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Doctors prescribe drug -> pharmacy dispenses drug -> pharmacy orders from manufacturer. All I hear about is pharmacies and manufacturers getting sued, but why

Doctors prescribe drug -> pharmacy dispenses drug -> pharmacy orders from manufacturer. All I hear about is pharmacies and manufacturers getting sued, but why not doctors? Why do they seem to get off the hook when they are the main cause. Sure, Perdue marketed it to doctors (and I don't even see a way that pharmacies were responsible at all), but "I was manipulated by marketing" isn't a convincing defense from an expert.

gostsamo 5y ago
Also, the producers pay he doctors and provide different insentives to make them prescribe their drugs.
- fallingknife 5y ago
  Encourage, not make. And that makes all the difference. If you take the money, you take the responsibility with it.
  - gostsamo 5y ago
    So, giving the money is not part of the problem? The responsibility of one of the sides does not relieve the other one from it.
scotty79 5y ago
I think doctors were directly lied to that those drugs are non-addictive.
- stathibus 5y ago
  This may have been a valid argument some decades ago. Greedy doctors killed my aunt by selling her all the drugs she asked for. This is commonplace in the US.
  - joshgel 5y ago
    Sorry that happened to your aunt. Doctors aren’t reimbursed for prescribing medications directly (except chemotherapy infusions). Was the physician selling the medication directly? That’s not commonplace. Clinicians may financially benefit from not refusing their patients requests and thus losing the patient to another doctor that will acquiesce. But that’s a tricky topic to untangle.
  - ejb999 5y ago
    I agree - goes on still, all day everyday all across the USA. Easiest thing for a doctor to do to not have to deal with a problem patient (i.e. a drug seeker - not saying your aunt was one of them), is give them what they want, and send them on their way. Doctors should be held accountable - every script they write, is tracked - it would not be hard to find the doctors that are outside the range of normal. Insurance companies should also be held accountable - they pay for a big portion of these oversubscribed opioids, they know who is writing those scripts, they know when a duration or quantity is out of the normal bounds, and yet they still keep enabling it. But doctors do not get a cut of the prescriptions they write, not legally anyway, so don't think its greedy doctors - more like doctors who have to see upto 32 patients a day, in 15 min increments, and don't have time to argue with persistent drug seekers, so the close their eyes and pretend they don't know what is going on - and move on to the next 15 min appointment.
    - stathibus 5y ago
      It is greedy doctors; they would prefer to keep the patient and keep collecting payments for their visits than to call them out on their addiction, or god forbid actually treat them for it.
      - ejb999 5y ago
        so they they are greedy for collecting payments for visits to keep writing prescriptions, but if they spend their time treating them during the visit, they are not greedy? How does that work? do you think somehow they get paid extra for writing prescriptions during a visit, vs spending their time during the visit coming up with alternatives? If you think that, you are wrong.
- fallingknife 5y ago
  This is the part that I don't get. There must have been hundreds of papers on oxycodone done by Perdue, and other people. You would think that lying just couldn't get you to where you need to be for this, at least not without it being obvious that you were doing it. Like, I can see making up data for one paper, or getting a few legit publications via statistical outliers, but I don't see how you manufacture a whole industry level consensus.
iamricks 5y ago
There are some laws that make it harder to sue doctors for malpractice, maybe this combined with the fact that they could get a bigger payout from the drug manufacturers.
CaptArmchair 5y ago
Oh, but they are: https://www.wrshlaw.com/blog/medical-malpractice/medical-malpractice-and-the-opioid-crisis/ https://www.wrshlaw.com/blog/medical-malpractice/medical-mal... The heart of the issue is that it's a legally approved drug. That's where the debate moves into questions like: To what extent can a doctor prescribe a drug before it can be perceived as medical malpractice? Since the 2010s, states and federal government in the U.S. have started to enact countermeasures against the Opioid Crisis. This includes cracking down on pharmacists and doctors who over-prescribe: https://en.wikipedia.org/wiki/Opioid_epidemic_in_the_United_States#US_federal_government https://en.wikipedia.org/wiki/Opioid_epidemic_in_the_United_... Reading into the above, you'll notice that the story is far more complex. It's a "wicked" problem with many in's and out's. On the surface level, fixing this seems easy, until you start digging into this and you see complex interests, countless stakeholders, political tensions, power structures, dependencies on other policy issues, etc. add to the complexity.

gostsamo 5y ago

Also, the producers pay he doctors and provide different insentives to make them prescribe their drugs.

fallingknife 5y ago
Encourage, not make. And that makes all the difference. If you take the money, you take the responsibility with it.
- gostsamo 5y ago
  So, giving the money is not part of the problem? The responsibility of one of the sides does not relieve the other one from it.

scotty79 5y ago

I think doctors were directly lied to that those drugs are non-addictive.

stathibus 5y ago
This may have been a valid argument some decades ago. Greedy doctors killed my aunt by selling her all the drugs she asked for. This is commonplace in the US.
- joshgel 5y ago
  Sorry that happened to your aunt. Doctors aren’t reimbursed for prescribing medications directly (except chemotherapy infusions). Was the physician selling the medication directly? That’s not commonplace. Clinicians may financially benefit from not refusing their patients requests and thus losing the patient to another doctor that will acquiesce. But that’s a tricky topic to untangle.
- ejb999 5y ago
  I agree - goes on still, all day everyday all across the USA. Easiest thing for a doctor to do to not have to deal with a problem patient (i.e. a drug seeker - not saying your aunt was one of them), is give them what they want, and send them on their way. Doctors should be held accountable - every script they write, is tracked - it would not be hard to find the doctors that are outside the range of normal. Insurance companies should also be held accountable - they pay for a big portion of these oversubscribed opioids, they know who is writing those scripts, they know when a duration or quantity is out of the normal bounds, and yet they still keep enabling it. But doctors do not get a cut of the prescriptions they write, not legally anyway, so don't think its greedy doctors - more like doctors who have to see upto 32 patients a day, in 15 min increments, and don't have time to argue with persistent drug seekers, so the close their eyes and pretend they don't know what is going on - and move on to the next 15 min appointment.
  - stathibus 5y ago
    It is greedy doctors; they would prefer to keep the patient and keep collecting payments for their visits than to call them out on their addiction, or god forbid actually treat them for it.
    - ejb999 5y ago
      so they they are greedy for collecting payments for visits to keep writing prescriptions, but if they spend their time treating them during the visit, they are not greedy? How does that work? do you think somehow they get paid extra for writing prescriptions during a visit, vs spending their time during the visit coming up with alternatives? If you think that, you are wrong.
fallingknife 5y ago
This is the part that I don't get. There must have been hundreds of papers on oxycodone done by Perdue, and other people. You would think that lying just couldn't get you to where you need to be for this, at least not without it being obvious that you were doing it. Like, I can see making up data for one paper, or getting a few legit publications via statistical outliers, but I don't see how you manufacture a whole industry level consensus.

iamricks 5y ago

There are some laws that make it harder to sue doctors for malpractice, maybe this combined with the fact that they could get a bigger payout from the drug manufacturers.

CaptArmchair 5y ago

Oh, but they are: https://www.wrshlaw.com/blog/medical-malpractice/medical-malpractice-and-the-opioid-crisis/ https://www.wrshlaw.com/blog/medical-malpractice/medical-mal... The heart of the issue is that it's a legally approved drug. That's where the debate moves into questions like: To what extent can a doctor prescribe a drug before it can be perceived as medical malpractice? Since the 2010s, states and federal government in the U.S. have started to enact countermeasures against the Opioid Crisis. This includes cracking down on pharmacists and doctors who over-prescribe: https://en.wikipedia.org/wiki/Opioid_epidemic_in_the_United_States#US_federal_government https://en.wikipedia.org/wiki/Opioid_epidemic_in_the_United_... Reading into the above, you'll notice that the story is far more complex. It's a "wicked" problem with many in's and out's. On the surface level, fixing this seems easy, until you start digging into this and you see complex interests, countless stakeholders, political tensions, power structures, dependencies on other policy issues, etc. add to the complexity.