My Doctor's Drug Pushing

• shoelessj
  
  Posts: 511
  
  
  Dec 12, 2008 6:31 AM GMT

  I think my doctor may be prescribing medication unnecessarily or at the very least pushing certain drugs based on his relationship with drug reps.
  
  To explain: I started seeing this doc a few months back. I like his no-nonsense, seemingly straight-talking approach. He's straight, drives a corvette [uggh, i know], wears an earring, and is the sort of guy who starts talking to you before he's even completely in the room, which i like more than the timid, well-mannered sort. My last doctor was nice and extremely polite and i couldn't stand him. Now its like my doc is Rahm Emmanuel.
  
  I thought it was kind of odd when i started going there that half the people in his office were pharma reps, who'd just walk in and stock the closets on their own and they all seemed to know each other and the nurses, receptionists, etc.
  
  But soon after i started seeing him he said alot of men have low testosterone and prescribed me androgel, which my insurance didn't cover and which cost me like $200 (needless to say, i'm not continuing on it, especially since it had no effect whatsoever).
  
  I have had high blood pressure problems in the past and was on medication for a while and recently he put me on another HBP med, which, surprise, isn't covered by my insurance and does not come in a generic and is like $125 a month! This i can't afford if it goes past a few months.
  
  So i wonder what you guys, especially since some of you are pretty wise about medical and professional things, think. Should i keep going to this doc or find another one who i don't get along with as well but who wouldn't make me broke with the prescriptions he writes? A pal even suggested already that i go back to the low cost gay clinic i used when i had no insurance and see if i can see a doc there and tell them i'd pay out of pocket since they don't write absurdly expensive prescriptions. Or, i'm even wondering how legal what he's doing is.
  
  

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  Dec 12, 2008 8:53 AM GMT

  well, did he actually check your testosterone levels?

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  Dec 12, 2008 3:13 PM GMT

  I say dump him. Some pharma rep probably promised him something nice in exchange for sales. Sounds like a greedy bastard to me.
  
  Ever had a female doc? I think female doctors are way more perceptive.

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  Dec 12, 2008 3:21 PM GMT

  badcat saidwell, did he actually check your testosterone levels?

  
  
  Yeah, my doctor checked mine through blood work, found it a bit low. Which tracked with symptoms of bone mass loss, fat gain, loss of energy, etc. And I agree, the replacement testosterone is very expensive.
  
  But needing that at 42 seems a bit early (I'm near 60). Haven't you discussed with your doctor your need for lower-cost meds, generic where possible? You can also ask the pharmacists if they can substitute generic on a prescription that calls for a drug by name-brand.
  
  If your doctor won't cooperate, then I'd say look for another. And BTW, I've noticed the same thing in my own doctor's office lately: drug company reps always hanging around the place. I wonder if the companies have become more aggressive lately.

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  Dec 12, 2008 5:48 PM GMT

  your doctor should always find a more sensitive drug, one that you can afford and that you need.
  
  Pharmaceutical companies "reward" doctors if they sell their drugs.

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  Dec 12, 2008 5:52 PM GMT

  you should also know that it is now illegal to have drug representatives in any part of a doctor's office where they might possibly have access to patients or patient records.
  
  According to the new HIPPA standards, doctor's office's now need to set aside a specified location outside of patient care where drug reps are to be met with. having them "walk around and stocking the shelves" would violate that new standard.
  
  If he's violating those standards, I'd question his integrity as a doctor - but that's just me.

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• styrgan
  
  Posts: 2017
  
  
  Dec 12, 2008 6:14 PM GMT

  shoelessj said
  
  I have had high blood pressure problems in the past and was on medication for a while and recently he put me on another HBP med, which, surprise, isn't covered by my insurance and does not come in a generic and is like $125 a month! This i can't afford if it goes past a few months.
  
  

  
  
  Have you had a discussion with him about what costs you can afford for maintenance medications?
  
  Two years ago, my GP discovered that I was suffering from some respiratory complications from having had a bad case of bronchitis in college. It wasn't terrible, but it would effect my morning run in the winter. He prescribed an inhaler (Advair I think) which was brand new at the time, and similarly, wasn't covered. I was pretty much fresh out of college and wasn't making enough at the time to handle extra expenses, so when I came back two weeks later, we talked about it, and the following month he prescribed something more cost-effective.
  
  I give alot of physicians the benefit of the doubt. Most genuinely want to help their patients, and they want to provide them the best and newest drugs available, which are not surprisingly, the most expensive ones that a patent hasn't run out on yet. It doesn't necessarily mean he's trying to gouge you.

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  Dec 12, 2008 6:15 PM GMT

  growingmusc saidyou should also know that it is now illegal to have drug representatives in any part of a doctor's office where they might possibly have access to patients or patient records.
  
  According to the new HIPPA standards, doctor's office's now need to set aside a specified location outside of patient care where drug reps are to be met with. having them "walk around and stocking the shelves" would violate that new standard.
  
  If he's violating those standards, I'd question his integrity as a doctor - but that's just me.

  
  
  In my case, I find the drug company reps in the patient waiting room, talking at the reception counter. In fact, a few times I got a bit annoyed, because I was kept waiting when I wanted to check in for my scheduled appointment.
  
  But to get to the patient records, and the actual administrative office areas, you must enter through a door leading from the patient waiting area. I've never seen reps back there.
  
  Does this satisfy the regulations you cite, or not?

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  Dec 12, 2008 7:59 PM GMT

  You should ask your pharmacist if there are any other drugs that are either covered by your insurance or are less expensive, and then have the pharmacist call your doctor for approval. Usually your pharmacist knows more about the drugs that you are taking than your doctor...

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• shoelessj
  
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  Dec 13, 2008 12:25 AM GMT

  no, i've not actually had my testosterone level checked, no results given.
  
  and on one visit a pharma rep was sitting in the examining room while the doc talked to me/gave me the androgel spiel. he did introduce her and said she was just there to 'observe.'
  
  
  

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  Dec 13, 2008 12:30 AM GMT

  Red_Vespa said

  growingmusc saidyou should also know that it is now illegal to have drug representatives in any part of a doctor's office where they might possibly have access to patients or patient records.
  
  According to the new HIPPA standards, doctor's office's now need to set aside a specified location outside of patient care where drug reps are to be met with. having them "walk around and stocking the shelves" would violate that new standard.
  
  If he's violating those standards, I'd question his integrity as a doctor - but that's just me.

  
  
  In my case, I find the drug company reps in the patient waiting room, talking at the reception counter. In fact, a few times I got a bit annoyed, because I was kept waiting when I wanted to check in for my scheduled appointment.
  
  But to get to the patient records, and the actual administrative office areas, you must enter through a door leading from the patient waiting area. I've never seen reps back there.
  
  Does this satisfy the regulations you cite, or not?

  
  
  
  Yes it would.
  
  The goal of the HIPPA regulations was to put a check on the rampant abuse of drug reps and the practices of the drug companies in getting their drugs recommended. There's a lot of regulations in HIPPA, I know as my mother was the HIPPA rep in her office and I also worked for a branding company that dealt with pharmaRx companies. (I quit because I hate the pharmaRx companies passionately).
  
  The OP stated that "I thought it was kind of odd when i started going there that half the people in his office were pharma reps, who'd just walk in and stock the closets on their own and they all seemed to know each other and the nurses, receptionists, etc." This is a clear violation of patient rights and federal FDA/HIPPA standards and should be reported.
  
  PS: I should clarify that HIPPA seeks to prevent patient records from being accessed by drug reps. The waiting room is considered public domain.
  

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  Dec 13, 2008 12:43 AM GMT

  shoelessj saidno, i've not actually had my testosterone level checked, no results given.
  
  and on one visit a pharma rep was sitting in the examining room while the doc talked to me/gave me the androgel spiel. he did introduce her and said she was just there to 'observe.'
  
  
  

  
  
  Serious violation of HIPPA - I would change for this alone - and you should report your doctor.

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  Dec 16, 2008 12:55 AM GMT

  shoelessj saidno, i've not actually had my testosterone level checked, no results given.
  
  and on one visit a pharma rep was sitting in the examining room while the doc talked to me/gave me the androgel spiel. he did introduce her and said she was just there to 'observe.'

  
  
  Dump the bastard and find someone worth his money!

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• PRDGUY
  
  Posts: 641
  
  
  Dec 16, 2008 12:48 PM GMT

  guess i'm lucky.....
  
  true i have very gud insurance, probably near the top. but....
  
  Reps are often in my doc office for which i'm extremely thankful for. My meds would have cost me over $16 K last year all but 4 covered. 3 were already appealed and approved, normally a 3-5 day affair, by the time I went shopping and drove home, about 3 or 4 hours.
  the fourth one costs sumwhere btween $17.50- 23.00 A PILL depending on # purchased . the rep was there to advise me on any questions i had, said this appeal would take 1-2 months, and would assist nurse fill out paperwork so my inc wud pay.... as he had dealt with this B4 [drug is Viagra, and avail 2me since i take hi blood pressure meds but not needed except for extra gratification, even tho we discussed how great this wonderdrug is]
  He went to the sample room and pulled out 15 packs... 60 100 mg pills, which they all sed for my RP purpose i cud split in half.
  
  They have a job to do and can be very helpful! esp w/ samples!

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