On 20/02/2013 02:10, Arfa Daily wrote:



I think that there are good and bad doctors, the same as there are in
any trade, and people make the mistake of thinking that doctors,
dentists, surgeons, airline pilots and so on are gods, not to be
challenged. For the most part, my doctor seems pretty fair at her job,
but I certainly don't just follow everything she says or tells me to do,
blindly. I have had run-ins with her on several occasions where I have
not agreed with her proposed action, or I have wanted to know more about
what my condition was exactly, and the full raft of treatments
available, not just the cheapest. I have a friend that started to be
treated for high blood pressure a few years back, and he has just
followed whatever he's been told and taken whatever was prescribed, even
though he was getting side effects from the medication, and worse, knew
that he was. I went through the same thing at about the same time, but I
took the trouble to check what the potential side effects of each
medication that they tried were, and I monitored myself carefully to see
if I was suffering any of them. All of the 'standard-try-this-first'
medications caused me problems with tiredness, odd feelings of
'detachment', irritability, loss of taste and so on, but I persisted in
going back each time, discussing the problem, and being moved on to the
next one. I probably went through about 8 different medications before
we found one that suited me, and I have been fine with that ever since.
My friend, on the other hand, is now a gibbering wreck. He has
completely lost his sense of taste, and shakes all the time. They have
checked for all the stuff like Parkinsons, but he comes back clear. I am
totally convinced that his general degeneration, is as a direct result
of the medication that he takes for his blood pressure ...

Arfa

Sometimes the choice of medicine depends almost entirely on price. So
they try cheapest, next cheapest, and so on until you (hopefully) get to
the cheapest one that works acceptably.

But, given that many medicines actually are very cheap anyway, the
savings to be made are, I suspect, often illusory. If A hardly works for
anyone, but C works for almost everyone, and the price difference is
small, it might overall be more efficient and economical to go straight
to C. Less wasted medicine. Fewer otherwise unnecessary appointments,
fewer additional prescriptions to try to address the issues of A, etc.
And anyway, prices change so A being chepest today does not mean it will
remain cheaper than B and C into the future.

One of the better statins has just dropped (or is about to drop) in
price by something like 92% due to becoming available as a generic. (And
though I am not generally keen on statins, some people might 'need'
them. And that serves as a ready example.)

--
Rod