3 ms·

This needs to end. I would take a pharmaceutical/drug related test (administered through the state), and it could be comprehensive; If I could renew my long te

This needs to end. I would take a pharmaceutical/drug related test (administered through the state), and it could be comprehensive; If I could renew my long term prescriptions. The pharmacist wants to see a blood panel before refilling, fine, I should be able to order one. (Only on long term medications (Blood pressure, diabetes, and most psychiatric drugs within reason) , and never antibiotics)

bluGill 5y ago
While I agree with the sentiment, anyone on long term medication needs regular monitors by a doctor anyway. If you are only 25 this won't make sense, but by the time you get to 50 you need regular checkups for lots of things that are best caught early. I've lost enough family to colon cancer (spouse of a second cousin - can I even claim him as family?), and several others are only alive now because their cancer was caught in time. Then there is heart problems which again are best treated before the heart attack (if possible) - I just named the two most common killers of old people that you can be sure is in your family and coming to get you in the future (I know of exceptions - genetic disorders that will kill at 50 or so), but regular doctors visit can hold off.
- hellbannedguy 5y ago
  I'm not arguing against physicals. Right now American law states you need to see a doctor once a year in order to procure medications. We all know how many times patients are brought in just to get that script. They (MD's) love the six week interval. It pays for the lifestyle. I'm lucky if my blood pressure is checked. And the Colon scan is something they might be mentioned while walking out the door. My point is if you have a conscience doctor, and good insurance, by all means take advantage of it. Many Americans don't have good insurance, but need medication. We shouldn't have to come into pricy office visits (basically a stare down, or if he's peppy--some dubious advice) just to get a medication we have been on for years.
  - d110af5ccf 5y ago
    Adding to this, in some US states insulin has been made prescription only. Because surely that won't have any unintended consequences.
  - bserge 5y ago
    On the other side of the ocean, one can wait up to 3 months for a levothyroxine renewal. Now, that's in extreme cases, 2-6 weeks is the average, but levothyroxine! A basic medication for lifelong illness with no addictive or stimulant properties. But hey, it's free-ish. If you ignore the "potentially being without it for a few weeks" part, which can be debilitating.
d110af5ccf 5y ago
The real question from my perspective is why the pharmacist can't be the one making the determination in the vast majority of cases. > never antibiotics Despite the common wisdom, the issue there wasn't (mis)use in humans but rather certain agricultural practices which I understand (in the US at least) to have largely been curbed at this point. Antibiotics that were still clinically relevant in humans were being added to animal feed en masse because "reasons" (ie cost cutting of various sorts). Evolutionarily, that went about as well as you'd expect.
ghufran_syed 5y ago
I think this is a fabulous idea and this kind of sensible approach to regulation could be applied in many different areas, increasing personal freedom without excessively increasing risk and third-party costs. For example, in finance, maybe the default could be that only fixed rate mortgages can be sold, but if you take and pass a rigorous exam and indemnify the government from any claims if you end up losing your house, then you can be sold an adjustable rate or interest-only mortgage. Maybe you could have default speed limits as we do now, but if you take an exam +/- agree to telemetry in your vehicle, you can go faster than the speed limits as long as it’s safe. Particularly for my low-income patients who end up coming into the ER for a refill (or a complication of having ran out of their meds), I’ll often write a 3 month supply and 3 refills, so giving them one year of access to their meds without needing a doctor. I still strongly encourage them to get a primary doctor and see that doctor in order to get help with their medical conditions, but the idea that we should effectively coerce patients into seeing a doctor by withholding life-saving medications (“it’s for their own good!!!”) seems grossly unethical to me, and doesn’t take into account the problems poorer people have in getting good affordable healthcare. But I’m pretty sure my position is an outlier among emergency medicine docs.
- kaba0 5y ago
  I think there actually is something like that in finance — I can’t just walk into my bank and do some very risky trading with high leverage without taking some exam. I’m hazy on the details, just have developed an app for a bank that had to do some validation on clients. But I think it is an EU rule (or perhaps Hungary only if someone were to know)

bluGill 5y ago

While I agree with the sentiment, anyone on long term medication needs regular monitors by a doctor anyway. If you are only 25 this won't make sense, but by the time you get to 50 you need regular checkups for lots of things that are best caught early. I've lost enough family to colon cancer (spouse of a second cousin - can I even claim him as family?), and several others are only alive now because their cancer was caught in time. Then there is heart problems which again are best treated before the heart attack (if possible) - I just named the two most common killers of old people that you can be sure is in your family and coming to get you in the future (I know of exceptions - genetic disorders that will kill at 50 or so), but regular doctors visit can hold off.

hellbannedguy 5y ago
I'm not arguing against physicals. Right now American law states you need to see a doctor once a year in order to procure medications. We all know how many times patients are brought in just to get that script. They (MD's) love the six week interval. It pays for the lifestyle. I'm lucky if my blood pressure is checked. And the Colon scan is something they might be mentioned while walking out the door. My point is if you have a conscience doctor, and good insurance, by all means take advantage of it. Many Americans don't have good insurance, but need medication. We shouldn't have to come into pricy office visits (basically a stare down, or if he's peppy--some dubious advice) just to get a medication we have been on for years.
- d110af5ccf 5y ago
  Adding to this, in some US states insulin has been made prescription only. Because surely that won't have any unintended consequences.
- bserge 5y ago
  On the other side of the ocean, one can wait up to 3 months for a levothyroxine renewal. Now, that's in extreme cases, 2-6 weeks is the average, but levothyroxine! A basic medication for lifelong illness with no addictive or stimulant properties. But hey, it's free-ish. If you ignore the "potentially being without it for a few weeks" part, which can be debilitating.

d110af5ccf 5y ago

The real question from my perspective is why the pharmacist can't be the one making the determination in the vast majority of cases. > never antibiotics Despite the common wisdom, the issue there wasn't (mis)use in humans but rather certain agricultural practices which I understand (in the US at least) to have largely been curbed at this point. Antibiotics that were still clinically relevant in humans were being added to animal feed en masse because "reasons" (ie cost cutting of various sorts). Evolutionarily, that went about as well as you'd expect.

ghufran_syed 5y ago

I think this is a fabulous idea and this kind of sensible approach to regulation could be applied in many different areas, increasing personal freedom without excessively increasing risk and third-party costs. For example, in finance, maybe the default could be that only fixed rate mortgages can be sold, but if you take and pass a rigorous exam and indemnify the government from any claims if you end up losing your house, then you can be sold an adjustable rate or interest-only mortgage. Maybe you could have default speed limits as we do now, but if you take an exam +/- agree to telemetry in your vehicle, you can go faster than the speed limits as long as it’s safe. Particularly for my low-income patients who end up coming into the ER for a refill (or a complication of having ran out of their meds), I’ll often write a 3 month supply and 3 refills, so giving them one year of access to their meds without needing a doctor. I still strongly encourage them to get a primary doctor and see that doctor in order to get help with their medical conditions, but the idea that we should effectively coerce patients into seeing a doctor by withholding life-saving medications (“it’s for their own good!!!”) seems grossly unethical to me, and doesn’t take into account the problems poorer people have in getting good affordable healthcare. But I’m pretty sure my position is an outlier among emergency medicine docs.

kaba0 5y ago
I think there actually is something like that in finance — I can’t just walk into my bank and do some very risky trading with high leverage without taking some exam. I’m hazy on the details, just have developed an app for a bank that had to do some validation on clients. But I think it is an EU rule (or perhaps Hungary only if someone were to know)