Why do insurance companies dictate how my doctor treats me? I can’t try xyz drug for my migraines until I try 20 other drugs first. I can’t get PRP or prolotherapy for my neck because they happen to be 20 years behind on their research. (They will pay for a fusion though, but not other less invasive treatments to avoid surgery)
It makes no sense. People that aren’t doctors and don’t understand my health issues should not have a say in the treatment that I’m receiving. Insurance companies are too powerful.
I agree completely. Every patient is different and has a different story, with different issues. You cannot treat a patient based on which drugs the insurance company wants to push that month (usually the cheapest variety). Insurance companies do not go to medical school and they do not know a patient’s history, so they have absolutely NO business telling a physician how to treat their patients (which tests to order, which meds to give them, which treatment to provide, etc). Only your doctor, who knows you and your medical history, should be deciding which form(s) of treatment are best for you. And the insurance company should just shut up and pay the bill.
I respectfully disagree with that. Insurance companies are just that: they pay insurance claims. They should not be advising physicians, PAs, RNs, how to treat the patient. Their job is to pay the claims. Period. Now, if something is suspicious - say, $45 for a bandaid - then, yeah, they should question the cost. But they should not be questioning the USE of the bandaid.
NPs and PAs routinely misdiagnose and provide the wrong treatment for patients. A patient diagnosed with depression being prescribed some expensive new drug first line or the wrong medicine should be questioned. It saves the patient from harm and keeps unnecessary costs down. Go to medical school then, not take a short cut and receive not even a tenth of the length of training with the quality of that training being far worse as well. Their practice SHOULD be scrutinized.
Yes, misdiagnosis happens with NPs & PAs, but it also routinely happens with doctors. This is why you should have a say in your own treatment- nobody knows your own body better than you.
There’s a big difference though, human mistakes vs much more consistent knowledge deficits. However a doctor has 16000 hours of standardized training, being trained by dozens of doctors in multiple specialties where every patient they see, every note they write, every order they put in, etc is supervised.
An NP meanwhile has 500 hours of online training, often shadowing over the internet, shadowing other trainees, and shadowing non-clinical staff at programs with near 100% acceptance rates. Is it shocking this loosely regulated field produces low quality practioners who just are in it for the money and saw an opportunity to practice medicine by taking a shortcut? Did you know in many states because they claim to practice “advanced nursing” a doctor cannot testify against them as an expert witness?
Just because you’ve been a stewardess for a few years doesn’t mean you know anything about piloting a plane.
There’s bad doctors and doctors make mistakes, but they’re not the ones pushing for care to be a race to the bottom all to enrich corporate healthcare.
PAs work under the supervision of a doctor - you don’t trust the doctors to handle it? Also, double check PA requirements. It isn’t a Sally Struthers VHS repair certificate. MDs & PAs aren’t that different in their requirements- most of MDs extra time comes from a surgery fellowship or if they have some similar focus. CME requirements are similar, too.
MDs are absolutely doing their part in screwing up our healthcare. They make money from prescribing certain drugs. They don’t stand up to insurance companies (except for the few that don’t accept it). These are the ones I actually trust, the ones that aren’t in big pharma’s pocket.
BECAUSE OF THE UNCONSTITUTIONAL OBAMACARE which is a FASCIST collusion with business, such as the insurance companies that deny claims because OBAMACARE and the business profit! 50% of OUR money in OBAMACARE goes to administration! OBAMACARE must be annihilated and healthcare returns to doctors and patients.
THAT schucking weak oink oanty rat JUSTICE JOHN ROBERTS took power he does not have, rewrote Obamacare and shoved hs law down out throats. THEN the dirty rat liar John McCain threw his fat middle finger in the face of ALL AMERICANS and voted to keep Obamacare because his bloated gaseous rot ego was bruised by President Trump.
OBAMACARE and the DEPT of ED are UNCONSTITUTIONAL on their faces and must be ANNIHILATED. SO take your anger and direct it to your senators and representatives and demand they get rid of BOTH!
No, because the supervision exists on paper only. Why do you think the government must spend tens of millions of $$$ to subsidize MD residents’ supervision meanwhile PA/NP “supervision” doesn’t require this and large employers make many millions of $$$ in additional profit instead. The supervision isn’t the same, one exists, the other exists on paper only. How can an MD see all their own patients and somehow double check a and “supervise” a half dozen other NPs and PAs all who have dozens of their patients of their own that day? No MD can discuss that many patients on top of their own.
No, PA school is 2-2.5 years. MD is 4 years medschool, 3-7 years residency. Then 1-2 years per fellowship. PAs training is “on the job” once they finish school. Guess who is the Guinea pig during that time?
PAs>NPs. At least PA training is somewhat standardized with high admission requirements vs NP school.
Which doctors are getting money doing that? PAs and NPs don’t? In what way are doctors supposed to “fight” insurance companies? I’ve never met a doctor like likes insurance companies.
What’s your method of knowing which doctors aren’t in big pharmas pockets?
I woke up and realized the truth over a period of years.
1 - most doctors only perform what they are trained to do. This training is often limited to surgery and drugs. Exploring outside this realm is heretical, uncomfortable, unaccepted and most important, not covered.
2 - your care is tightly controlled by the pharmaceutical companies. Doctors are coerced to use treatments where drugs are used and thereby funnel $$$ to pharmaceutical conglomerates. Doctor training is provided by institutions which are funded by the pharmaceutical industry.
If a procedure or therapy does not send money to a drug company it is not recommended. If a medication cannot be patented and provide income to Big Medicine, it will be ignored.
Natural products such as nutritional supplements will not send money to a pharmaceutical giants so these are labeled as wild, controversial, alternative, medieval, unproven or unscientific.
Stem cells cannot br created in a lab nor can they be patented and thus controlled. Therefore a $100,000 hip replacement will always usurp a $5,000 stem cell injection.
Am I a bitter, grumpy senior citizen, angry because he cannot always get his way? I prefer to think I understood the system long ago and made efforts to search for what I needed. I have found help from chiropractors, acupuncturists, massage therapists and naturopaths. Very often I had to pay out-of-pocket.
There are great doctors and treatments out there. But do not expect the medical world to point you to the best option, only the most controlled and most profitable.
If we’re lucky, HHS Secretary Robert Kennedy, Jr. will shake things up.
perform outside of your scope, you get sued if something goes wrong or because you deviated from the standard of care
what is your evidence NPs, PAs, and doctors are being “coerced?” If they are what’s being done to prevent this ?
The problem with supplements for example is there are very little studies on the many thousands of them. The ones that do exist are very small and often give conflicting results.
I’m thinking you must be an MD, or an aspiring MD. Or, you’ve never actually been to a doctor.
There are tons of studies on supplements. There are studies on everything. Just because you choose not to look at them is on you, and the problem with most doctors.
You are right on! The education of doctors (all in the medical profession) is like a shake and bake system. They teach more about pharmaceuticals than any other treatments. I am greatly disheartened at the state of our medical system.
I completely understand what you are saying! The reality is that the doctor is free to do what they feel is best regardless of insurance payment. The best doctors are the ones who do not take insurance and let people try to be reimbursed on their own. Doctors do need to be paid and most have yielded to this game of insurance reimbursement.
I have a lot to learn about health insurance in order to offer any solutions. There are so many factors that come into play it makes my head spin. Bottom line-the health insurance is a business and is in the game for profit. I am big on capitalism because it truly spurs innovations, but there has to be some sort of way to limit how much control they have. The government penalizing you on your taxes for not having insurance is not helping the situation. I bet there are people who have worked in this industry who has a few solutions up their sleeves.
I had a very aggressive form of skin cancer on the side of my back, my cancer dr sent in a prior authorization to do the new SRS radiation treatment on me so I wouldn’t have do surgery or chemo. All of these prior authorizations go through a team of NON medical professionals for approval or disapproval. I checked into the company that Bcbs used for theirs & they accountants, CEOs of pharmaceutical companies. There’s no instance where anyone but me and Doctor should be making medical decisions about my heath. Those azzholes denied it the 1st & going to make me go through surgery that would have cost me a 1000$ deductible where the SRS radiation treatment was 250$ dollars for the 21 treatments that were required. Had he not appealed the decision to the next level & I was required to pay that 1000$ dollars for surgery I’d been dead by Christmas (6 months) was the life expectancy with no treatments. Which would have been me because I can’t just spit out a 1000$ dollars. But the next level of appeals were actually drs & they approved the radiation treatments. I believe insurance companies & DEA & CDC & FDA & any other government or non government agency needs to get the freak out of my healthcare decisions. Leave it to Me & my doctor & God other than those it’s no one else business.
Very mad & uneducated Much ? Obamacare keeps your ass from being discriminated against by insurance companies for having pre-existing conditions. Obamacare insures 30-40 million Americans, people who wouldn’t have healthcare if the republicans had gotten their way & John McCain hadn’t stuck his fat f¥€king finger in the air there would be no healthcare for chronic pain patients who aren’t old enough for Medicare & don’t qualify for Medicaid. I tried getting health insurance after my husband went off work disabled. I was turned down by them all because I have asthma a pre-existing condition. I suspect that you’re not that frigging healthy yourself or you wouldn’t be here bitching about insurance companies & John McCain & Obamacare. I don’t know maybe you’re just racist that’s why you think the way you do about Obama. I can promise this, he is 10,000% more a man than Donald Trump could ever dream of being. Considering the only reason you’re here is political. You’re here to rant & rave about what you think of Obama.
We are here because we suffer from chronic pain & need the insurance companies & government out of our medical decisions.
There’s plenty of studies, many of which are poorly designed, have small sample sizes, don’t control for confounding factors like exercise , aren’t broadly applicable based on the demographic they studied, published in “pay to publish” journals, and provide conflicting results. Then you have the issue of many supplements not containing what they say they contain since it’s not super regulated. It takes a lot of research to find the right supplements that have the correct certifications and when you do, they’re usually very expensive. I’m very much open to supplements and they have their place.
Taking it one step further, you can also see which providers are taking money or are being wine and dined by big pharma…they spend millions doing this because it influences prescribers to write for the more expensive drugs, they don’t do it for charity. Please share with everyone: