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September 15, 2006

Comments

david

Yeah, there ought to be *some* way to re-jigger the medical system to allow certain people (based on passing a test? experience?) to obtain generic antibiotics for common conditions. The "medical monopoly" won't ever let it happen, though...

moorcat

The reason given by the AMA for not allowing antibiotics to be sold over the counter is actually two fold -

1) the illergic reaction to antibiotics can be life threatening and therefore the drugs should only be used under a doctor's supervision

And

2) Antibiotics when overly used produce a number of side-effects such as antibiotic resistant diseases, developed allergies, and loss of effectiveness in the patient.

Now, all that said, the countries that DO distribute Anti-biotics over the counter have NOT experienced any of these feared results. In fact, France (where you can buy a LOT of "perscription drugs" over the counter has, per capita, far fewer cases of illergic reactions or antibiotic resistant diseases than the US.

I agree with you... If you know you need an antibiotic, you should have to have some $90 per visit doctor tell you what you already know...

Moorcat

moorcat

Sorry, that should have been "Yiou should NOT have to have some $90 a visit doctor tell you what you already know"...

Moorcat

Justin

I think you read my mind, I was just commenting to the same effect over at 4 & 20 B-birds. Why are we obligated to pay doctors that don't do anything, but we're not legally obligated to pay anyone else if they don't do their jobs? How come doctors can get away with it, but not say, mechanics or carpenters or window washers. If you hire a carpenter to build you a house, and he doesn't do it, you don't have to pay him. If you "hire" a doctor to fix a medical problem though, and he doesn't do squat, he still sends you a bill and you still have to pay. Why can doctors get away with it? No one else can. Why didn't I go to medical school?

Mike

Everything that I've read on the subject actually indicates antibiotic resistance is increasing throughout Europe and other places where antibiotics are available over the counter (reference the Alexander Project). The problem inherent in allowing a person to treat themselves with an antibiotic involves simply choosing the right drug for the right bug...something I doubt many folks are capable of. Many folks actually get pissed that doc's and NP's won't provide them a prescription for antibiotics when their presenting symptomatology suggests a viral infection, which then helps increase resistance further and doesn't do anything more than make the patient feel better that his or her doctor provided him with "a pill" to fix their problems.

I do believe the "medical monopoly" should be actively engaged to help bring mid-level practioners into the system via the use of Nurse Practitioners and Physician Assistants for the routine prescribing of antibiotics, thus allowing the physician to concentrate on areas where his/her expertise is needed most.Numerous studies have shown that NP's and PA's are more cost effective at delivering primary healthcare but at least in Montana, their respective roles are often guided or in many cases dependent on physician approval...and who's going to give up part of their bailiwick without a fight?

I think the problem with Justin's argument concerning physicians "that don't do anything" is that often times those seeking healthcare, often without the benefit of an insurance or other wellness program (another subject entirely), enter the system too late. In walks a patient to an office or ER after smoking, drinking or eating too much for their entire life, experiencing shortness of breath, chest pain, or other acute pain for days, weeks, or months, and then expects the doc's and nurses to fix whatever ails them and then discharge them quickly back into the same destructive environment so that the process can be repeated again down the road.

National healthcare or a single payer system won't fix the problem because you simply can't cure stupid, nor realistically expect to pay for such a system given the current political climate, regardless of what political party controls X branch of government. We need to focus on preventative healthcare at an early age and then provide an incentive to insurance companies to promote wellness among their policy holders, and rather than punitively punish them with high deductibles provide a financial incentive for not getting sick and preventing problems that either the best insurance or no insurance at all cannot fix.

moorcat

I find the Alexander project to the flawed in many areas - primarily because it assumed a conclusion before it began. It is also funded by those that don't want to see a program of over the counter drugs in the US )as well as other patient benefits...). It began assuming that a lay person was incapable or unwilling to accurately identify thier own symptoms or that the lay person was incapable of recognising the symptoms of a disease that they had previously had (like Wulfgar's sinus infection).

As a child, I was particularly suseptable to sinusitus - a disease easily controllable with the use of antibiotics. This was a regular thing with me - every six to eight months, I would get it. After dozens of visits to the doctor, (always ending with me being perscribed antibiotics...), there was no vector identified WHY I got sinusitus.

I didn't need a doctor to tell me that I had sinusitus. I certainly didn't need a doctor to know that I needed to take an antibiotic to cure it. The only help a doctor could give me that I couldn't do myself was identify WHY I got sinusitus that regularly - and they never did. In time, the sinusitus went away and I haven't had to deal with it since I was 23.

Moorcat

Justin

Moorcat hit the nail on the head with that one. Two kinds of untruths in the world, outright lies and statistics. Before believing stats, always consider the source because if the folks paying for the study have something to gain from the results going a certain way, that's the way the results will go every time. If the results don't go their way, the whole "study" will never see the light of day. It's no different for government stats either, they're just tools for social engineering. If they don't go the way they want them to, they'll either reword it so they do, or we'll just never see the results at all.

I know, I know, conspiracy theorist wacko, someday I'll find a nice padded room to move into . . . ;)

moorcat

While I am not as down on "statistics" as Justin, I certianly believe that there is an integrity to science that you can't monkey with if you want to actually learn something. Unfortunately, the days of "pure science" (if they ever really existed) are long gone. Now science is either funded by big business (with an agenda) or by the government (with an agenda). Before I accept any conclusions made by modern "studies", the first thing I do is look at three things - What is the methodology used for the study, Who is paying the bills, Do the ones paying the bills benefit from the study.

If those things are suspect, then the study in and of itself becomes suspect. Don't get me wrong, I will still look at the data and conclusions, but I will certainly take them with a grain of salt...

Moorcat

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