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I think one of the problems is that the medical and legal community seem to be incapable of doing anything but extremes. About 5 years ago I went to the doctors

by lovich 9y ago

I think one of the problems is that the medical and legal community seem to be incapable of doing anything but extremes. About 5 years ago I went to the doctors for headaches and was given a subscription for 90 pills every month of fioricet and expected to only take it when I needed it and not more than 3 a day. About a year and a half ago after I got a new doctor who was appalled, asked me if I would consider going down to 30, and was surprised when I told him I had no problem with that because it was unneeded and I was already only refilling it 1-2 times a year anyway. Now in the past year I hurt my shoulder pretty badly, to the point where I was having difficulty using it due to the pain and was dropping light weights. I was told physical therapy and aspirin and if it still hurt too much to use I could try more aspirin. We seem to swing wildly between giving out a ridiculous amount of drugs(90 a month no questions asked) to giving out none, even when people are in pain. Why can doctors not prescribe something like 3 pills a month to someone? Its not nearly enough to get addicted on, but can help someone experiencing severe but temporary pain. Is it something in our legal framework that only allows doctors to prescribe a months worth at a time with the assumption that its taken every day? Is it some pressure from insurance companies who don't want to deal with paying out small claims like for 3 pills?

cperciva 9y ago
There's two issues here. The first is that "as needed" is really hard for pharmacies and insurance companies to handle; the only way they can avoid arguments (and potential lawsuits) is to dispense the maximum allowed. So even if your doctor expects that you're only going to need an 1 pill/day on average, if he writes "as needed up to 3 polls/day", you're going to be given 90/month. The second issue is deliberate overprescription. Most insurance companies have rules on the amount of medication which can be dispensed -- 100 days is a common limit, but some limits are as low as 30 days. The justification for this is that they don't want you to end up with lots of unneeded medication if your needs change; but usually the real reason is that they don't want to end up covering costs which can be offloaded to your next insurance company if you change insurers. In response, some doctors will deliberately inflate prescriptions -- e.g., if your doctor thinks you need one pill/day and trusts you not to abuse the medication, he might write a prescription for 3 pills/day so that your insurance company will approve an amount which will last you for longer.

by lovich 9y ago

cperciva 9y ago

There's two issues here. The first is that "as needed" is really hard for pharmacies and insurance companies to handle; the only way they can avoid arguments (and potential lawsuits) is to dispense the maximum allowed. So even if your doctor expects that you're only going to need an 1 pill/day on average, if he writes "as needed up to 3 polls/day", you're going to be given 90/month. The second issue is deliberate overprescription. Most insurance companies have rules on the amount of medication which can be dispensed -- 100 days is a common limit, but some limits are as low as 30 days. The justification for this is that they don't want you to end up with lots of unneeded medication if your needs change; but usually the real reason is that they don't want to end up covering costs which can be offloaded to your next insurance company if you change insurers. In response, some doctors will deliberately inflate prescriptions -- e.g., if your doctor thinks you need one pill/day and trusts you not to abuse the medication, he might write a prescription for 3 pills/day so that your insurance company will approve an amount which will last you for longer.