Physician compensation must be very different where you live from where I live. Here, a doc writes a prescription and you’re out the door in five minutes. They get no percentage of the $$$ from the prescription. That’s illegal. They would make much more if they spent more time talking with patients for therapy. Unfortunately, there are too many patients, too few doctors, and too little funding from the govt to pay for therapy. Pushing pills is cheaper for socialized medicine.
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My doc gives me six refills for my APs/ADs. Each refill is a month’s supply. I only need to see him 2x year for head issues. It’s the diabetes, heart, and weight that have me seeing him monthly or more.
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Yes you are partially correct. However prescriptions can be written for anywhere between 1-3 or more months worth at a time depending on what the prescription is for. A prescription can have ? x’s refills so that the person only has to go to the pharmacy, not the doctor, for the refill. I know this based on my own prescriptions as well as my son’s and my hubby’s.
I disagree. There is no payment to doctors for a “prescription” - there is payment for time only.
If you just come in to talk with them - they get paid the same as if they wrote you a prescription - so there is not financial “incentive” for them to prescribe you anything.
And - if they went into any other medical specialty - they could make more money. So there has to be something other than money that makes people go into psychiatry - either personal interest in the disorder (frequently a family member has had some mental disorder), or interest in helping people.
True, and going along with what Pixel said, while they may not get kickbacks directly, the patients continual return guarantees their practice…
And while direct kickbacks are illegal in many places, it does still happen. Just because it’s illegal doesn’t mean no one does it, as with anything else illegal that many people do anyways, even despite knowing the risks…
And while not a direct kickback per prescription, this stuff shows there is a financial incentive… basically, advertise my pill and I’ll pay you…Note here it says they are paid for ‘promotional talks’
In recent years, drug companies have started releasing details of the payments they make to doctors and other health professionals for promotional talks, research and consulting. As of 2013, 17 companies published the information, most because of legal settlements.
Where do you think they get all those nice big framed ads for pills like Abilify and Latuda you see in a lot of psych clinics?
And here, like i said, despite that it’s illegal…
According to the federal lawsuit, Reinstein routinely prescribed anti-psychotic and other psychiatric medications to his patients based, not on their need but on his receipt of kickbacks from pharmaceutical companies.
Reinstein routinely prescribed Clozaril, the trade name for clozapine manufactured by Novartis, and he often had more than 1,000 patients using the medication at any given time, the lawsuit state. For many years, Novartis paid Reinstein to promote Clozaril, it alleges.
In July 2003, Novartis notified Reinstein that it would be withdrawing its support for Clozaril, and ended the regular payments that it had been making to Reinstein.
In August 2003, the lawsuit says Reinstein offered to switch his patients to generic clozapine manufactured by Ivax Pharmaceuticals if the company met several conditions: Agree to pay Reinstein $50,000 under a one-year “consulting agreement”; pay his nurse to speak on behalf of clozapine; and fund a clozapine research study by a Reinstein-affiliated entity known as Uptown Research Institute.
Ivax agreed and Reinstein immediately began switching his patients from Clozaril to Ivax’s clozapine, according to the lawsuit, which noted that he “quickly became the largest prescriber of generic clozapine in the country.”
Also:
The practice of pharmaceutical companies working with doctors to develop new medications to treat conditions and help promote those medications has been in place for decades, but Ornstein, who is investigating this practice, said, “The promotion part has gotten a lot of attention in recent years because drug companies have paid hundreds of millions and sometimes billions of dollars to settle lawsuits that have accused them of improper marketing and giving kickbacks to doctors.”
Ornstein continued, “It’s illegal to give kickbacks to a doctor to prescribe drugs, but it is legal to give money to doctors to help promote your drug. Some doctors make tens of thousands or hundreds of thousands of dollars a year beyond their normal practice just for working with the industry.”
Easy way to avoid doctors like this. Take your business to the ones who ask questions like…
“How do YOU feel about this?”
“Are you happy with how you are functioning on this medication?”
“What side-effects are you experiencing that affect your mood and functioning?”
“What things are you doing to improve your health? Diet and exercise okay?”
“What can I do to help you move forward in your recovery?”
The good doctors seek your input and adjust their treatment accordingly. They don’t just push pills.
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Agreed with all of that, and to add: ones who say they use medication as a last resort when all else has failed. Also ones who will tell you they themselves are leery of just prescribing a pill without having a good diagnoses, or knowing someone well…
My current doc shares my goal of minimum dose to no dose whenever possible. We have gotten my weight down and diet improved enough that I’m back off the Metformin for diabetes. While I doubt I’ll ever go completely without head meds, the less, the better.
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Yes - that is what all the literature says now - everyone should be on the lowest dose possible on these medications.
Obviously you have to take time to titrate down to that lowest dose so that you don’t relapse. But definitely your approach is supported by all the research and in my discussion with researchers.
Ideally. The thing with Psychiatry, you don’t have to deal with flesh unlike with other specialty. That can contribute to that for sure? Anyone who just want to be called an MD, with relatively lucrative pay can choose one of the easiest path if not the easiest. Imagining being a Psychiatry student, and seeing their bible and how subjective and frail it is, I find it to a be a big turn off, so there must be something rather than benevolence or true interest that drives or could drive their intellectual minds. In reality, if not initially, money always and will have to do with it.
Is that really the case? I just read an article where a US pdoc admitted that talk theraphy doesn’t pay. And even semi-theraphy can risk you to be side-tracked.
I’m not American. In Canada doctors are paid per procedure. Procedures that take more time (or require a higher degree of skill) come with more compensation.
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