Friday, April 12, 2013

Scooters for All!

Here is another strong case for the plea:  “Don’t Ask Your Doctor.”  Earlier I pointed out what a delicate position doctors were in, caught between the advertisers and their best judgment, while being pressured by patients who only know what they saw on TV or read in a magazine.  The ask-your-doctor promotional ploy is specifically designed to put doctors into this position of disappointing or even potentially losing a patient whose expectations have been raised by promoters of particular drugs.  Remember, these are the same doctors who pay large sums for malpractice insurance because people are so sensitive about getting flawless care.  If the patient says that he wants a certain pill because he saw it advertised on TV, is it easier for the doctor to prescribe it, or to argue about its appropriateness?

Furthermore, the move to reduce the cost of prescriptions makes the pill less expensive and more desirable.  Then all we need is for the placebo effect to kick in, and the patient thinks the advertising was right and the pill helped, the doctor has avoided a difficult conversation about proper care for the problem, and the drug companies get richer.

A new twist, as this article points out, comes from the scooter industry.  They advertise on TV showing elderly people scooting around, happy and carefree on scooters that may be totally paid for by Medicare.  “Wow, a free scooter, and all I have to do is ask my doctor!”  The down-side should be easy to understand – “hundreds of millions of dollars in unnecessary spending by Medicare, which is only supposed to pay for scooters when seniors are unable to use a cane, walker or regular wheelchair” and the medical profession’s concerned that “seniors who use scooters unnecessarily can become sedentary, which can exacerbate obesity and other disorders.”  Of course it’s easier and more fun to use a free scooter than to walk off the weight or do the physical activity to stay healthy or regain more mobility.  It’s clearly a discipline issue, detrimental to the senior and costly to a healthcare system that can’t afford it.

Again, don’t ask your doctor about an advertised drug, with the preconceived expectation that it’s right for you.  Tell your doctor your symptoms and let your doctor discuss the options with you.  If you force your doctor into a corner you may end up spending more for pills you don’t need or a scooter you shouldn’t have, undermining your own health and driving up the cost of healthcare for everyone.  But as Medicare or insurance is forced to pick up the cost of more and more treatments, these quick-fix solutions are very tempting.

1 comment:

  1. Reinforcing this idea about pressure on doctors, I found the following in a Johns Hopkins newsletter: "[Doctors] noted several barriers that kept them from stopping PSA screening [after age 75 as recommended], including 'My patients expect me to continue getting yearly PSA screening,' 'It takes more time to explain why I am not screening than just to continue screening," and "By not ordering a PSA, it puts me at risk for malpractice.'"


Click again on the title to add a comment