I wanted to write a seperate blog on this topic but briefly come back to a blog written yesterday talking about using marijuana for PTSD as there is more to the story. A lot of people in favor of this think that doctors against it are evil people who do not want to bring relief to patients so they can continue to get rich by making money from drug companies. I am here to tell you as someone who has been thoroughly educated in a University training program that physicians no longer recieve absolutely ANY benefit when they prescribe any medications. Physicians could care less about which medications to prescribe in terms of doing it for reasons other than choosing the best one for their patients.
Also physicians do not get paid for writing prescriptions in general! I encourage my patients to choose therapy more often than not and stay away from medications-and I am a physician! My colleages do the same and the misconception about this unfortunately is propogated in the public and the media.
Most psychiatrists are against using marijuana for PTSD because we do not feel it will help the patients on a long-term basis. Refer to my recent post that discusses why, but I want to make it clear that there no longer is incentive to use medications for physicians. For the most part we really do care about what is best for our patients and just because something makes you numb and emotionless, it does not mean it is “good.”
Moving on from that specific example however, I want to quickly educate people on what has happened to the drug industry and the impact it has had on physician’s prescribing patterns. I am the first to acknowledge the old days of physicians getting lavish vacations and cruises given to them by drug companies surely influenced their prescribing practices but luckily those days are long gone. Every large university has eliminated drug reps from evening coming to provide cookies for the doctors let alone any kind of monetary gift or great vacation. In the private sector drug reps still see physicians but are largely limited to bringing chinese food or a fruit basket. Trust me, as a physician, I can tell you the nicest spread of food in the world will not influence a physician to prescribe their latest medication and the benefits of prescribing the medicine are minimal-a doctor may stop recieving a monthly free lunch but in turn won’t have to deal with the drug reps anymore which are time consuming and a pain.
When drug reps are valued is in practices that see patients who cannot afford medications prescriptions and the samples the reps leave can be extremely helpful if used responsibly by the physician. This means not giving them 6 months of samples knowing that the samples are limited or will end and a person will be stuck on a medicaiton they cannot afford. However when used properly there are benefits to free samples. However giving these to patients is entirely benevolent because they cannot afford a comparable medication so it is for the benefit of the patient and not the doctor.
So in the end, please realized physicians no longer have any incentive to prescribe certain medication or a certain number of prescriptions. We also cannot bill more to insurance or a patient if we write a prescription or multiple prescriptions. Physicians bill insurance entirely on both time spent with a patient and a number of diagnostic factors such as questions asked, and exam/testing done.
Generally doctors are good people who do best for their patients is my point.
Michael Yasinski M.D