Do doctors need to be regulated?

Short answer; yes (kinda).

There's something inherently wrong with the idea of having a profit motive driving the care being given by someone who is supposed to have the patient's best interest at heart, and not the pharm company, insurance provider, or whoever has their hands on the purse strings.

I do not think the two can co-exist, and that eventually the system would unravel if left unchecked. It's one of the few industries where I think government oversight/regulation can actually be a benefit. There has to be some sort of altruistic watchdog. Sam has posted some brilliant articles and studies on this subject, maybe he can link us up again.

 

Not as much as you'd think. It's more like a fear of retribution from sue happy patients.

It's not extremely bad for the body in therapeutic doses: it's beneficial to attentiveness.

They're prescribing it because the kids are having trouble with focusing their attention for more than a short period of time. The ability to finish the homework like its watching TV is what its meant to do for these children. The doctor is likely getting paid either with or without prescribing adderall because of HMO payment rules.

All-in-all, physicians are one of the most regulated professions in the US. In every direction, our autonomy has been chipped away to nothing. So in answer, they already are.

 

Adderall can be habit-forming when used in higher doses than recommended by your healthcare provider or for extended periods of time. The consequences of Adderall abuse can be extremely dangerous, sometimes resulting in an irregular heartbeat, dangerously high body temperatures, and/or the potential for cardiovascular failure or seizures.

Every physician and pharmacist know to watch for it.

From UpToDate...
Many of the side effects associated with methylphenidate and amphetamines are mild, of short duration, and reversible with adjustments to the dose or dosing interval [16,17]. The occurrence of side effects is similar with methylphenidate and amphetamines, although treatment with mixed amphetamine salts may be associated with greater decrease in weight over time than treatment with methylphenidate [16,18,45,46]. Side effects may occur more commonly in children who are treated for ADHD during the preschool years [47]. Methylphenidate does not appear to increase the frequency or severity of seizures in children who also are receiving appropriate anticonvulsant medications [48-50].

 

Doctors don't need to be regulated, people making a living out of suing doctors, on the other hand, should be. I'm all for suing a doctor who harmed a patient with malicious intent. But this joke of a "malpractice" law suit system we have in place is what's causing all this crap. Millions of dollars are being wasted on that nonsense, and it's one of the most important factors in making our healthcare system as bad as it is right now. Doctors have to cover their a$$es by ordering unnecessary tests in addition to having to pay a crapload of money for "malpractice insurance".

You know what's really sad? The fact that this new healthcare bill fails to even address this problem, and that's my biggest beef with it. I was very optimistic that actual reform was going to take place (public option, strict reform on malpratice law suits), but we ended up with this watered down bill thanks to idiot republicans and corrupt congressmen from both sides that sell their souls to special interests (and the fact that the majority of them are lawyers, and they look after other lawyers' wellbeing. ie: we can't stop B.S malpractice law suits! that's how our fellow lawyers make their living!)

It's sickening.

 

Tort Reform is a drop in the bucket for the cost of health care. It's just another pain in the ass for physicians.

 

That's a cop-out. There's no evidence that doctors that prescribe more tests get better results or have fewer malpractice issues.

If your biggest beef with the bill is that it doesn't address a tiny portion of the health care system and given that tort reform has been shown in multiple states (Texas included) to have zero impact on health care costs, it seems like you think it's a fantastic bill. Yes?

 

Adderall is way too common among college students and even high school. I work @ a pharmacy and the number of people coming in with adderall scripts is insanely high... and majority of them are pretty young.

 

They are. They are regulated by the Bar Rules and by Rules of Civil Procedure. If an attorney files a knowingly false or baseless pleading in Court, they can get in serious trouble.

Sure...to the same extent that a single one gallon bottle causes the Atlantic Ocean to have all that water.

Malpractice suits generally do not cost all that much comparatively. All we ever hear about on TV are the extreme outlier cases. The run of the mill, everyday cases are much more modest. You don't hear about them because they aren't interesting and do not draw ratings.

Wrong. Doctors do not order tests that are not medically relevant. Some doctors order more precautionary tests than others, but that has a lot more to do with their own comfort level in the individual diagnosis than it does about a lawsuit.

Why is malpractice insurance in quotes? It is real insurance. If you get sued, the insurance company will pay the defense attorney. If a judgment is rendered, the company will pay it. I don't get the quotes...as though it were imaginary or something.

No type of tort suit has ever required that you maliciously injure somebody. That is why it is called a negligence suit. In order for a doctor to lose a malpractice suit, it has to be shown in Texas that the doctor failed to act in accordance with the accepted standard of medical care. Who decides what that standard is? DOCTORS. It is the minimum standard of medical care as determined by the medical community. In Texas, for a medical malpractice suit to ever see a courtroom, a doctor must sign a letter stating that under these circumstances, it appears that the minimum standard of care was not met.

We have had that in Texas since Proposition 12 passed in 2003. It has not been the magic bullet you seem to think it is.

Yeah...that must be it. It couldn't be that they know what the rest of us do - capping damages on lawsuits or barring all but the most egregious claims will not solve the problem, will likely lead to much less effective care, and will put a practical bar on the courthouse door to meritorious plaintiffs while the doctor hams people with impunity.

What percentage of the suits have no merit at all? I suspect that you don't know the answer to that. The real answer likely is...not many. Again, you hear about only the most extreme cases, because they draw ratings. Do not mistake the extreme for the norm.

 

Ok.....


No offense but why are you talking about stuff you have never tried?


I understand what you are trying yo say BUT YOU ARE TOTALLY WRONG ON THIS.


I have been prescribed Adderall for 2 yrs now. Basically I don't even use it for my focus too much anymore, I've had depression for a long time and it helps me focus in that respect.

Technically I am not even addicted to it, I don't take it on weekends and have had gaps of about 2-3 weeks where I haven't taken it b.c I couldn't go see myh doc for a refill.

Its basically so controlled that the statement you are making is ironic. My PCP physician who is well aware of this would not prescribe it to me when I was all out even though he knew I was taking it for a while. He told me it was up to my psychiatrist to prescribe it. I have had to go through so much of a hassle to get it everytime. Basically I can't get a prescription till the last tablet runs out.

I don't have enough free time to drive 2 hrs to houston everytime I need a refill. So I always have a gap of like a week of not taking it.

Its a great medecine for depression. And the habit **** is WAYYY overrated.

Adderall is NOTHING like meth btw, so don't think of it as methamphetamine. I had tachycardia problems earlier on it but that was due to a Mg defficiency.

I understand you hear a lot of stories but making assumptions like these are just flat out wrong. I can tell you that if someone abuses their adderall they would have to take at least 80 +mg, and they would run out fast as hell.

IMO doctors do just fine, its not like they want lawsuits on their asses.

 

I'm actually planning on weening off of it, I would stop cold turkey but I need to be in the same state of mind when taking finals.

Its not even a great drug. Lowered appetite is whats bugging me and the fact it increases anxiety.

You are honestly reading too much into stuff.

 

How are individual doctors making money from prescribing Adderall? Do you think Shire Pharma is writing checks to the doctor who prescribes the most Adderall to his patients? Sort of like the middle schooler who sells the most magazine subscriptions and wins a pizza party at the end of the semester?

If you think so, you are an mistaken.

Medicine is the most regulated field in America. Do you think some random person of the street can open up an medical practice and call himself doctor? Even foreign doctors who have practiced in places like Eastern Europe, Africa and Asia have to come here and do their residency training all over again and sit for all the national board exams.

Finally, there is nothing wrong with Adderall. It has been approved by the FDA.

 

what..? not even "possible constipation"..? astounding..!

 

How do you supposed you "regulate" doctors further? Have some dude sit in every doctor's office and let him agree/disagree with the diagnosis and treatment?

Child please

 

One of the best posts I've read here on the subject, Ref, and I've read a lot of them here over the years. I made sure the salient points would be easy to read, because I've read countless unfounded, uninformed comments here about this subject. Perhaps if your points are hard to miss, some of those folks will actually pay attention. Kudos, true, and right on target!

 

Thanks, Deck.

My ex-wife's father is a doctor. I was married to his daughter in 2003, when he was in strong support of Prop 12. He thought it would drop his insurance rates and protect him against wrongful lawsuits.

Since then, I have taken a keen interest in following where this has led. Not a whole lot has changed. Appears to be a money grab by the insurance carriers. The claims they have to pay are smaller (if they are heard at all - the caps have made it difficult to find an attorney to take the case), yet what they charge for premiums has not dropped much. The net result? The carriers make more money.

As Yakov Smirnov would say...What a country.

 

Mmm... I remember the Prop 12 fight. Man, that was bloody.

Sucks that it has turned out that way.