4 ms·

> Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper. I’m curio

by jmye 6mo ago

> Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper. I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically.

tastyfreeze 6mo ago
Go to doctor, get prescription for restricted medicine, pick up prescription. If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.
- jmye 6mo ago
  That’s… not how actual telemedicine works. That’s how jackasses “disrupt” healthcare for very specific drugs. Mostly birth control, ED meds, and various hair regrowth meds. It’s really clear that some of you are really mad about something you don’t understand.
A_D_E_P_T 6mo ago
I'll give you a case in point. This article was discussed the other day: > https://www.nytimes.com/2026/04/02/technology/ai-billion-dollar-company-medvi.html https://www.nytimes.com/2026/04/02/technology/ai-billion-dol... People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription. The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.
- hombre_fatal 6mo ago
  I think access is a good thing. The issue isn't with telemedicine but the fact that there's a prescription wall for helpful meds like GLP-1 in a country where we've failed people by creating one of the worst food environments. Also, most doctor's visits aren't any different from getting it if you want it except it's gated on the mood/attitude of the doctor, maybe your ability to sell some sob story. And then you book a different doctor until you get it. Telemedicine just makes the process easier an arbitrary system.
  - kube-system 6mo ago
    GLP-1 prescriptions are easy to get in the US. It's filling the prescription that is the problem, because insurance rarely covers it and it is beyond the disposable income of most Americans. The prescription hurdle is absolutely necessary -- these are not drugs that anyone can safely take without guidance. It's the price that needs to be fixed.
    - hombre_fatal 6mo ago
      I know a lot of people on GLP-1 meds and even took a dose myself out of curiosity. You take a dose every two weeks. And if you accidentally double dose because you misread 1U to mean 1 dose, it just gives you some nausea. Are we going to pretend it's hard to take this drug now too? Or that the doctor has some magical insight into your getting-on? Remember to eat. That's it. I guess a few people might need the doctor to go "you're eating, right?" but I don't believe in infantilizing everyone over that.
      - kube-system 6mo ago
        One dose is one thing -- but there are other risks that can lead to complication or death here if taken improperly for a long period of time. Musculoskeletal issues, cardiac issues, thyroid issues, etc. Additionally, getting the correct dose is not straightforward for a layperson as it is for other OTC drugs with standard doses.
        tptacek 6mo ago
        There are similar risks, and probably more likely, to all sorts of consumables that aren't regulated at all. It is reasonable to ask whether the prescription regime for GLP-1s makes sense. It isn't the only substance posing that conundrum! Ondansetron is OTC in a lot of countries, but not in the US, Canada, or UK. But ondansetron is arguably less dangerous and more helpful than pseudoephedrine.
        kube-system 6mo ago
ai_critic 6mo ago
I take certain medications--nothing interesting, nothing controlled, nothing abusable. I have to deal with a whole thing just to get refills, because my PCP forces me to come in every time--and even that is now just a telehealth call that is annoying. In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense. (Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)
pedalpete 6mo ago
The "perscription system" used to be that you'd have to go see a doctor, the doctor knew who you were, and would make decisions on what prescriptions/medications you should be given. Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription. Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.
- jmye 6mo ago
  > Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you. This is only true for a handful of drugs that are basically OTC already (or that have OTC formulations). Additionally, telemedicine didn’t take advantage of drug advertising- that’s an odd assertion.
  - pedalpete 6mo ago
    The system changed from the doctor deciding what drugs you should take to the patient asking for the drug by name from the doctor. I think this enabled telemedicine to work in the way it does not. The patient says "I want wegovy" and the telemedicine platform says "ok, here you go". Would telehealth pill-pushers exist without this mentality?
phil21 6mo ago
> I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically. They basically operate as a "pay for a prescription" service. Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't. 5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice. It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route. Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.
- cycomanic 6mo ago
  Well that's a problem with the profit driven US health system (although admittedly other countries have similar problems to varying degrees) not prescriptions in general though? In particular the take home from this should be to make it more difficult to get the prescriptions not to do away with prescriptions.

by jmye 6mo ago

tastyfreeze 6mo ago

Go to doctor, get prescription for restricted medicine, pick up prescription. If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.

jmye 6mo ago
That’s… not how actual telemedicine works. That’s how jackasses “disrupt” healthcare for very specific drugs. Mostly birth control, ED meds, and various hair regrowth meds. It’s really clear that some of you are really mad about something you don’t understand.

A_D_E_P_T 6mo ago

I'll give you a case in point. This article was discussed the other day: > https://www.nytimes.com/2026/04/02/technology/ai-billion-dollar-company-medvi.html https://www.nytimes.com/2026/04/02/technology/ai-billion-dol... People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription. The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.

hombre_fatal 6mo ago
I think access is a good thing. The issue isn't with telemedicine but the fact that there's a prescription wall for helpful meds like GLP-1 in a country where we've failed people by creating one of the worst food environments. Also, most doctor's visits aren't any different from getting it if you want it except it's gated on the mood/attitude of the doctor, maybe your ability to sell some sob story. And then you book a different doctor until you get it. Telemedicine just makes the process easier an arbitrary system.
- kube-system 6mo ago
  GLP-1 prescriptions are easy to get in the US. It's filling the prescription that is the problem, because insurance rarely covers it and it is beyond the disposable income of most Americans. The prescription hurdle is absolutely necessary -- these are not drugs that anyone can safely take without guidance. It's the price that needs to be fixed.
  - hombre_fatal 6mo ago
    I know a lot of people on GLP-1 meds and even took a dose myself out of curiosity. You take a dose every two weeks. And if you accidentally double dose because you misread 1U to mean 1 dose, it just gives you some nausea. Are we going to pretend it's hard to take this drug now too? Or that the doctor has some magical insight into your getting-on? Remember to eat. That's it. I guess a few people might need the doctor to go "you're eating, right?" but I don't believe in infantilizing everyone over that.
    - kube-system 6mo ago
      One dose is one thing -- but there are other risks that can lead to complication or death here if taken improperly for a long period of time. Musculoskeletal issues, cardiac issues, thyroid issues, etc. Additionally, getting the correct dose is not straightforward for a layperson as it is for other OTC drugs with standard doses.
      - tptacek 6mo ago
        There are similar risks, and probably more likely, to all sorts of consumables that aren't regulated at all. It is reasonable to ask whether the prescription regime for GLP-1s makes sense. It isn't the only substance posing that conundrum! Ondansetron is OTC in a lot of countries, but not in the US, Canada, or UK. But ondansetron is arguably less dangerous and more helpful than pseudoephedrine.
        kube-system 6mo ago

ai_critic 6mo ago

I take certain medications--nothing interesting, nothing controlled, nothing abusable. I have to deal with a whole thing just to get refills, because my PCP forces me to come in every time--and even that is now just a telehealth call that is annoying. In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense. (Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)

pedalpete 6mo ago

The "perscription system" used to be that you'd have to go see a doctor, the doctor knew who you were, and would make decisions on what prescriptions/medications you should be given. Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription. Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.

jmye 6mo ago
> Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you. This is only true for a handful of drugs that are basically OTC already (or that have OTC formulations). Additionally, telemedicine didn’t take advantage of drug advertising- that’s an odd assertion.
- pedalpete 6mo ago
  The system changed from the doctor deciding what drugs you should take to the patient asking for the drug by name from the doctor. I think this enabled telemedicine to work in the way it does not. The patient says "I want wegovy" and the telemedicine platform says "ok, here you go". Would telehealth pill-pushers exist without this mentality?

phil21 6mo ago

> I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically. They basically operate as a "pay for a prescription" service. Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't. 5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice. It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route. Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.

cycomanic 6mo ago
Well that's a problem with the profit driven US health system (although admittedly other countries have similar problems to varying degrees) not prescriptions in general though? In particular the take home from this should be to make it more difficult to get the prescriptions not to do away with prescriptions.