and blood pressure measurement are.

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=11325325

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15192060&query_hl=4
women need a pelvic done whether or not they are going to be on BC if they are sexually active...

i know i personally would NEVER have one done if it wasn't absolutely necessary.
i mean ewwwwww....
 
bbmuffin said:
women need a pelvic done whether or not they are going to be on BC if they are sexually active...

i know i personally would NEVER have one done if it wasn't absolutely necessary.
i mean ewwwwww....
Even though pap smears are important, not having one performed should not prevent women from accessing contraception. It's an inappropriate gatekeeper system. Even with a bad pap smear, women will not be denied birth control.
 
against!

It will just lead to the pt coming to the pharmacist in a retail situation asking which antibiotic/BCP is better for these symptoms. The middle men, ie the physician and we future pharmacists are necessary to make sure the pt is getting the appropiate treatment.
 
Definately against! Antibiotics are over prescibed and misused as it is... we don't need to make them more available and encourage the development of any more resistant strains. Besides, some antibiotics are targeted for specific types of bacteria- how is the patient to know which drug is appropriate for a given infection or even diagnose that infection correctly?

For BC- I agree the morning after pill should be OTC but regular (maintenance?) BC should require a rx because of the possible complications that might develop. Also, other forms of contraceptives are OTC (ie. condoms) and many people don't use them because of the cost. Do you think providing OTC BC would actually increase the number of people using it? I would think many people would be discouraged because of the increase in cost when the insurance no longer pays for it.

Anyway, just my opinion.
 
I agree with putting more prescriptions drug OTC in the pharmacy.

several reasons:

scripted drugs allow the physician to be the gatekeeper to drug access. by allowing more drugs otc, this will put the decision in the pts hand and , most importantly, in the PHARMACY, since pt will invariably ask the pharmacist about the drugs and thier proper usage. Maybe then we can utilize more of our education and be compensated for the svc. pts benefit because they don't have to go thru many gatekeepers to get some Z-pak for a simple infection. the role and importance of the community pharmacy will increase. however this will strip some power from MD especially the GP that treat common ailments. The AMA will fight tooth and nail to prevent this.

some antibiotics and other drugs which are scripted in the US are OTC in many countries. the role of the pharmacists as health care provider in these countries are quite important.

a side note, whether the pt pays out of pocket for OTC or the insurance pays for scripts is a moot point because when it all comes down, someone have to pay and the patient is the one that pays for their drugs whether directly or indirectly, whether it is upfront or as company "benefits" which is still part of the worker's total compensation package. there is no such thing as a free lunch.
 
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bananaface said:
Even though pap smears are important, not having one performed should not prevent women from accessing contraception. It's an inappropriate gatekeeper system. Even with a bad pap smear, women will not be denied birth control.
i'm thinking more along the lines of STDs...
 
ccpbruin said:
I \. pts benefit because they don't have to go thru many gatekeepers to get some Z-pak for a simple infection.


Oh man....simple Zpak....that's the opinion that needs to be changed! As most people know, after you have ID, that azithromycin is not a simple antiobiotic, it is a pretty powerful one. We definitly don't need to be passing these out for "simple" infections. If that happens, give it 2 years, and it will no longer be able to be used for the type of infection it was meant to be used for, ie pneumonia, etc becuase of resistance from misuse. THere is definitly a reason that people need to go thru "gatekeepers" to get antiobiotics. And I firmly believe that shoudl stay in place. A good example of overuse of antibiotics is in acute otitis media. Now, low-dose amoxicillin can no longer bu used, it must all be high-dose. Just wait another 5 years of overuse, and amox will no longer be able to be used at all...

Just my two cents.
 
zpak is not a simple antibiotic, if you read my post carefully. it generally have less drug interactions and side effects than some of the others. alot of MD's are already giving antibiotics, like z pak and zithromax to peds and adults, based on a "probaBILITY" of a bacterial infections. WHY you may ask? because the office visit is 15 minutes and no doctor will order a culture to determine what the specific bacteria is before giving a drug that specifically targets that bug. economics would not allow it. its easier to give an antibiotics and see if the pts symptoms will improve.

my point is by shifting drugs from prescription to otc, you will shift some of the clinician roles from the MD office to the pharmacy. who will benefit from this?? We will, the pharmacists. people will go to the pharmacy to get a recommendation for a drug for their ailments just like how its done in alot of other countries with scripted drugs on otc. we can even charge the pt for the triage and recommendation. the dreams of the pharmacy gods can be finally fulfilled.
 
ccpbruin said:
who will benefit from this?? We will, the pharmacists.
uh...and what happened to patient safety?
 
rxgal8 said:
uh...and what happened to patient safety?

patients safety is best served when the people are in control of their own healthcare and makes their own informed choices. don't underestimate the people. you'd be surprise how educated the general public is especially in these age where information is at your fingertips literally and a bachelor's is an entry level degree.
 
ccpbruin said:
patients safety is best served when the people are in control of their own healthcare and makes their own informed choices. don't underestimate the people. you'd be surprise how educated the general public is especially in these age where information is at your fingertips literally and a bachelor's is an entry level degree.
Actually in low-income communities, a lot of patients can't speak english, don't have access to the internet, don't even know what "antibiotic" means, etc. I don't think antibiotics or BC's should go OTC. The average person does not understand or even know about antibiotic resistance. We already have a problem with resistance, imagine what would happen if antibiotics went OTC. I don't think patients should start diagnosing themselves and treating their viral infections with antibiotics, and so on.
 
rxgal8 said:
Actually in low-income communities, a lot of patients can't speak english, don't have access to the internet, don't even know what "antibiotic" means, etc. I don't think antibiotics or BC's should go OTC. The average person does not understand or even know about antibiotic resistance. We already have a problem with resistance, imagine what would happen if antibiotics went OTC. I don't think patients should start diagnosing themselves and treating their viral infections with antibiotics, and so on.


if you read my previous post carefully, you will realized that by having SOME prescription go otc in the pharmacy, this will allow the pharmacists to develop a stronger clinician-patient relationship. the patients that do not understand will have a pharmacists to help them choose the right drug tx, just like what we do now with naproxen, ibuprofen, & sudafed etc. community pharmacy can change where the pharmacists are more involved CLINICALLY as a health care provider.

You're under estimating people. do you see rampant GI bleeds in poor communities from abuse and incorrect use of NSAIDS? More drugs going otc= more opportunities for involvement of pharmacists as clinicians utilizing our 6+ years of education. the MD's and their powerful AMA lobbying group knows this. They are the real legal "drug dealers", gatekeepers of drug access. Pharmacists are not the "drug dealers" if you think about it. We only "deliver" the drugs once the MD has "deal" the drugs to the patient( in the form of a script). Alot of people are tired and jaded of this setup. Why do you think the herbal,vitamin, & alternate medicine industries are a multi-billion dollars operation?? Alot of folks, especially the educated 401-k baby boomers, want to have direct control and choice over their healthcare.


a side note, bacterial resistance to drugs is part of the natural process. organisms get threaten with their survival, organisms evolve and adapt to survive. humans adapt and invent new drugs to fight organisms. circle of life. the key is whether bugs are adapting faster than we can invent.
 
ccpbruin said:
patients safety is best served when the people are in control of their own healthcare and makes their own informed choices. don't underestimate the people. you'd be surprise how educated the general public is especially in these age where information is at your fingertips literally and a bachelor's is an entry level degree.

You can't be serious. Have you ever talked with the general public?
 
imperial frog said:
You can't be serious. Have you ever talked with the general public?


Have you?
 
People need clinicians to choose appripriate antibiotics, period. Not all antibiotics work on all bacteria. And the type of bacteria likely to be involved vary by type of infection and sometimes region. The public is simply not educated enough to make appropriate clinical decisions. There is no reason to believe that people would consult us on antibiotics or BC pills any more often than they do with any other OTC product. That's simply not enough. Why would we want to advocate a system which is not in the best interest of the patient and also reduces reimbursement for our services?

Industry has been developing money makers instead of focusing on antibiotics lately. It's not like we are going to just pull a new antibiotic out of our butts. If what we have now is no longer effective, we are seriously screwed.
 
Pretty much every single day of my 25+ year working life. True, a lot of educated people out there would take the time to research a little before they popped something into their bodies, but I also know a hell of a lot of educated people who wouldn't do the necessary research. And I know and have worked with a hell of a lot more people who won't talk with a pharmacist and will take an OTC product because they assume it's going to be perfectly safe simply because it has that OTC label. And bonus...they don't really have to talk to someone about the embarrasing infection or their sex life now...because most people just won't.

By assuming that everyone has "fingertip access" to information and, more importantly, the ability to process it adequately, you're ignoring the needs of those most at risk.
 
Case study:

My bf's brother, 29, educated master degree etc... his dentist gives him amoxicillin 8 at a time with PRN refills, prophylaxis for a heart condition. He takes it whenever he "feels sick, and it works." He's a sickly person in general. He thinks abx should just be over the counter and there's no changing his mind. He hates pharmacies and gets his drugs online.

I don't know what to do about it. I don't think that dentist should be giving him PRN refills. Should I do something? What would I say?

My bf also took some of his brother's amox and I punished him. He'll never do it again. :oops: I don't know how to educate people without resorting to physical violence though....

(him->) :D+pissed+ (<-me)
 
ccpbruin said:
if you read my previous post carefully, you will realized that by having SOME prescription go otc in the pharmacy, this will allow the pharmacists to develop a stronger clinician-patient relationship. the patients that do not understand will have a pharmacists to help them choose the right drug tx, just like what we do now with naproxen, ibuprofen, & sudafed etc. community pharmacy can change where the pharmacists are more involved CLINICALLY as a health care provider.
Not all patients will ask pharmacists questions on OTC meds. They'll just assume that since they're OTC, they must be safe. And plus they'd rather just take the med than reveal what medical condition they have.

You're under estimating people. do you see rampant GI bleeds in poor communities from abuse and incorrect use of NSAIDS?
You don't?

More drugs going otc= more opportunities for involvement of pharmacists as clinicians utilizing our 6+ years of education.
Yes, I totally agree that if more drugs were OTC, pharmacists would play a bigger role. However, you have to understand that by making a drug OTC, we can't control it. Patients can buy it with or without asking advice from us. Besides, OTC drugs aren't always purchased at a pharmacy's register.

Pharmacists are not the "drug dealers" if you think about it. We only "deliver" the drugs once the MD has "deal" the drugs to the patient( in the form of a script).
That's because we aren't trained to diagnose, MD's are. So how would we prescribe without knowing what we are treating. Our job is to check for interactions, etc.

Why do you think the herbal,vitamin, & alternate medicine industries are a multi-billion dollars operation??
As opposed to pharmaceutical companies??? Other factors play a role as well, eg marketing.

Alot of folks, especially the educated 401-k baby boomers, want to have direct control and choice over their healthcare.
They may want to, but don't have the knowledge to effectively treat themselves.

a side note, bacterial resistance to drugs is part of the natural process. organisms get threaten with their survival, organisms evolve and adapt to survive. humans adapt and invent new drugs to fight organisms. circle of life. the key is whether bugs are adapting faster than we can invent.
So we shouldn't care about antibiotic resistance? You don't think there's a possibility that we'll run out drugs to treat bacterial infections if antibiotics are overlyused for the wrong purposes?
 
<< by allowing more drugs otc, this will put the decision in the pts hand and , most importantly, in the PHARMACY, since pt will invariably ask the pharmacist about the drugs and thier proper usage.>>

For every 1 person that asks a pharmacist a question there are going to be twenty (and that's being generous) who don't. There are already millions of dollars spent annually due to complications due to medication interactions and misuse. Putting these drugs OTC would only make the situation worse.

Are you a pharmacy student or a medical student? Because if you are, you must not value your education. You're basically implying that the public can chose the best medication for themselves over a trained pharmacist or physician. Why is that? Just because the public is "more educated", and I beg to differ, doesn't mean that they have the training than pharmacists and physicians have.

As far as antibiotics go, dosing is critical, especially for peds patients. The dose is usually based on weight and not by age, and I'm sorry, but the general public is not familair with units like mg/kg. Not to mention the public health fiasco this will create when all the bacteria out there become resistant to every antibiotic we have.

As far as the birth control, women need to see a gynecologist and be tested for STDs,have a breast exam, and have a pap done. With OTC access to birth control, most women would no longer do these things. I can picture women messing horribly with their bodies by thinking things like "Although I bought Ortho-Tricyclin last month, Target is having a sale on the Lo-estrin, so I guess I'll try that one this month." Drugs aren't like toothpaste, but I could see this happening.
 
orchidd said:
The FDA is considering expanding the number of prescription drugs it converts to over-the-counter status. This may include birth control pills and antibiotics. So are you supporting or against this issue? so what is your opinion on this?

Thanks!

Hi orchidd. I am interested in this and would like more info - does anybody know a source about this - which drugs specifically they are considering?

I would certainly support this for some drugs. Abx - no. OCP - probably yes.
 
I tend to think that going straight to OTC status with these drugs is nuts. On the other hand, the creation of another class of drugs that require pharmacist counselling or approval before use, but not subject to a prior visit to a physician would most likely be beneficial. As far as the education level of the average public is concerned, I have read a number of sources indicating that the average reading level of most adults is only a 5th grade reading level. I have seen and been in contact with a number of people who are entirely illiterate and others who simply don't speak the language well and make many mistakes.
 
Against antibiotics for all the reasons already mentioned by everybody, we are overmedicated population. However, have you ever considered BCP w/out prescription, OTC, but dispensed only by pharmacists, to describe dosage, side effects, etc?
 
Ugo said:
Against antibiotics for all the reasons already mentioned by everybody, we are overmedicated population. However, have you ever considered BCP w/out prescription, OTC, but dispensed only by pharmacists, to describe dosage, side effects, etc?

That seems logical to me.

Although, the insurance issue is not solved. Many plans do not cover OTC, so a woman who normally got her birth control pills for $5 (or free) now must pay $20.
 
rxgal8 said:
Not all patients will ask pharmacists questions on OTC meds. They'll just assume that since they're OTC, they must be safe. And plus they'd rather just take the med than reveal what medical condition they have.


You don't?


Yes, I totally agree that if more drugs were OTC, pharmacists would play a bigger role. However, you have to understand that by making a drug OTC, we can't control it. Patients can buy it with or without asking advice from us. Besides, OTC drugs aren't always purchased at a pharmacy's register.


That's because we aren't trained to diagnose, MD's are. So how would we prescribe without knowing what we are treating. Our job is to check for interactions, etc.


As opposed to pharmaceutical companies??? Other factors play a role as well, eg marketing.


They may want to, but don't have the knowledge to effectively treat themselves.


So we shouldn't care about antibiotic resistance? You don't think there's a possibility that we'll run out drugs to treat bacterial infections if antibiotics are overlyused for the wrong purposes?



again you are under estimating the general public. stop having a paternalistic view. control & marketing?? marketing is to get the information out and people decides. people buys and use alternate med and vitamins because they want to and there are no gatekeepers and hassles. its a multibillion dollar industry because people "vote" with their dollars. thats what they want. they are not dumb as you believe. you are assuming that marketing tactics trick people to buy and they don't know what they are doing. again the general public is not that dumb. free will is the key here. a communistic view of health care is not good. Again otc NSAIDS are quite "dangerous" in your communistic and paternalistic view. ARE there rampant gi bleeds up and down main st. USA?? people are not dumb as you think.

again the key is that people are not as dumb as you would like.

another thing. if you had some real life experience you would know. we dont check interactions...the computer checks interactions. flag it then we determine whether its clinically relevant. no pharmacists can remember all the drug interactions out there. the sad part of this is that MD's also have the clinical judgement to determine what interactions is relevant if they had access to a drug interactions database when "dealing" out the drugs. you obviously have not been in pharm school long; we take 2 -3 years of therapeutics, how do we not know what to treat??? pharmacy school is not all about remembering drug facts and interactions, thats what a computer is for.

the bottom line is that for pharmacy to move into the future and thrive, we need to be more clinically involved in healthcare. perscription going otc will lead to that. IT will shift some of the clinical roles from the MD office to the pharmacy.
 
gablet said:
That seems logical to me.

Although, the insurance issue is not solved. Many plans do not cover OTC, so a woman who normally got her birth control pills for $5 (or free) now must pay $20.

5 dollars or free??? there is no such thing as a free lunch. money don't appear out of no where. the woman is paying indirectly thru her insurance premiums and company fringe benefits which is part of the whole compensation package in which the company "barter" in return for her labor. she pays either directly or indirectly.
 
OSURxgirl said:
<< by allowing more drugs otc, this will put the decision in the pts hand and , most importantly, in the PHARMACY, since pt will invariably ask the pharmacist about the drugs and thier proper usage.>>

For every 1 person that asks a pharmacist a question there are going to be twenty (and that's being generous) who don't. There are already millions of dollars spent annually due to complications due to medication interactions and misuse. Putting these drugs OTC would only make the situation worse.

have you ever thought maybe that "twenty you mentioned" might not need your help. that they actually know how to read the back of the box and inserts then use the otc drugs correctly??? don't assume the general public is dumb.



Are you a pharmacy student or a medical student? Because if you are, you must not value your education. You're basically implying that the public can chose the best medication for themselves over a trained pharmacist or physician. Why is that? Just because the public is "more educated", and I beg to differ, doesn't mean that they have the training than pharmacists and physicians have.

I value my education, thats why I want to increase the role of pharmacist.


As far as antibiotics go, dosing is critical, especially for peds patients. The dose is usually based on weight and not by age, and I'm sorry, but the general public is not familair with units like mg/kg. Not to mention the public health fiasco this will create when all the bacteria out there become resistant to every antibiotic we have.

mg/kg??? you must be kidding me. :laugh: ratios are taught in elementary, again repeated in jr high and high school. and alot of folks these days have at least a college education. again people are not dumb.


As far as the birth control, women need to see a gynecologist and be tested for STDs,have a breast exam, and have a pap done. With OTC access to birth control, most women would no longer do these things. I can picture women messing horribly with their bodies by thinking things like "Although I bought Ortho-Tricyclin last month, Target is having a sale on the Lo-estrin, so I guess I'll try that one this month." Drugs aren't like toothpaste, but I could see this happening.


thats what a pharmacist is for in a pharmacy selling otc drugs. do YOU value YOUR education???????
 
I DO value my education BUT I am also a realist. I have worked in various pharmacy settings for years, and I can say with much certainty that the general public is not educated--and definitely not to the level that pharmacists are. A few months ago in AJHP they had an article about just how bad the health literacy problem is in this county.

They have also done studies which have revealed that although the average person can understand a DTC print ad pretty well, the average patient information sheet given with a medication is not readable or understandable by most. If you want actual stats, I will dig out my old class notes. I'm pretty certain if a patient cannot understand a patient information sheet, that they will also have difficulty understanding instructions on OTC products.

You say this will give pharmacists more of an opportunity to counsel. What about patients that come in when the pharmacy isn't open? And for you to think that only 1 in 20 of the general public is going to need counseling is crazy. 1 in 20 might think they need counseling, but the truth is, everyone taking antibiotics or birth control pills needs counseling, and pharmacists will not have the time or staff level to provide that.

And trust me, most people aren't going to understand things like mg/kg. My husband graduated college with a 3.8 and has a 3.9 grad school GPA in a non science related field, and he had no clue what I meant by mg/kg.

Because I value my education, I want to use it in REALISTIC, DOABLE, and SAFE ways to improve the lives of my patients. I know it's hard to believe in this fast paced, consumer-driven world, but SAFETY is more important than CONVENIENCE.
 
bananaface said:
The incidence of metronidazole 'allergy' would certainly go up!


Hahahahaha....I love it! :laugh: Cheers to that! (and undoubtably that would happen all the time if abx went otc...shudder)
 
ccpbruin said:
again you are under estimating the general public. stop having a paternalistic view. control & marketing?? marketing is to get the information out and people decides. people buys and use alternate med and vitamins because they want to and there are no gatekeepers and hassles. its a multibillion dollar industry because people "vote" with their dollars. thats what they want. they are not dumb as you believe. you are assuming that marketing tactics trick people to buy and they don't know what they are doing. again the general public is not that dumb. free will is the key here. a communistic view of health care is not good. Again otc NSAIDS are quite "dangerous" in your communistic and paternalistic view. ARE there rampant gi bleeds up and down main st. USA?? people are not dumb as you think.

again the key is that people are not as dumb as you would like.

another thing. if you had some real life experience you would know. we dont check interactions...the computer checks interactions. flag it then we determine whether its clinically relevant. no pharmacists can remember all the drug interactions out there. the sad part of this is that MD's also have the clinical judgement to determine what interactions is relevant if they had access to a drug interactions database when "dealing" out the drugs. you obviously have not been in pharm school long; we take 2 -3 years of therapeutics, how do we not know what to treat??? pharmacy school is not all about remembering drug facts and interactions, thats what a computer is for.

the bottom line is that for pharmacy to move into the future and thrive, we need to be more clinically involved in healthcare. perscription going otc will lead to that. IT will shift some of the clinical roles from the MD office to the pharmacy.
My views are paternalistic and communistic???

You might want to read the APha Code of Ethics, and you'll notice a combination of beneficience and autonomy. I don't know what kind of pharmacy experience you have or how much interaction you've had with patients (obviously very little) but for the past 4 years I have worked in several places, including OC (even there, the patients are not as knowledgeable as you may like to think). Look at the facts, you can't just assume that the general public is brilliant. The average reading level is 7th grade. And for the marketing comment, a lot of the nutritional supplements sold are not as beneficial as patients think they are. We live in a capitalistic society, that relies on marketing. Obviously the general public doesn't know enough to realize which supplements would actually benefit them or not, hence the high sales.

It's not about how dumb I would want people to be. Face reality!

Are ALL 300 million people in the USA knowledgeable enough to diagnose themselves and then treat it with the appropriate medication??? When you say general public, you have to include EVERYONE. And please realize that not everyone will ask a pharmacist for advice before purchasing an OTC product.

Again, I don't know how much pharmacy experience you've had, but computers don't catch everything, why else would pharmacists be needed then? They could just have drug vending machines in doctor's offices. You value your education so much yet doubt that you will be able to use it???

I've been in pharmacy school, or any health profession for that matter, long enough to KNOW that 2-3 years of therapeutics is not enough to diagnose a patient. There's a huge difference between what doctors are trained for and what pharmacists are trained for. I hope you will realize this soon!

Thanks.
 
ABSOLUTELY! I have worked in general public pharmacy for 10 years.Well put, my friend. People would eat shoe polish if they 'heard it on tv' that it would cure something. :confused:

bananaface.."The public is simply not educated enough to make appropriate clinical decisions. There is no reason to believe that people would consult us on antibiotics or BC pills any more often than they do with any other OTC product."
 
I'm paternalistic. Patients do not always understand what is in their best interests and it is part of my role to enforce certain boundaries.

I have to admit, I'm not quite sure what the term "communistic" is being used for, except perhaps as a means to push buttons. If there were a spectrum between personally funded and government funded healthcare, almost every one of us falls in the middle somewhere. I don't know that many of us would turn away every person with an inability to pay for services, nor would we want all healthcare services channeled through the government.
 
ccpbruin said:
5 dollars or free??? there is no such thing as a free lunch. money don't appear out of no where. the woman is paying indirectly thru her insurance premiums and company fringe benefits which is part of the whole compensation package in which the company "barter" in return for her labor. she pays either directly or indirectly.

I am talking about copays. I am not on BC anymore, so I will give another example. I was prescribed prilosec and my insurance company did not cover it because it is offered OTC. So, instead of the normal $5 copay, (as with most of my other prescriptions, like antibiotics) I had to pay $15 for OTC. I did not need to take the prilosec for more than 2 weeks, so it doesn't affect me much. However, those whose insurance companies used to pay for more prescriptions, now won't cover them because they will be offered OTC. The insurance company is not going to suddenly lower their rates because some common drugs are being moved to OTC.
 
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