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Old 07-07-2009, 08:48 AM
 
Location: Cleveland, OH
753 posts, read 2,164,690 times
Reputation: 765

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Should insurance companies and hospitals have to cover people going back and forth to the the Dr and ER if the person is not taking their medications. I'm not refering to people who have to chose between paying for meds and food or rent or whatever. Just patients who refuse to take medications that are needed to treat their condition.

I am asking this because I work in a healthcare facility. One of our patients has been hospitalized since March for over 60 days on 6 different occasions. Every time he states he does not take his prescriptions, which is obvious when he goes in with his heart rate over 200.

So, if a prescription is filled and testing proves the medication is not in the persons system, should they be cared for?
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Old 07-07-2009, 09:06 AM
 
1,704 posts, read 2,950,698 times
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THIS IS EXACTLY WHAT I'VE BEEN TALKING ABOUT!!!!!! Why do I have to pay for non-compliance. Everytime I bring this up I get shouted down by "they can't afford them"!! Nobody realizes how prevalent this behavior is. Diabetics are the worst. I've seen countless diabetics who ARE covered by insurance just not take their meds and leave the hospital piece by piece. All these surgeries could have been avoided.
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Old 07-07-2009, 09:15 AM
 
5,767 posts, read 10,025,848 times
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I don't see how this would be workable at all. For instance, let's say an irritable doctor or a doctor who does not particularly like a certain patient deems "refusal to take medication" as the cause of the patient's problems, then throws the patient out on the street.

If the patient then dies, and the doctor turns out to have been incorrect, you can imagine the enormous uproar that would follow.
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Old 07-07-2009, 09:29 AM
 
31,385 posts, read 31,051,757 times
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I don't know how prevalent this problem is or the OP's direct knowledge of what they perceive to be the problem, but I have encountered more than a few physicians, some in my family, who refuse to treat patients who don't quit certain behaviors or who refuse to follow their instructions. So, I'm not convinced this is the a huge issue.

Caveat, my brother-in-law who is an emergency room physicians has serious problems with folks who tend to get shot wounds for living that street lifestyle but what is he going to do?
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Old 07-07-2009, 11:12 AM
 
1,704 posts, read 2,950,698 times
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Well theres no medication that prevents you from "living the street lifestyle" there is however a drug that will maintain your blood sugar, or reduce you chol, or control your HTN. You choose not to take them and your ins(whatever it is) should be able to deny you. It's like giving an alchoholic a new liver. A person who makes changes and still has issues should be treated, someone with high chol who still drinks cream soup with a side of cheese everyday should not qualify for stents and prime cath lab time.
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Old 07-07-2009, 11:22 AM
 
Location: Victoria TX
42,668 posts, read 71,538,289 times
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The price of zero-tolerance is higher than you want to pay. You have to allow for a few cases to slip through the cracks, unless you want to spend all your resources policing the system. Just let it go.

Just as an illustration, The administration has just outlined sweeping reforms in food safety. Our food is already way over-safe. Our economy will spend another 100-million to comply with regulations that will reduce the number of deaths from unsafe food from 20 to 10. That's ten-million per life saved. Not to mention additional millions per life saved through car safety, child's pajama safety, extension cord safety, the list is endless. The lives saved through these safety measures are mostly the imprudent people who will find ways to kill themselves through misadvanture anyway.

Off the point, but it goes back to how much we are willing to spend, in our effort to stamp out all bad things absolutely. Policing a system to zero tolerance wastes more money than allowing a few abusers to slip through.

Last edited by jtur88; 07-07-2009 at 11:38 AM..
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Old 07-07-2009, 11:29 AM
 
1,704 posts, read 2,950,698 times
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Yeah thats the attitude we should all take about everything, things will be better then. Actually why have standards for anything? When the patient shows up and asks whats wrong we should just shrug because they're not going to listen.
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Old 07-07-2009, 12:09 PM
 
Location: Victoria TX
42,668 posts, read 71,538,289 times
Reputation: 35864
Quote:
Originally Posted by sickofnyc99 View Post
Yeah thats the attitude we should all take about everything, things will be better then. Actually why have standards for anything? When the patient shows up and asks whats wrong we should just shrug because they're not going to listen.
We have standards in the hopes that people will see the social utility of standards, and comply with them. Almost everybody does, voluntarily, if the standards have merit. How much is it worth to squeeze every single squae peg into the round holes?
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Old 07-07-2009, 12:19 PM
 
Location: Cleveland, OH
753 posts, read 2,164,690 times
Reputation: 765
The Dr doesn't get to decide who is not taking their meds, only cases proven by lab tests. And if it is not in their system, then they must prove the script was filled.

I have never met a Dr who won't treat a patient because they don't like them, I have seen some patients discharged from care due to noncompliance. But Dr's should be allowed to discharge patients for noncomplaince. Why should they waste their time on someone who won't listen, when the point of going to a Dr is to get medical advice.

And noncompliance where I work is very prevalent. They know if they don't get their treatment, they can just go to the ER when they start to feel sick. Actually, I think if more people knew how prevalent noncompliance is, they would be horrified! Straight up sickened by it! But I work in the ghetto, so that needs to be taken into account also.

I just don't understand why patients knowingly put themselves in medical jeopardy when all they have to do is get ongoing treatments and take their meds. Why wait until it is a crisis?
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Old 07-07-2009, 12:48 PM
 
Location: 125 Years Too Late...
10,296 posts, read 9,975,609 times
Reputation: 9075
In my view, if the doctor has prescribed a med and you are not taking it, you are in essence opting out of the system. Which is your right of course, but at that point, you should be a big boy and face the consequences of your actions. You either pay the money to correct the consequence out of your own pocket or you have no further treatment. Sounds harsh, but if you want to play that game, you need to stand by your choice's outcome. As I've argued in other posts, everyone should have the right to refuse medical treatment (in this case prescription medication), but if you do that, you've made your choice and you are on your own.
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