View Full Version : Do doctors really care


janesays
11-07-04, 09:38 PM
Does anyone know if doctors get certain benefits for prescribing specific drugs?

I think I have heard of this before.

Anyways

A friend of mine could get what ever drug she wanted from one of her doctors. He's put her on Klonopin, Effexor, Adderal, Strattera, Wellbutrin, Zoloft, Ambien, to name a few. Basically if she makes a complaint about something she's got whatever she thinks will help cure it.

My doctor whom I have not seen and am on my last batch of Adderall suddenly wanted me to switch to concerta. The Adderall has been working wonderfully as far as she knows. I have made no complaints what so ever about it. I told her my sleep was fine and my appetite was fine so why the sudden switch. She said that Concerta was a 12 hour dose. Well I did some research on my own. Concerta is totally different than Adderall. It's not even composed of the same drugs. It's more like ritalin.

I want to see a different doctor one with their head on straight. Instead of "sure we'll just flop you over from one drug to the other. " The hell.

gingagirl
11-07-04, 10:18 PM
My doctor also thought that a drug with a longer duration would be better --I think this is a convenience that lots of people like, especially kids in school (so they don't need to take a dose at school). I prefer regular adderall --sometimes I don't want that second dose. Although lately I've been experiencing a big time crash when it wears off ...I fall asleep and lose valuable evening hours. So I'm gonna talk to my dr at my next appointment.

Did your doctor suggest that you switch to Concerta, or did she demand that you switch? Maybe she was just suggesting a different drug because she thought you'd appreciate the longer duration. Maybe she was visited by a concerta rep & she was hyped up on the benefits of that medication. I'd recommend going to your appointment and talking with her. If you're happy with the Adderall and aren't experiencing any bad side effects, then just tell her you don't want to switch ...if it ain't broke, don't fix it!

Trooper Keith
11-07-04, 10:47 PM
Doctors occassionally make agreements with certain pharmaceutical companies, and will then get benefits from that company for prescribing their medication. This isn't that common, but it does happen. The doctors normally won't prescribe something that won't work because of these agreements, however. Oftentimes, the doctor is a member of a pharmaceutical club, or gets benefits from the corporation, for using and recommending their medications. That's why you see pharmaceutical representatives, and that's why doctors have all those pens with drug names on them. The pharmaceutical representatives try and convince the doctors that their product is superior. This is so that the pharmaceutical company gets people to use their medicine, and the doctor gets happy patients and sometimes benefits from the companies. Doctors will also often have "favorite" drugs that they will start you on first to try out. This is because the doctor has had patients who have been successful on the medication. For instance, if prescribing an SSRI, a doctor might like to try Zoloft first, because he likes Zoloft and has seen it work, or Lexapro, for the same reason, etc.

Tara
11-08-04, 12:11 AM
There are more and more rules which are prevetning doctors from getting any type of kick back from pharm. companies. It's the HMO's who profit from the Pharm companies. The pens and other stuff with the medication name on it are marketing tools that they send out to just about anybody they can.

A lot of time when an MD suggests a certain med over another it is because they have had other patients who have benefited from that med or because they have learned something new about that med.

Concerta does last longer than both regular Adderall and Adderall XR. It also has less potential for abuse because of the way its made since it can not be crushed an snorted. Cetain HMO's are actually charging patients less for concerta than most other stimulants because of this. There has also been a lot "bad press" in the past several months about ADDerall.

Like Gingagirl suggested it is very good idea to communicate your doctor about why she thinks concerta may be a better choice for you.

janesays
11-08-04, 01:21 AM
Thanks KMILLER for all that info. I knew there was some sort of arrangement like that. I just don't understand why after being on Adderall for 5 years my doctor would even suggest I switch to Concerta. I think I should start learning a little bit more about my rights when it comes to the doctors office. I'd really like to see all the little annoying scribbles she makes on her pad about me. When she doesn't even ask me open ended questions.

mctavish23
11-21-04, 12:37 PM
My late father was a Urologist turned Psychiatrist. He practiced medicine for almost 50 years. I had the privilege of working with him in 2 different settings before he passed away. My late uncle was a Johns Hopkins trained eye surgeon in Washington D.C. and my late grandfather, whom I never met, was a horse and buggy country doctor in rural SE Georgia. Having grown up around doctors and now having worked with them professionally for over 27years (we have 4 psychiatrists and 3 clinical nurse specialists/ nurse practitioners who can also prescribe at our community mental health center), I can tell you that doctors DO NOT get kickbacks for prescribing certain meds!!!! That is absolutely false. My father never got a dime from a pharmaceutical company.

Pharmaceutical reps bring cookies, candies, notepads, pens, coffee cups and calendars,etc. Everyone does this as a form of advertising (and not just in the drug industry as I get several different calendars from other sources such as dry cleaners, car dealers, etc.). Our non profit community mental health center also gives away pens, as does the Minnesota Psychological Association.The bottom line is that these are accepted standards of practice and not out of the ordinary methods of doing business.

I also have heard these types of rumors in the past, especially in chat in ADD Support in Yahoo. If you've ever been in that room, which is where I met most of the people that I know well ( and greatly respect) in here, then you know I have a very strong reaction to the insinuation. I believe it is usually attached to the "ADHD is fake" mindset or the myth of "bad parenting." Either way this is a great place to discuss those types of issues and I appreciate your having brought it up.

Good luck and welcome to the forum.

mctavish23
11-21-04, 01:05 PM
One thing I forgot to mention has to do with doctors who prescribe in a reckless or unethical manner. Unfortunately, there are good and bad practitioners of everything;regardless of the profession. My experience has been that they are more often than not trying to build up their practice by prescribing in such a manner.The meds they prescribe are the same ones that other docs prescribe ethically. They DO NOT have secret agreements with pharmaceutical companies anymore than other docs do. It's not like they're selling on a comission basis. While their actions are certainly suspect ,they are NOT getting "kickbacks" for prescribing certain meds.

paulbf
11-21-04, 01:45 PM
I think the reason for the change is probably fear of abuse. Concerta is less abusable & not as easy to sell on the street. I think doctors must face some risk or threat from the DEA or some such that puts their liscense & crdibility on the line if they are discovered to be preescribing too many controlled substances carelessly, they may also have moral problems with putting people at risk of abusing narcotics unnecessarily.

I agree you should insist on remaining with the medication that works for you. Let him change his policy for new patients.

mctavish23
11-21-04, 03:39 PM
There is always ongoing /constant monitoring by the DEA. As far as why a doctor would want to change a med after 5years of it working well, I have no idea. I too would encourage you to ask whatever questions you feel are appropriate. From the sound of it, it appears that you are either unhappy with and/or somewhat distrustful of her. I hope you can straighten things out.

Russell Barkley, in his book Taking Charge of ADHD, recommends for you to become an "executive parent". This is where your child is the corporation, you are the CEO and the schools and the doc are consultants.Good luck.

janesays
11-21-04, 07:47 PM
I am so ****ed off at my doctor. I called her six times last week wanting to schedule an appointment. I left three messages and she never returned the call. I have enough Adderall for the next 5 days then I'm out. What if I can't get ahold of her. I didn't take it today for fear that I'd run out during the holiday and I've gnawed off all my fingernails cleaned out my fridge and slept. I haven't done any homework and now my boyfriend planned a double date. I can't say no because all week I've been blowing off this other couple and my boyfriend so pretty much he was like "yeah were going, I don't care if you want to or not." I am so bloated from vegeing out all day and I have so much homework it is impossible to get done. I really wish I could admit myself so people would just leave me alone till I can get through this. I don't wanna take pills anymore! I'm gonna go buy a pack of cigarrettes although I quit three months ago then I'm gonna pop an adderall and power clean maybe by then I won't feel like such a slug.

paulbf
11-21-04, 08:54 PM
Take it easy, maybe just try drinking lots of coffee, that seems to work for a lot of people though it's not as healthy, better that ciggaretes.

Mee
03-12-05, 12:59 AM
Pharmaceutical reps bring cookies, candies, notepads, pens, coffee cups and calendars,etc. Everyone does this as a form of advertising :eek:

Imnapl
03-12-05, 01:23 AM
Mee, so do food supply reps. Do you eat in restaurants?

mctavish23
03-22-05, 12:21 PM
I just got some very nice handouts from the Shire (Adderall) rep, including material on the recent FDA warning. She also gave me a form to fill out and send in to them if I wanted to see the research involved. I have been passing them out to parents, especially those with kids on Adderall.

I'm not sure what you were inferring Mee by the qoute, but none of that is inappropriate or unethical. In fact, for pharmaceutical reps to bring handouts in to pass out to clients/patients, is a very good thing.It helps the public understand those particular products and also the problem(s) addressed by the meds. Informed consent and full disclosure are ethical obligations. To not provide material would be negligent (and unethical).

I use my wall poster that shows the science behind ADHD in terms of how dopamine and norepinephrine are invloved to teach both parents and kids that ADHD is a real, brain based disorder. That makes it easier for them to understand.Then they can take the other handouts home or show them to teachers, etc. In that way they become helpful tools in advocating for the ADHD student by eliminating myths and misconceptions, etc. I don't do a commercial for Adderall while I'm doing it either.

What really frustrates me is that people are ready to accept completely bogus ideas about monetary kickbacks but raise their eyebrows at candy, etc. My insurance agent gives me calendars and pens. So does the plumber and the healthfood store I frequent at the mall.Even our church had some pens made up not too long ago to distribute on Father's Day.Good luck finding mine, but that's for a different post on How Many Things Have You Lost This Week ? .:) . None of this is inappropriate. There are no medication clubs!!

Asylum
02-03-10, 11:02 AM
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