Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of ancillary revenues.
Why dangerous? For a number of reasons.
One, physicians still grapple with the perception that it is improper for a physician to make money from …
There is a lot of press about a study recently published in the New England Journal of Medicine that shows that adding tiotropium (Spiriva) to an inhaled steroid might have benefit in asthmatic patients. This study is creating a lot of buzz due to recent concerns of ICS/LABA safety and might prompt doctors and patients to start switching (some already have before this study came out). However, this …
Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.
And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and …
by Daphne Swancutt
Two people in the United States just died in the last hour. Seventeen more will die in the next 7 to 8 hours. Over a year, that number will accumulate to about 7,000.
The reason? Medical errors that include misread or otherwise misinterpreted handwritten prescriptions. Believe it. This means that doctors are being sloppy, pharmacies are making mistakes and people are getting dead.
Even more …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 70-year-old woman with hypothyroidism fell and fractured her hip. During preoperative evaluation for hip fracture repair, she mentions recent mild fatigue, which has not significantly limited performance of her daily activities, and ongoing right upper-quadrant abdominal pain after eating. She takes levothyroxine, 0.075 …
Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve.
Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, …
Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.
The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:
Costco: $27
Walgreens (with Saver Card): $325 (without Card): $380
CVS: $361
Walmart: $347
Target: $340
These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …
by Arnon Krongrad, MD
The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.
Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. …
Advertising is everywhere.
That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these …
I am a medical doctor. I am also called an allopath, someone who practices “Western medicine.”
We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials. We want to know the “mechanism of action.” We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them. We feel more confident about …
An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.
In 1993, the FDA approved Neurontin for the treatment of epilepsy. This should have been a cause for celebration at Warner-Lambert, the drug company that introduced it, but the celebration was muted. The FDA had …
About a month ago, a 44-year-old insurance executive came to see me with complaints of headaches and muscle cramps. His pain was caused by the typical cluster headache located behind one eye, accompanied by one-sided tearing and nasal congestion, and often triggered by occasional wine or chocolate. The muscle cramps mainly affected the legs and seemed to worsen after exercise.
When I got the results of his lab work, I was …
I’ve been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential for testosterone to alleviate depression in older men.
One of the difficult questions facing clinicians is when is testosterone too low in older men.
One problem with answering this question is the …
It is insulting to think that doctors who are ostensibly smart enough to save one’s life are in fact so stupid, or merely gullible enough, to be swept away by what is in actuality only a very weak potion of sales-presentation intermixed with and embedded within generally informative and pharmaceutical-balanced subject-focused medical lectures.
Such lectures occur usually at a private function room at a restaurant or, in conjunction with a served …
by Marianna Rakovitsky, RPh
Oh, Summer! The weather is warm, the sun is shining and it is the time when we try to get outside as much as possible. Summer is my favorite time of the year. I love the beach, days that are filled with light and sunshine, trips to the orchards and hanging out in the backyard. The sunshine that makes the summer such a …
by Edison Wong, MD
With the recent proposal to repeal the so-called Massachusetts “gift ban” (more appropriately referred to as the “interaction ban”), I asked myself who stands to gain the most from such bans?
Is it the consumers or patients? Is it the physicians or their practices? Is it the federal or state governments? Nope. Sadly, it is the insurers who gain the most, at the expense of patients.
The …
As we have established repeatedly on LesliesList.org, prescription prices can vary a lot from one pharmacy to another.
But did you know that some pharmacies will actually match a competitor’s price? This could save you a ton of cash, but you have to know how, and whom, to ask for this service. Pharmacy retail chains all have different policies. I spoke to a pharmacist recently at each of the seven top …
If you have spent anytime with a palliative care team in a hospital you will know of their efforts to essentially blacklist Demerol (meperidine) from use in the hospital.
Some hospitals have removed it or restricted it from the formulary all together. In medical culture, Demerol has been a go to opioid peri-OR and mostly favored by surgeons. The drug has been purported to be less likely to cause billiary spasm, …
As reported in MedPage Today, the FDA announced the end for CFC-propelled inhalers. Of the seven inhalers with deadlines for removal, only three are still being made:
Flunisolide (Aerobid Inhaler System) on June 30, 2011
Albuterol and ipratropium combination (Combivent Inhalation Aerosol) on Dec. 31, 2013
Pirbuterol (Maxair Autohaler) on Dec. 31, 2013
The reason for this is because CFC’s are harmful for the environment, and the newer inhalers have to be replaced with …
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