Doctors and their drugs - Physicians? Or the equivalent of car salesmen?

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zoeyridge
New Member


Date Joined Mar 2008
Total Posts : 7
   Posted 10/30/2008 11:22 AM (GMT -7)   

Approximately three years ago I was diagnosed with Crohn’s disease after a lifetime of digestive issues.  Aside from two other flare ups, it was quite manageable until this year.  

 

Since January I have been on disability due to Crohn’s.  It wasn’t until early October that my sed rate finally fell below 90.  My spirits were up and I was feeling closer and closer to getting back to work and a normal life.

 

However, about three weeks ago my symptoms started to return and are now back with full force. With severe joint and muscle pain, erythema nodosum all over me, and a sed rate of 118, I have definitely had the wind taken out of my sails.

 

In the middle of this relapse, my disability insurance provider sent me paperwork for proof of continued disability.  I brought this paperwork to my doctor on Oct. 17th, to be filled out and faxed to the insurance company.

 

At my visit with my doc, he continued to push Remicade and Humira.  I told him that I was apprehensive to try either as I know someone who passed, due to lymphoma, after being on Remicaid.  The thought of Humira didn’t (and still doesn’t) really appeal to me either.  He told me he was going to put the paperwork through for Humira anyway since I already had a negative PPD (is that the test for tuberculosis?) test earlier this year. 

 

I told him “fine” but I still wanted to explore my options, which I did, and now I have an appt. with a naturopath on Tuesday.  I told him that I just wanted to work with him and the Naturopath to exhaust all my options before I try the Humira.  I am well aware that people with Crohn’s are pre-disposed to lymphoma anyway but I am too afraid that this drug might increase my chances – just a weird gut feeling (like I need another one ;)

 

His response was, “Well I’m not sending in the disability paperwork if you are no longer under my care”.  WHAT??!!!  Then he yelled at me and said that he thought I was in trouble.  Yes, I do understand that but I am not going to be backed into a corner of Humira.  Not until I truly feel I have no other choice.  This is ridiculous!!! I gave him this paperwork two weeks ago.  In the meanwhile, I have had bloodwork twice and have been put back on Cipro and Flagyl by HIS prescription!!  If I wound up in the hospital today, I would list him as my doctor.  I am obviously still under his care, like it or not. Besides that, HE is the one who has not sent in the paperwork after two weeks.  I only told him about the Naturopath yesterday.  What was he waiting for?? 

 

I cannot believe this.

 

I am sorry for the lengthy post but I had to vent my frustration and thought this might be a good opportunity to hear if anyone else had such frustration with a doc.

 

Thank you, fellow Crohnies and I hope everyone is feeling better every day.

 

Take care.


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 10/30/2008 1:18 PM (GMT -7)   
Can you take this up with your insurance? I have had more than my share, IMHO, of doctors who were not working on the same page as me. The last one, was last week, for a migraine that I have had for 10 weeks. I was in the hospital and after having tried prednisone 3 times, she decided to try again, at 400 mg a day, when I refused since it hadn't worked the week before and she had no real reason to think it would work this time, she just sent me home with out any treatment what so ever and a referral to a headache clinic that has been closed for 4 years. I now have new neurologist and a new plan of attack.

It sounds like you can't just get a new doctor, since you are relying on this one for your paperwork, but is there some sort of board of appeals you can go to? Can you call someone at the disablitly board and explain what is going on and get a temporary extension?
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


EMom
Veteran Member


Date Joined Aug 2007
Total Posts : 990
   Posted 10/30/2008 2:22 PM (GMT -7)   
Zoeyridge, I'm so sorry you're dealing with this. Welcome to the forum, though!

Your post got me thinking...(cute remark about car salesmen, btw).... Do doctors actually make money on each prescription they write? Like a kickback? Anybody know? I know they often get "perks" from drug companies and/or their reps. Just curious...

I have had numerous frustrations with docs through the years. I'm sorry to say that I don't trust the vast majority of them. I know there are a few exceptions--and I do appreciate those few! Sadly, one of my most recent frustrations was my son's GI brushing aside diet and probiotics to manage Crohn's. Personally--and maybe this is just my problem--it made me feel like all he wanted to do was write us a prescription... Thankfully I didn't listen to him...

The way your doctor behaved is inexcusable... I hope he has a change of heart.

I also hope you have great success with the naturopath!
Mom to 16 year old son diagnosed in June, 2007.
Omega 3s, digestive enzymes, probiotics, vit. C, calcium w/D3, a good multivitamin and SCD legal yogurt
Started The Maker's Diet in Sept. '07. Gradually learning/using more Specific Carbohydrate Diet (SCD) recipes, too! (cooking challenged)


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/30/2008 2:32 PM (GMT -7)   
I'm afraid it sounds like a God complex to me. If you are without faith you are cast out into the nether darkness. I just don't quite give doctors that much credit for wisdom that I am willing to accept their methods - mostly provided by the drug companies - without question. Not every patient is so stupid that they can't possibly understand the medical considerations of their own illness. (Sarcasm!!!)

gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 10/30/2008 2:37 PM (GMT -7)   
Hi Hope he didn't have you on steriods when you took yout TB test as it can frig up the results. Darn things always seem to be such a battle for us at times .Hope you can brave this out without feeling too bad about your Dr. 's comments. By the way what is going on he feels you need the Humira? lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


EricaM
Regular Member


Date Joined Jan 2007
Total Posts : 184
   Posted 10/30/2008 7:50 PM (GMT -7)   
Hi!  I hate to bring bad news but I have dealt with disablity myself and I have learned that if you refuse the treatment that you doctor  suggests they then can not fill out your disability form due to your refusal of the therapy your physician wants to put you on.  I wouldn't be mad with him but direct it towards the insurance companies.  Also note that the most dangerous drug out there that we have been on are steriods....have you looked at the side effect of prednisone? 

Erica
Crohn's and Ostomy in 2004


EricaM
Regular Member


Date Joined Jan 2007
Total Posts : 184
   Posted 10/30/2008 7:59 PM (GMT -7)   
One more thing I recently started to work for my GI doctor and I can tell you they do not get kick backs for prescribing certain meds...that is against so not only rules but there are laws in plave to protect the patients.  Biologics have shown to promote muscosal healingif you wait until you are really sick the chances of them working dramatically decreases.  My first doctor delayed remicade and started it once I was in the hospital and it was too late and I lost my colon and I live with a permanent ostomy at the age of 32.  Biologics (Humira, Remicade, Cimzia) work best when they are used as proactive treatments and not reactive.

Erica
Crohn's and Ostomy in 2004


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 10/31/2008 4:45 AM (GMT -7)   
I think your doctor could have explained that in a better way. I think what Erica said is very true as well.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


zoeyridge
New Member


Date Joined Mar 2008
Total Posts : 7
   Posted 10/31/2008 5:06 PM (GMT -7)   

Thank you all, so much, for your replies.  I never thought of calling the insurance company and informing them of this situation.  I have to admit that I was feeling sort of helpless and backed into a corner.  I understand what Erica is saying and I appreciate that he wants to see me treated.  I am not counting Humira completely out, I just want to exhaust my other options and I have not yet explored the naturopath...path.   I don't see why integration of something else, or even a second opinion, has caused such a problem with him.  I had hoped that he would be more open-minded.  It's a bit disappointing. 

By the way, I thought I had put this in my 'signature' but I can't seem to get that to work - Prednisone, Asacol, Pentasa, Enticort, Cipro and Flagyl, LDN.

Thanks again

-Zoey


Diagnosed with CD in 2006
Have been prescribed (with no or limited success):  
-Prednisone
-Asacol
-Pentasa
-Cipro and Flagyl
-Enticort
-LDN
 
 
 


zoeyridge
New Member


Date Joined Mar 2008
Total Posts : 7
   Posted 10/31/2008 5:07 PM (GMT -7)   

Oops!  There it is.  Didn't work the first time!

 


Diagnosed with CD in 2006
Have been prescribed (with no or limited success):  
-Prednisone
-Asacol
-Pentasa
-Cipro and Flagyl
-Enticort
-LDN
 
 
 


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 10/31/2008 5:07 PM (GMT -7)   
I think he would endorse an second opinion of an MD I bet...LOL
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


zoeyridge
New Member


Date Joined Mar 2008
Total Posts : 7
   Posted 10/31/2008 5:14 PM (GMT -7)   

Darn tootin', Navy!  I have thought the same thing!  I know doctors work hard and I do appreciate it.  I just wish all that work wouldn't close their minds so much.  Not every doctor, of course, but most.  


Diagnosed with CD in 2006
Have been prescribed (with no or limited success):  
-Prednisone
-Asacol
-Pentasa
-Cipro and Flagyl
-Enticort
-LDN
 
 
 


tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 11/3/2008 1:32 AM (GMT -7)   
I know for fact that doctors do not get kickbacks for using a particular drug. I have a brother, sister, and brother-in-law that all are drug reps and medical device reps. In the past, the reps used to be able to try and get the doctors to use their products by providing them with gifts, lavish vacations, event tickets, and other items, but that was taken away quite a few years ago. Now, they are able to bring lunch to the office staff, take the doctor out to eat in order to discuss their drug or device, or have banquet type dinners so that multiple doctors can attend. They also provide them with small gifts such as pens, tissues, note pads, blood pressure cuffs, and other job type equipment ect. that has their product name on it. ( I have a ton of these products that around my home that were extras. My favorites being my viagra fridge magnet and flowmax bathroom tissue box that sits on top of my toilet.)
I think that most doctors have our best interests in mind. Sometimes it is really easy to get frustrated when we are not seeing any success, but we have to remember that the doctors are human and get frustrated too. I had to switch G.I.'s when he finally admitted that I was too hard of a case for him and that he had reached a point that he just did not know what to do now. Many G.I.s do not deal with severe cases of Crohn's disease and are overwhelmed or even intimidated to go outside the box and try a new medication or biologic. They are afraid of being sued or hurting their patients. I am sorry if it seems that I am on the side of the doctors, but I just hope that we see it from both sides. I have been frustrated by many doctors in the past and have either talked to them about a solution or moved on. We all have free agency and should not be afraid to change doctors if we do not fully trust them. Ultimately, you are the deciding factor in you course to remission. I am on SSDI (disability) and you can always call the people from the disability and inform them that you may be in the process of changing G.I.s due to not wanting to use a medication. I have had to due this when I was on long term disability through my work and they gave me an extension so that I could change doctors.
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