Is There A Conflict Of Interest ? Is Your Doctor On The Payroll Of Any Drug Or Medical Equipment Co. ?

By jigsaw Latest Reply 2014-06-12 06:54:31 -0500
Started 2014-06-10 12:13:21 -0500

Here's is something I've always wondered about, with my doctors.

Find Out If We Have a Conflict of Interest
Ask your doctor if he or she is on the payroll of any drug or medical equipment companies. It may make no difference to you as a patient, but if tests are ordered or prescriptions are written for conditions that seem borderline, it may be an issue. Many doctors get monetary compensation for prescribing certain medications or by enrolling patients in a trial, says Dr. Egener. And although most say their decision making is not influenced by these connections, a new law called The Physicians Payment Sunshine Act (part of the Affordable Care Act) will take effect September 30, 2014 that will require pharmaceutical and medical device companies to list all physicians to whom payments are made. You’ll be able to look up your doctor (once the resource is available to patients, the American Medical Association will post a link) and find out whose payroll he or she is on (if any at all.)

Use the Front Office to Your Advantage
“We have appointments of different lengths for different purposes,” Dr. Egener says. “It takes longer to do a physical, but we have a shorter appointment if you come in for a rash.” So, make sure to communicate effectively when calling for your appointment—say, “I have three things I want to talk to the doctor about.” If you hate waiting, ask for the first appointment of the morning or the first one after lunch.
Also important: You should have a clear list of things you want to discuss, and be aware that you may not get to all of them.
Lastly, the office staff will ask about insurance. If you don’t have any, say so, and then ask if there is a sliding fee scale. You may be able to negotiate a fee, Egener says.

We Don't Always Know What Your Medication Costs
If your insurance won't cover a particular medication—or it's still expensive even with what your insurance pays—let your physician know. "If you cannot afford a medication, usually there is another alternative," Dr. Wen says.
Doctors are also willing to discuss the medicines they've prescribed to their patients. "I don't expect that patients are going to agree with me on everything," Egener says. "I'm the expert in medicine, but you're the expert on your body." Doctors may prescribe a medicine that you would rather not take, so discuss your decision carefully with your physician to determine the risks and benefits of not filling a prescription.

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Don't Be Embarrassed—We've Seen It Before
Whatever your symptoms, no matter how crazy, unusual, or embarrassing, your doctor has seen it before, and probably at least once or twice this week. “I want my patients to know that they can bring up any topic with me,” says Barry Egener, M.D., a Portland, Oregon, internist and medical director of the Foundation for Medical Excellence.
“We see and hear everything, and it’s helpful for us to know what’s worrying you. If you’re feeling not sure whether or not you should say something, you probably should say it. If you’re feeling on the fence, bring it up. We accept that people come in with every potential history and past behavior,” he says

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18 replies

Trudie Ann
Trudie Ann 2014-06-12 01:20:55 -0500 Report

Great article jigsaw. I have actually wondered about my doctor because no matter what I go in for all he seems to want to do is increase my meds. I went in due to an infection and of course he gave me antibiotics, but he also increased my Gabapentin. I went in due to severe head aches, he prescribed more Gabapentin. I am wondering if taking too much meds. is part of my problem. I asked him to schedule me an appt. ( referral ) for an endo. since I have never seen one. He him-hawed around but finally did it. I had to wait 2 months for the closest opening but finally, my endo appt is this coming Monday and my meds. is one of the things I am going to talk to her about. I have a lot of questions so I hope she has the time to listen and answer since I live in N. Arkansas and I'm having to drive to Mo. which is the closest endo in my ins. network. Again Thank You for this post.

jigsaw 2014-06-12 06:37:46 -0500 Report

Hopefully, your new doctor will be helpful.

Naturopathic doctors lean more toward finding the underlying cause rather then prescribing meds. Conventional medical doctors frequently prescribe medications (the bandaid approach) without ever addressing the cause. The ideal situation is a doctor that practices both approaches. They are few and far between, but they do exist. I actually had a doctor that combined naturopathic and conventional medicine in his practice. He was one of the best and most caring doctors that I've ever had.

I believe that being familiar with both approaches to good health is extremely advantageous. It affords an individual a much broader prospective to healthcare in general.

theladyiscrazy 2014-06-10 17:17:42 -0500 Report

My doctor changed a med for me because I couldn't afford it even with insurance (seems it was a "brand" they didn't authorize).

jigsaw 2014-06-11 06:25:53 -0500 Report

I usually have my doctors prescribe generic versions, after confirming that it is safe to do so!

theladyiscrazy 2014-06-11 06:41:18 -0500 Report

Unfortunately, I have been on meds that do not have generics. Hence where the problem can in, otherwise I typically like generics. I was very happy when my Singulair (asthma and allergies) went to a generic less than a year ago. Some of my diabetic meds are not though.

jigsaw 2014-06-11 12:05:31 -0500 Report

I've run into that situation also. I guess sometimes we're stuck having to purchase an outrageously expensive medication. Seems that the pharmaceutical companies got us by the cogliones!

Type1Lou 2014-06-10 15:28:19 -0500 Report

I think it's good that we'll be able to check whether our doctors are getting compensation from pharma. I think I've been lucky and haven't had any meds pushed on me in the last few years.

jigsaw 2014-06-11 06:28:05 -0500 Report

I think it's a good idea also. I'm sure most of my doctors have been honest with me, but there are those few that I wonder about.

frog1951 2014-06-10 13:12:11 -0500 Report

All doctors have conflict of interests with pharmaceuticals - they push drugs - I have not met one yet - well maybe my pediatrist and my rhumatologist - my endo is definitely tied to a few drug companies - he listens to nothing but starts talking drugs as soon as you get in - he is an NP - I have tried to change in the group but the receptionist is trained - there is not much more in town so I am screwed unless I want to drive 100 miles.

jigsaw 2014-06-11 06:30:20 -0500 Report

Will your doctors listen if you question them? That's a rough deal to have to go that far to find another doctor.

camerashy 2014-06-10 13:08:15 -0500 Report

I don't think my doctor is. Either one of them. Neither prescribes anything I don't need, or don't ask for. Neither one changes my brands, or only when I tell them that my insurance no longer covers a certain brand. Yay me!

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