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Yes! It's so infuriating. I usually go to Chinatown where they will sell you contacts without an exam or prescription. I asked my optometrist once why a prescr
by nsedlet 7y ago
Yes! It's so infuriating. I usually go to Chinatown where they will sell you contacts without an exam or prescription.
I asked my optometrist once why a prescription was necessary to buy glasses or contacts, and why prescriptions expire so quickly, and she gave me the reason offered in the article: that it forces people to be screened early for treatable eye diseases. But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. It's hard to see it as anything other than a cynical ploy to extract money from people.
- quotemstr 7y agoMedical paternalism was the norm until surprisingly recently. See https://en.m.wikipedia.org/wiki/Medical_paternalism https://en.m.wikipedia.org/wiki/Medical_paternalism
- arcticbull 7y agoI can see the case for it, I mean, I don't go into a car dealership and approve or deny which parts are to be replaced or which procedures are necessary. I have no basis for knowing.
- eru 7y agoYes, but if you insist, your mechanic will probably still do what you ask them, as long a you pay up.
- Scoundreller 7y agoI’m 50/50 on this. The dealerships can be mindless flow-chart followers: It’ll say “When A occurs, try replacing X” and they’ll do that, even though my notes stated that I switched all the Xs around and the problem didn’t move with them.
- eru 7y agoYes. And sometimes I even want a service provider that insists they know better. (Eg I frequent some coffee shops like that.) The crucial thing is that there are alternative providers where I can get exactly what I say I want, and get it.
- zrobotics 7y agoAs a former mechanic, at least my shop would occasionally refuse to let a vehicle leave the shop- the one example that I remember most clearly was a SUV that came in for an oil change. The owner was planning on a 800 mile trip with their family and wanted an oil change before leaving. One of the wheels had a serious suspension problem, and would likely fall off shortly & cause a rollover. We weren't going to let that truck leave our shop w/o getting fixed, none of us wanted dead kids on our conscience. We extended credit to the customer & cut our rate so the owner could afford it. Point being, in this case we definitely knew better than the customer, somehow they didn't realize a wheel falling off at highway speed is dangerous. P However, that was a very rare situation. If a customer insisted they wanted work done that we didn't feel was necessary, we would tell them so but still do the work if they wanted it.
- quotemstr 7y agoSure. And you can take steps toward dealing with ignorance that are still compatible with informed consent. For example, we should ban the advertising of prescription drugs on television. Most other respectable countries do.
- arcticbull 7y agoMost would see that as an argument in support of paternalism, and as do I, which is why I agree with your position. Advertising drugs to consumers is akin to advertising specialty testing equipment to individuals: at best neutral and at worst harmful. You have no business self-diagnosing with a risk of stroke and running in there to demand Plavix. There should be no world in which the doctor goes, "Huh, Plavix! I've never heard of it, and if you think you're at risk of stroke, well bud, here you go, one years supply."
- ByzantineO6 7y agoi get despicable "surprising early signs of <random dread disease>" sucker-traps injected into my iphone browsing ALL THE TIME. Faugh!
- Gibbon1 7y agoI do that all the time.
- bane 7y agoMy regular eye exam caught early stage glaucoma. I go to follow-up screenings yearly to track progress, but it's entirely correct to say that going to my optometrist to get my updated prescription probably saved my sight. All that being said, I always ask for a copy of my prescription so that I have it in my wallet just in case. I've been abroad when my glasses broke and having that on-hand made getting an emergency pair of glasses very simple. edit I get my glasses at Costco, probably $120 all-in.
- tmm84 7y agoI think many people don't hear this enough. Eye exams can catch things and since a lot of the people I know get a good 4~6 years out of their glasses it makes since to get an exam when replacing them. Sure, exams might cost time/money but most people just don't hear the story of going to get a new pair of glasses and being saved from xyz eye condition story enough. I live outside the USA now and to get contacts you need a recent eye exam to purchase them. I think this works out good because the country I live in has a high number of contact users and I feel it ensures better health for the great amount of those who need vision correction.
- WarOnPrivacy 7y agoEye exams catch problems in the healthcare wealthy. They catch nothing in the dozens of millions of Americans who aren't (and haven't been).
- tomjakubowski 7y agoSounds like a great reason to subsidize yearly eye exams for those who can't afford them. Or even to cover the cost of an annual exam for every person, to avoid the usual problems with means testing.
- cbsks 7y agoI usually travel with an extra pair of glasses. My preferred frames, including lenses, are $30 from Zenni. I’ve been using the same prescription for about 6 years, it may be about time to see an optometrist and get my eyes checked out...
- mrep 7y ago> But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. Happens to women too for birth control.
- sliken 7y agoMy dentist pushes a periodic "comprehensive/full panel" xray. More than the usual, and claimed the justification was in case I have jaw cancer or something serious (non tooth/gum) related problem. I asked what about all the rest of the bones in my body? I skipped it.
- bluedino 7y agoRoll the story where the person has an abscess and dies from it weeks later
- sliken 7y agoSeems unlikely, at least for people willing to seek medical care when they have a surprisingly pain in their jaw. Large doses of xrays aren't without risk. Apparently the comprehensive xray uses 4-6x the exposure of a normal xray.
- randommuser90 7y agoSource?
- WarOnPrivacy 7y agoI was willing to seek medical care for the ongoing pain of TMJ and I didn't because what I can afford is one Dr visit & one RX for generic opioids (the only treatment that touches that pain). But there was no point. The only Dr I could afford became terrified of prescribing opioids (thanks DEA. yes it was the DEA). No matter that I had, for years and years, taken opioids responsibly. However it's no longer a problem. That only Dr - that countless thousands of us could afford to visit - just closed up shop. Am I willing? Sure. Able, no. Not in any way.
- sysbin 7y agoHappens to transgender people to get HRT.
- dimensi0nal 7y agoInformed consent is a thing in most of the US now.
- sysbin 7y agoMost of USA isn't all. I don't follow the USA anymore since moving to Canada but when I lived in USA it wasn't informed consent in my area. Nevertheless I was downvoted for giving another example to OP. I would also say the needing a prescription for the years I did.. ruined my life because all doctors for years would deny me on religious grounds.
- 55555 7y agoIf you have a digestive disease your Dr may refuse to fill your prescription if your last colonoscopy was more than ~2 years ago. Even if you have a less serious condition. (I'm providing another example, but I agree they shouldnt withhold care.)
- eru 7y agoThey should care and ask you to do it, but no need for them to insist (or for there to even be a law or regulation to force them to insist).
- astura 7y ago>I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. Ha!! Many woman feel this way about birth control! It's held hostage until you get a pap smear. Yearly pap smear, mind you, evidence and recommendations to the contrary be damned. This is despite the fact that cervical cancer screenings have zero to do with safety of birth control. Just to be clear, cervical cancer screenings are very good! Especially so when done at evidence based intervals. But birth control can be safely prescribed without it, yet many health care providers require a pap test before they prescribe birth control.
- notzuck 7y agoWhat a shit mess - in the UK you just go get your blood pressure done then get a 6 month prescription.
- luddaite 7y agoI think the recommendation from USPSTF is every 3 years. If a provider is forcing yearly examinations on you without a good reason (i.e. suspicious findings on the path report) then I would consider talking to your provider or finding a new one. edit: Here is a link to the recommendation https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening https://www.uspreventiveservicestaskforce.org/Page/Document/...
- lettergram 7y agoI have severe allergies that occasionally requires epinephrine... without an annual checkup doctors typically won’t give me a prescription. I’ve similarly been hospitalized for asthma, same deal with an inhaler. I had to really hunt to find a doctor who would give me a prescription without an annual checkup.
- cududa 7y agoLegally they can’t. If you have a steroidal inhaler, you’ll need to be evaluated every few months to ensure the steroids are hitting your lungs instead of blood stream.
- mcherm 7y ago> If you have a steroidal inhaler, you’ll need to be evaluated every few months... [emphasis added] I am reasonably sure this is not true, at least for most people's definition of "few".
- JeremyNT 7y agoCame here to post this same experience. I have terrible asthma and allergies that are completely controlled by the typical prescription medications that any lay person would select after a few minutes of googling, but I can only receive access to them for up to one year without going back to a doctor. The result is I often run out at inopportune times so I try to hoard / ration medication to avoid that situation.
- bdcravens 7y ago> But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. Certain medications require regular testing (example I'm familiar with is Orkambi for Cystic Fibrosis, and regular liver screens are required due to potential side effects), and the prescribing doctor won't renew those prescriptions otherwise.
- Dylan16807 7y agoThat's the opposite of unrelated. They're worried the medications are going to damage you.
- bdcravens 7y agoTrue - I misread the quote
- RomanBob 7y agoHealthcare has always been used by their practitioners as a tool to extract money from customers. Often they will say "it's for your own good". In reality, it's just a cartel, extremely protected by government regulation. For some reason, people think that the rules of economics don't apply when it comes to healthcare.
- cowmoo728 7y agoThat's less true now than it used to be, but it's worth remembering that the AMA killed universal healthcare in the US... in the 1950s! They were specifically worried about doctor's wages and fees going down.
- copperx 7y agoSomeone who isn't me has forged eye prescriptions with Photoshop to get around this problem to buy contacts and glasses online. I don't know in how much legal trouble he could get, but I think many people can understand.
- woliveirajr 7y agoSomething that I don't understand (and I haven't lived in the USA to know): when you get tested for something, you don't walk away with the results? They are kept in some system that only the MD who asked for them have access ??? You are unable to give the results to some other doctor, asking for a second opinion?
- mcherm 7y agoYes, that is accurate. In the US, lab results are nearly always sent to the doctor who prescribed the tests, not to the patient. (And most tests cannot be requested without a doctor's order.) Some doctors are good about sharing the detailed results with their patients while others are not. You can ask your doctor to send the results to another doctor (more often you just tell the new doctor to request them from the original doc). By law you are entitled to a copy of your medical record yourself but with many doctors it is surprisingly difficult to get them to do this. I have heard of cases where it took many weeks and the threat of a lawsuit. Ostensibly, the reason for this state of affairs is so a patient can have a professional help explain and interpret the results.
- joelberman 7y agoI can go online and get all of my test results including graphs that show change. X-ray reports. The only thing not online is surgical notes, but I easier got copies of them. This is from the UCLA healthcare system. Also Quest labs has online results to patients. This is in CA. My brother-in-law, could not get results from tests in Virginia to get a second opinion. Perhaps it varies by state.
- hansthehorse 7y agoI go to a VA medical center and every word they have written about me, all my labs and scans are available online.
- Bubbadoo 7y agoI had the option of having all test results emailed to me. I had the results of my physical before my doctor did. This is a result of modern medical information systems.
- jagged-chisel 7y ago> ... prescriptions expire so quickly ... If you mean 'come with a written expiration date,' then mine never have and I would find this practice abhorrent. If you mean 'really is no good in six months,' then your eyes are actually changing.
- kgwxd 7y agoCan't wearing "good enough" glasses and contacts cause vision quality to degrade faster?
- temperusjenkem 7y agoI've been wearing my "good enough" glasses about twenty years now. I know what the perfect vision feels like (I can get 20/10 easily with "right glasses") but that is just too much for me. I just can't live with that, everything is way too sharp. Glasses that give me 20/20 but no more make me feel much better. I always order online nowadays, and never have been subjected to this American "you need prescription/license (= pay) for this" way of dumbing things down. In general, degrading quality of vision is most likely a symptom of something. Needing reading glasses when you age is the only exception, that is just normal.
- Fjolsvith 7y agoAsk your optometrist why that argument fails for people who don't need vision correction.