I just spent an hour trying to order Real Rhapsody from the Internet when it should have taken five minutes at most.
Am I really that retarded? It's just like I've always said. The world is crazy, not the individual. I set out to research why this elementary task of using a Visa could become so difficult for a reasonably intelligent person. Okay, I did mess the numbers up during the first attempt. I proof read and made the necessary corrections then re-entered them. I then received a message my address was wrong so the order couldn't be processed. I put in my address every way imaginable but still no luck. I put in my old address, still no cigar. Alas! I remembered that the bank had made an error with the street number when I applied for the card 3 years ago. I had instructed them to fix it at least 10 times over the past but the thought that they probably never had done so dawned upon me and I decided to try entering an address where I don't live and never have lived. This was crazy. It worked beautifully. What the heck, at least I won't receive any junk mail and I'm enjoying my favorite music today at last.
I haven't seen Sicko yet but I felt it several times during the past week. I saw at least a dozen Pharmaceutical Reps during the week who updated me on how wonderful their drugs were for my patients. I must say the detailing is usually pretty good and I like having a break from just talking to patients every now and then. It's nice that the drug companies care so much about my patients.
At this point the number of prescriptions rejected by the managed care people are about at 30 to 40%. This means I have to fill out a form to explain why I want my patient to have this particular medication. I thought that was settled with the Pharmaceutical Rep earlier. It's suppose to be the state of the art treatment for what I have diagnosed the patient with. Now some unknown entity in some unknown location is giving me hoops to jump through before I can see the Wizard and get my wish granted. After the 7th or 8th time of going through this for the week, I am so frustrated and pissed that I feel like letting somebody have it. The last time I talked to a real person on the phone I spent 30 minutes on hold to finally be told that half the dose prescribed would be approved but that they might reconsider if I could produce 2 epidemiological clinical studies supporting the treatment dose I was prescribing for the patient. I thought I was the expert, but certainly not in medical economics. Since that day I abstain from talking to idiots because it's a big waste of time and it makes me homicidal.
I think it's better to fill out the forms most of the time than to give in and prescribe the generic product I'm pressured into prescribing. Sure it takes a bit of time and if the wrong box is checked the med is still not approved. The process has greatly damaged the clinical science in treating a patient. It is reduced to the Dr. taking an exam for the managed care organization. Can we give them the answers they want? I'll play their little game for now to get the medication I want to use in my patient but I know that the rules will continue to change as soon as I catch on to the answers they want me not to give.
Is this not just sicko?. The Pharmaceutical Industry is not regulated and can charge a thousand dollars for a bottle of pills it cost them five dollars to manufacture while the Managed Care companies have the incentive of saving their funds to satisfy their shareholders. The product intended to help the patient may never reach them because it's priced higher than what their third party payer wants to pay. So whose getting screwed the hardest here? If I choose to be passive or not play the game or fight back it will indeed be the patient. If managed care wants to be the clinical decision makers I think they should be forced to do their research scientifically and should carry the liability malpractice insurance.
Let's face it. This system is total bullshit (for the consumer) and we can and must do better than this as a country. When I think of the billions spent in Iraq unneccesarily and the lives lost it enrages me. We've been told there isn't money for healthcare and education. Don't be fooled, there is not an endless supply of fossil fuels but it is guaranteed the rich in America will never run out of money. If they do they will just print some more and make the middle class and poor pay for it.
Thank you for supporting this emergency vent, it may have saved my sanity and my life.