Pain Meds

How do doctors determine how much pain a patient is in and how much pain medication is necessary for their patient? Physicians must prescribe the minimum amount of pain medication because narcotics are controlled substances. Physicians must try to distinguish those seeking drugs because they are addicted to them or want to sell them from those who actually need narcotics to relieve pain. Even a weaker narcotic such as hydrocodone can be sold for more than five dollars a pill. Doctors are responsible for making sure that the medicines they prescribe are used for their intended purpose by the patient. Doctors can be disciplined for prescribing too much of a controlled substance. Does the fear of consequences prevent doctors from prescribing meds to those who truly do need them? Is it fair for a doctor to judge pain or prescribe less medication than a patient may actually need in order to protect themselves from legal trouble?

Campus Health

Last Monday I went to campus health where I was diagnosed with the flu after having a temperature of 103.4. There are antivirals such as Tamiflu or Relenza that reduce the severity of the flu (either influenza or H1N1), yet neither of these drugs were prescribed. I was told to stay in my room until I had been without a fever for atleast 24 hours and get over the counter meds to treat my symptoms. If I was sick enough to be asked to wear a mask while in the campus health building, or any other building, why was I not treated with the appropriate medicines. It is Saturday, and now I have a sinus infection and fluid on my ears that developed as a result of the flu. I would not still be sick if I had been prescribed the antivirals designed to prevent complications of the flu such as sinus infections or pneumonia. I understand why the antivirals were not prescibed. Doctors do not want to overuse them and decrease their effectiveness. So instead I am now taking antibiotics, which also lose effectiveness with overuse. So either way I was prescribed medicine that is selectively prescribed to only those who need it, just the wrong one five days too late.

Even though I knew I had an infection and needed antibiotics on Wednesday I waited until I got home on Friday to see a doctor. I have completely lost faith in campus health. Campus health is free and my copay is $60 at RoMed. I have learned that you get what you pay for.

The cost of medicine and the idea of pro bono work to offset it

One of the blogs that I am following, Bioethics Discussion, has a post about requiring doctors and even insurance companies to do pro bono work as a solution to the high cost of health care in the United States. First of all, insurance companies are picky enough about the money that they allow their policy holders to use, it is doubtful that they will do pro bono work. Secondly, it is not simply a matter of doctors donating their time and knowledge to treat those with no health insurance. They would need access to labs, procedure rooms, radiology equipment, and drugs that have also been donated. Many hospitals and practices are struggling as it is and others have already been bought out by large companies such as Novant Health, a company that owns both huge hospitals and small practices in North Carolina, Virginia, and South Carolina. These facilities have cut nursing staff and litterally scan every roll of tape so that it can be charged to a patient's bill. However, Novant does provide free treatment to those who make 300% or less than the Federal Poverty Level and offers discounts and payment plans to those who qualify. No person will go untreated due to inability to pay medical bills. Many doctors do their best to help patients with financial issues by giving drug samples or trying to use generic drugs. Many doctors also donate money out of their own pocket to hospitals and charities that provide care to those who can't afford it. People should not be forced by law to do pro bono work, they should make that decision themselves.

Medicine is expensive due to the cutting edge technology and medications. The research that is required in order to produce these new, lifesaving medicines and machines is outrageously expensive, therefore the products are outrageously expensive. The companies that produce new drugs must get the money that they deserve for creating the drug during the first few years, because after that generic medications can be produced and sold by other companies who invested nothing in the research and testing of the original drug. Do we want pharmaceutical companies to stop researching new drugs or computer companies to stop producing new scanners because people don't think that medical care should be so expensive? The answer is no, people seem to want the best treatments available. No matter what it is, the newest, most advanced product is always significantly more expensive than the old, less functional one. Why are medical supplies and services expected to be any different?

Organ Donation

I believe that every person should be an organ donor. There is no reason for a person who has suffered brain death, or has injured their brain to the extent that when taken off of life support death would occur not to donate their viable organs to save the life of another person. According to Discovery Health about 18 people die daily while waiting for an organ. This number would not be so high if more people were willing to donate their organs instead of burying or cremating them.

There is an organization, separate from the United Network for Organ Sharing (UNOS), that prioritizes organ donors over those who choose not to donate. I think giving organs to those who are donors before non donors is not only fair, but a great way to encourage more people to sign up to become organ donors.

Please check your driver's license to make sure that the symbol for organ donation (a small red heart in NC) is on it. Also, don't forget to donate blood whenever you have the chance... you can save a life with less than an hour of your time and a pint of blood!

Introduction

I will discuss important topics in the medical field and as I become aware of what areas I am most interested in my posts will begin to focus on those areas of medicine. At UNC there are currently 1900 freshman listed as pre-med/dent. Only about 150 members of the class of 2013 will actually attend medical or dental school. I want to be one of the few. I hope that creating and maintaining this blog will strengthen my knowledge of the medical field and help me decide what type of medicine I would like to study.