Hey doc, how much will it cost?

[DannyD]

I went to the doctors office for the first time in a long while. This isn't worthy of a 60 Minutes expose, but I found it to be interesting for reasons other than what my ailment was.

My ailment is simple. A rash. Doesn't hurt, doesn't itch, doesn't bother me, it just hasn't went away. He told me what the issue was. It was some big word I've already forgotten what it's called. It was your run of the mill 5 minute doctors visit for $80.

The interesting part IMO was the other stuff. When he thought I had insurance, he was going to recommend a $300 cream & $$$ pills. When he saw I didn't think it was that important & wasn't about to pay that much, he came up w/ some samples for me & a $10 subscription. Of course he gave the "this isn't as good" speech. Obviously I felt it was important enough to visit him. For $80 I'll fix it. For $500+, well that rash will just have to be my new girlfriend cuz it's gonna be w/ me for awhile.

What happened was once he told me what it was, I asked him for the spelling of what I had so I could go online & see if I could find the fix myself. That's when he gave me the samples + the $10 subscription. I figured that was good enough so I didn't bother to write it down. If this doesn't work I'll call back up there & get the spelling.

I guess what I'm getting at here is it sort of gave me a little glimpse into how the medical/insurance relationship works. Why wouldn't they try the low $ application first & see if that works?

I don't think the guy is a fraud. It's not like I felt he was sizing me up & seeing how much $$ he could make. I've been to a couple of chiropractors where I feel they're just out for the fast buck & quit using em. I'd go back to this guy if I ever felt the need. I think since he at first figured I had insurance I might as well get the best treatment I could.

My appointment was one little incident. A drop of water in an ocean of medical cases. There was a potential for a lot of wasted money in that transaction. I can only imagine what goes on w/ people who are sick & really need a doctor.

 

[moose]

please give us one rezone why health insurance providers needs to cut costs .
it's in their best interests to jack up the price.

 

[witness23]

A nice honest post with honest questions.

I am not a Doctor, and do not know the inner workings of a Doctor's office, but I do have a brother-in-law who is a doctor with a practice, and his wife used to be a pharmaceutical rep. I will be seeing them this Sunday for Easter and will ask them the questions you have raised.

 

[EnglishLady]

I'm not that au fait with the Health System here .... do Doctors/Hospitals get any commission from Pharmaceutical Companies if they use their products?

 

[greg334]

I'm not that au fait with the Health System here .... do Doctors/Hospitals get any commission from Pharmaceutical Companies if they use their products?

Nope it is really illegal and unethical to get any money from any sales. There were some cases where Merke and Pfizer had provided some 'perks' to docs who prescribed their meds only and got their hands slapped hard by the FDA over those perks and some fines.

What goes on with pharma sales is amazing, the reps, who are equal to carpet salesmen/women push hard to tell the docs that this drug or that drug is more effective with specific problems while leaving out some key information. Many don't have a medical degree which is one HUGE problem while others do but play the sales game. There is a limited amount of time the rep has with the docs, and a lot of times the reps will buy lunch for the staff to get the time with the docs, a practice I feel steps over the line. Most of it is not what people think goes on and the docs seem to be dependent on what the rep knows which a lot of times isn't much.

One of the tricks is the conferences where they do make big sales pitches and so on. One company used to hold conferences to tell docs about their drug providing more than what the drug was allowed to be prescribed for. They got caught and paid big big fines. The practice happens a lot in the doc's office. One such situation is reps telling the docs that anti-depressants are safe for kids, which they are not.

The pharma companies don't really know what level of sales many of the practices provide them, a lot of doctors will not disclose how many times a specific drug is prescribed while others who skirt the conflict of interest laws by not just providing numbers but also have a preferred drug based on the 'rewards' the docs get.

With that said, what happened has nothing to do with the doctor knowing what the insurance provides. He knows that this med will be more effective in helping the patient while that med may take a little longer. What happen was the doc was honest, he was not going to let a patent go untreated while knowing the limitations of the patient. A lot of doctors don't care and will write a script anyway and let you deal with it.

The insurance cost isn't because of the doctor's practice, it is because of the underfunded services related to elective issues, the example I use is a sex change operation but there are a lot of others. See many don't get that the $300k that is put into a sex change operation is not what is put into by the subscriber in their life time but the pool of money is finite and limited by the company to keep it viable. IF the insurance company had to pay for every little thing for every patient, then this issue of high cost of insurance pops up. With that the cost of running a practice of hospital is high because of the liabilities involved, OB/GYN docs have the highest malpractice insurance rates - know one who pays $3M a year for his practice, and he has to charge more to keep the insurance. There is more to it than that, hospitals have to maintain clean linen and etc...

The doctor is also not the one who you can depend on to figure out interactions of drugs or side effects - the pharmacist is the one to ask.