7 ms·

Or, I go to a doctor, who is a medically trained professional, and they prescribe a medicine to me based on their experience and training, without any incentive

Or, I go to a doctor, who is a medically trained professional, and they prescribe a medicine to me based on their experience and training, without any incentive for financial reward?

jaspax 5y ago
Do you think that doctors don't have financial incentives to treat patients?
- throwaway3699 5y ago
  Not where I live. This is a uniquely US problem among first-world countries.
  - mrweasel 5y ago
    Technically I don't think it's unique to the US. In Denmark doctors get a fee per consultation. It's pay with tax money, but still the doctor is financially motivated to see patients. It might only apply to general practitioner though, I think hospital doctors are on a fixed salary. One issue, that could excuse medical companies going directly to the patients would be a lack of knowledge among doctors. Doctors contently write prescriptions for medication that's no longer available and is often not as updated as a pharmacy on new medication. This means that at least some doctors aren't suggesting the best treatment, simply because they aren't aware of it.
    - varispeed 5y ago
      The doctor can also put a generic name of the drug on the prescription and patient can tell the pharmacy to sell them a particular brand instead of a generic. So there is space where such direct advertising could work.
  - isaacremuant 5y ago
    Ireland is extremely for profit in everything they do and very poor compared to many places in Europe in terms of response and quality. People just assume a lot about the world.
    - entropyie 5y ago
      I don't think it's fair to put Ireland in the same category as the USA here: 1. Zero ads for prescription medication anywhere 2. Medical card for everyone on low income covering everything 3. Never pay more than EUR114/month for prescriptions, no matter how much you medication you need or your income. I've never had doctors pushing any kind of medication on me or my family.
      - nceqs3 5y ago
        Poor people in the US also get free everything...
      - isaacremuant 5y ago
        I was curious about another HN poster from Ireland so I looked at your other comments and you're defending RTÉ so it's safe to say we won't see eye to eye. You're a glass half full type of person, to put it in polite terms. I could rant all day about media and health in Ireland. Specially from a migrant perspective but it's not really the place. What is undeniable is that Ireland ranks amongst the worst in Europe and it's very much for profit. It's just Irish people don't know any better and they look at the wrong place (USA) and only at the money aspect, not the quality. Quality wise, I'd much rather be in USA than Ireland because treatment here is terrible in many cases and there's always a sea of excuses and bureocracy.
  - refurb 5y ago
    A financial incentive to treat? No, that's pretty common across healthcare systems. It's being worked on as system move away from fee-for-service, but generally, the more a physician does, the more they make.
- johannes1234321 5y ago
  They should have an incentive to treat them, they shouldn't have an incentive to suggest specific medication.
  - waterhouse 5y ago
    For what it's worth, it seems doctors are heavily advertised to: https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-photo-essay/ https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-phot...
- wiz21c 5y ago
  My doctor is certainly not backed by investors who are putting her under pressure if she doesn't make 10% ROI.
- Bancakes 5y ago
  No, I don't pay the doctor, the healthcare pool does. And then, the doctor is incentivised to cure me, not keep me in a perpetual drug-purchasing lifestyle as big pharma would.
  - varispeed 5y ago
    Doctors get cash and hospitality benefits from big pharma though based on how they prescribe. If there is drug X from company Y and drug A from company B and then there is no difference in therapeutic benefits between two drugs, but company B gives doctor cash and has access to regional sales data where the doctor operates, they can modify the benefit based on sales. Then the doctor is incentivised to prescibe the A. This may be harmless, but if the doctor gets into a financial trouble or simply get overwhelmed by greed, this can quickly turn into something that harm patients. In my country doctors don't have to disclose those relationships and they don't even have to declare this as income.
    - Bancakes 5y ago
      In my country, general practitioners can only prescribe a limited number of drugs and specialist visits a month, so as not to overwhelm the healthcare system. It's their moral choice to deem a person sick enough for a certain course of action. Whatever pill the doctor writes me up, I always end up asking the apothecary or looking up online the cheapest substitute. This is how the elderly here cope, they can barely pay bills, let alone choose which pills to skip. I've personally not had any problems with big pharma substitutes so far.
    - robbiep 5y ago
      This is absolutely not true in most countries. Where I practice you can get into big trouble for this. You have do declare pharma affiliations, cannot accept sponsorship and the age of junkets through drug companies is long in the past. I could be deregistered if I was found to be accepting anything (travel, hotels, conferences) and not declaring it
      - murukesh_s 5y ago
bserge 5y ago
You need to go to a doctor anyway. Not all of them are good, and imo they shouldn't have absolute say in what you take. If you suggest some medication you saw an advertisement for, they should take it into consideration instead of telling you to stfu about it. Yes, my experience with doctors has been terrible.
bmj 5y ago
without any incentive for financial reward? Except when they do get financial rewards? https://www.nytimes.com/2019/05/02/health/insys-trial-verdict-kapoor.html https://www.nytimes.com/2019/05/02/health/insys-trial-verdic...

Or, I go to a doctor, who is a medically trained professional, and they prescribe a medicine to me based on their experience and training, without any incentive for financial reward?

jaspax 5y ago

Do you think that doctors don't have financial incentives to treat patients?

throwaway3699 5y ago
Not where I live. This is a uniquely US problem among first-world countries.
- mrweasel 5y ago
  Technically I don't think it's unique to the US. In Denmark doctors get a fee per consultation. It's pay with tax money, but still the doctor is financially motivated to see patients. It might only apply to general practitioner though, I think hospital doctors are on a fixed salary. One issue, that could excuse medical companies going directly to the patients would be a lack of knowledge among doctors. Doctors contently write prescriptions for medication that's no longer available and is often not as updated as a pharmacy on new medication. This means that at least some doctors aren't suggesting the best treatment, simply because they aren't aware of it.
  - varispeed 5y ago
    The doctor can also put a generic name of the drug on the prescription and patient can tell the pharmacy to sell them a particular brand instead of a generic. So there is space where such direct advertising could work.
- isaacremuant 5y ago
  Ireland is extremely for profit in everything they do and very poor compared to many places in Europe in terms of response and quality. People just assume a lot about the world.
  - entropyie 5y ago
    I don't think it's fair to put Ireland in the same category as the USA here: 1. Zero ads for prescription medication anywhere 2. Medical card for everyone on low income covering everything 3. Never pay more than EUR114/month for prescriptions, no matter how much you medication you need or your income. I've never had doctors pushing any kind of medication on me or my family.
    - nceqs3 5y ago
      Poor people in the US also get free everything...
    - isaacremuant 5y ago
      I was curious about another HN poster from Ireland so I looked at your other comments and you're defending RTÉ so it's safe to say we won't see eye to eye. You're a glass half full type of person, to put it in polite terms. I could rant all day about media and health in Ireland. Specially from a migrant perspective but it's not really the place. What is undeniable is that Ireland ranks amongst the worst in Europe and it's very much for profit. It's just Irish people don't know any better and they look at the wrong place (USA) and only at the money aspect, not the quality. Quality wise, I'd much rather be in USA than Ireland because treatment here is terrible in many cases and there's always a sea of excuses and bureocracy.
- refurb 5y ago
  A financial incentive to treat? No, that's pretty common across healthcare systems. It's being worked on as system move away from fee-for-service, but generally, the more a physician does, the more they make.
johannes1234321 5y ago
They should have an incentive to treat them, they shouldn't have an incentive to suggest specific medication.
- waterhouse 5y ago
  For what it's worth, it seems doctors are heavily advertised to: https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-photo-essay/ https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-phot...
wiz21c 5y ago
My doctor is certainly not backed by investors who are putting her under pressure if she doesn't make 10% ROI.
Bancakes 5y ago
No, I don't pay the doctor, the healthcare pool does. And then, the doctor is incentivised to cure me, not keep me in a perpetual drug-purchasing lifestyle as big pharma would.
- varispeed 5y ago
  Doctors get cash and hospitality benefits from big pharma though based on how they prescribe. If there is drug X from company Y and drug A from company B and then there is no difference in therapeutic benefits between two drugs, but company B gives doctor cash and has access to regional sales data where the doctor operates, they can modify the benefit based on sales. Then the doctor is incentivised to prescibe the A. This may be harmless, but if the doctor gets into a financial trouble or simply get overwhelmed by greed, this can quickly turn into something that harm patients. In my country doctors don't have to disclose those relationships and they don't even have to declare this as income.
  - Bancakes 5y ago
    In my country, general practitioners can only prescribe a limited number of drugs and specialist visits a month, so as not to overwhelm the healthcare system. It's their moral choice to deem a person sick enough for a certain course of action. Whatever pill the doctor writes me up, I always end up asking the apothecary or looking up online the cheapest substitute. This is how the elderly here cope, they can barely pay bills, let alone choose which pills to skip. I've personally not had any problems with big pharma substitutes so far.
  - robbiep 5y ago
    This is absolutely not true in most countries. Where I practice you can get into big trouble for this. You have do declare pharma affiliations, cannot accept sponsorship and the age of junkets through drug companies is long in the past. I could be deregistered if I was found to be accepting anything (travel, hotels, conferences) and not declaring it
    - murukesh_s 5y ago

bserge 5y ago

You need to go to a doctor anyway. Not all of them are good, and imo they shouldn't have absolute say in what you take. If you suggest some medication you saw an advertisement for, they should take it into consideration instead of telling you to stfu about it. Yes, my experience with doctors has been terrible.

bmj 5y ago

without any incentive for financial reward? Except when they do get financial rewards? https://www.nytimes.com/2019/05/02/health/insys-trial-verdict-kapoor.html https://www.nytimes.com/2019/05/02/health/insys-trial-verdic...