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Years ago, I had a truly great primary care doctor. She had her own practice, which was typical at that time. She was caring, but above all, extremely compete

Years ago, I had a truly great primary care doctor. She had her own practice, which was typical at that time. She was caring, but above all, extremely competent. After she retired, I've yet to come across a situation remotely as good. I think she was so good because she was allowed to be directly engaged with her patients and that resulted in some sort of feedback loop where she was always striving to stay on top of the state-of-the-art. These days, those sorts of practices are hard to find. There's the doc-in-a-box places that dominate, and they seem surprised if you want to see the same doc rather than whoever can just see you. There's also someone else in the room these days - the government and (practically the same thing) insurance company. The doctor / patient relationship is now more like the doctor stooge snooping on the patient relationship. Just look at how many doctors no longer will prescribe medicine for pain due to the war on drugs. They're scared of losing their license. The collateral damage is the poor people who need strong pain management but find it increasingly hard to get it.

DanBC 10y ago
> Just look at how many doctors no longer will prescribe medicine for pain due to the war on drugs. They're scared of losing their license. The collateral damage is the poor people who need strong pain management but find it increasingly hard to get it. Doctors haven't stopped prescribing opioids because of the war on drugs. They've changed prescribing because opioid meds are not effective to treat long term pain, and certainly not effective in the way they were being prescribed. People with long term pain given opioids will quickly develop tolerance to those meds, and need to increase the dose. They quickly reach dangerous levels of opioid use, often with multiple meds, and they're still not getting relief from their pain. So now they're still in pain, and they have an opioid addiction. People with long term pain need rapid access to specialist pain clinics, with a full range of treatment including physiotherapy and prescribing, and -if needed- carefully prescribed opioids.
- nullstyle 10y ago
  > Doctors haven't stopped prescribing opioids because of the war on drugs. They've changed prescribing because opioid meds are not effective to treat long term pain, and certainly not effective in the way they were being prescribed. Watch the documentary "Dr. Feelgood" (http://www.imdb.com/title/tt5192362/ http://www.imdb.com/title/tt5192362/) for a couple of very extreme, living and breathing refutations of that claim. It's not nearly cut and dried one way or the other.

DanBC 10y ago

> Just look at how many doctors no longer will prescribe medicine for pain due to the war on drugs. They're scared of losing their license. The collateral damage is the poor people who need strong pain management but find it increasingly hard to get it. Doctors haven't stopped prescribing opioids because of the war on drugs. They've changed prescribing because opioid meds are not effective to treat long term pain, and certainly not effective in the way they were being prescribed. People with long term pain given opioids will quickly develop tolerance to those meds, and need to increase the dose. They quickly reach dangerous levels of opioid use, often with multiple meds, and they're still not getting relief from their pain. So now they're still in pain, and they have an opioid addiction. People with long term pain need rapid access to specialist pain clinics, with a full range of treatment including physiotherapy and prescribing, and -if needed- carefully prescribed opioids.

nullstyle 10y ago
> Doctors haven't stopped prescribing opioids because of the war on drugs. They've changed prescribing because opioid meds are not effective to treat long term pain, and certainly not effective in the way they were being prescribed. Watch the documentary "Dr. Feelgood" (http://www.imdb.com/title/tt5192362/ http://www.imdb.com/title/tt5192362/) for a couple of very extreme, living and breathing refutations of that claim. It's not nearly cut and dried one way or the other.