I so appreciate both perspectives. My dad was an old school GP/surgeon. Delivered babies, took care of the entire family. He left medicine when in his words, the MBAs took over. It became about the money. What we see now is complicated. We can’t be reductionistic about it. Keep bringing all of the perspectives because we need to hear each other. Thank you for all you do!
Yes, these were great letters. There are times, places, and uses for all these medications. As the one doctor said, character means looking out for the patient's interest, and not everyone does that. My mom got pancreatic cancer about 25 years ago and she was on OxyContin for about 8.5 months until she ran out of options. She was clearly in need and if she got addicted, it didn't matter. Our family belief is to stay off meds unless you absolutely need them.
Good medicine is absolutely the fewest pharmaceuticals a person absolutely needs. One thing I have noticed about good doctors like Doc No 2. They take time with the patient. If they constantly have their hand on the door knob of the exam room trying to to get to the next patient that is not an indicator of a good doc.
My grandmother died of that. It was horrible to watch when even the highest doses of morphine didn’t help. Fentanyl would have been a great option. If she accidentally overdosed, it would have been merciful.
I am a recovering drug addict. I have been clean for 33 years. My wife is also a in recovery (about 9 years now). Doctors were never part of my supply chain. However in the case of my wife they were her main supplier. In retrospect I have found this to be true…I was a drug addict. I always knew this was on me. I knew I was living outside of the law and outside of social norms. So getting my life right was a clear choice. Conversely, for my wife, it was so much more confusing. For the longest time she had no idea she had a problem. Her behavior was 100% inside the bounds of social norms. In the end this was THE single biggest obstacle to her getting clean. It nearly killed her…literally. I nearly gave up…and our relationship barely survived. Finally with that life in our rear view mirror life is so much better. Lastly…a shout out to AA and every affiliated association. Living that life, doing the hard work every day is still the only way out.
Quite an honest confession. Living life pretending to be something we are not is in itself a disease. I believe the Good Lord created all of us uniquely and carefully and we shouldn't mess with His creation.
We are overprescribing for everything and it makes me frustrated and angry. Both myself and my youngest daughter go to a naturopathic doctor now because we want to avoid pharmaceuticals as much as possible. The naturopathic doctor is the only one (after 3 different docs -- two pediatricians when she was younger, and a doc she found when she was 19) who actually diagnosed what was wrong with her digestive system and FIXED IT using diet and supplements. No one other than the naturopathic doctor took blood and stool tests to find out what was wrong. So I'm 99% done with so-called modern medicine. (There are exceptions, of course.) .... My #2 daughter (adult) is on multiple prescriptions including Adderall and anti-depressants and more. I'm distraught over it but she won't talk to me about it because I've always been skeptical about most drugs. I told her I'd pay for her to go to a naturopathic doctor to get off all the prescribed drugs ... but apparently, naturopathic medicine is not allowed in NY.
My daughter has an allergy but failed histamine testing. Her pediatrician said, take singular and prilosec and see how things go. We walked out to the car and I could tell my daughter was angry. We got in the car and she said I don't want to take those to feel better. My answer was, it is probably a food we could do an elimination diet and I'd start with dairy. Girl loves her ice cream and she said "fine." She's fallen off the wagon a few times to unpleasant consequences but at 12 she has no interest in medication to treat her ailments.
I had an experience similar to yours, and as a result all my care for the past 20 years has been provided by a naturopathic doctor. I am well into Medicare age, and as a result I must pay for all this care out of my own pocket since Medicare will not cover it. (In a bizarre twist, Medicaid does pay for naturopathic care. ) So every prescribed dangerous opioide on the market is reimbursed by my insurance but safe and natural remedies are not. I include the Federal government and insurance companies among the "pushers".
interesting. i pretty much avoided taking anything stronger than Advil (and not much of that) my entire life. Only exception is statins which i have taken in very low doses and seen good results.
anyway, i m 61 now and starting to have to consider taking some pain management solutions for arthritis and such. every one of the prescriptions sends me to pluto (and i cannot stand being "high") or causes some other reaction. i do not know how people do it with all of these meds. For the most part i just keep making life style changes and deal with the pain.
appreciate the advice though basically most of that stuff, for me, just increases the price of my urine. Thankfully lifestyle changes, no red meat or red wine, changing my workout routines, have been very beneficial.
Try curcumin and boswellia. Check out www.terrytalksnutrition.com for explanations (he is internationally known and not a wacko - you will not find a bad word about him on the internet). His products are available at www.terrynaturally.com. I've used his products almost 30 years.
DMC, check into the research on Turmeric (95% pure curcuminoids,, not the Costco, Walmart, or Sam’s type brands) for arthritis relief. I swear by it—1600-2000 mg pure curcuminoids spread out into four doses per day. Properly processed/prepared curcumin relieves inflammation, go figure!
P. S. A friend at church just informed me she takes 2000 mg/day (pure stuff) for her knee osteoarthritis and has been able to avoid surgery, and plans to continue.
Our kid had concussion caused Depression. She was given SSRI's and we accepted it. She got better...tried to get off SSRI...side effects were vertigo and others. Talked with Pediatrician and she looked at the side effects of SSRI and said "vertigo isn't a side effect". After some internet sleuthing and being in science, I explained she probably needed to taper longer. Pediatrician..who we really like...had no idea. This was shocking and goes to show....you MUST be a curious advocate for yourself and your family. Not all docs are clean and some finished at the bottom of their class.
As an orthopedic surgeon, who has recently become more aware of the domination of medicine by Big Pharma, I lean towards the PCP. I do want to acknowledge the pain specialist that there are some patients who are candidates for long term opioids, mainly because nothing else can help them but they are a small minority of patients.
I think the point that the PCP is making, and I think the point you are making, is the overarching influence of Big Pharma on medicine. Did you know that Pfizer is now paying medical school tuition for one of the Houston medical schools?! When Ken Langone does it for NYU, I don't have a problem. However, when Pfizer does it, how can you not feel like they are training dutiful medication prescribers? The recently published evidence showing that depression is not due to serotonin imbalances in the brain thus rendering SSRI's useless (and they have a black box warning!) and that statins are basically worthless for treating cardiovascular disease can really make you skeptical about my profession. And although you disagree with this point, the vaccine schedule! When I was a kid, we had chickenpox parties. Now, we have another vaccine for it as well as for several other diseases that are largely managed with clean water and sanitation while vaccine manufacturers have zero liability for vaccine injuries. It is too much.
Like our politics, it is time for a turning over in medicine.
I've had experience with opioids for over a decade, and Matthew Perry's kind of reaction to it is something I just don't understand. I experienced a bad (as in highly painful) condition with my spine that nothing short of surgery will help - and considering how only half of the people who get that surgery get any relief, and some actually get worse, I've tried to avoid the knife. I've been on oxycodone for years. The exact same dose (5 mg. twice a day.) I rarely take it that often, mostly because I'm aware that building up a tolerance kills the drug's ability to get rid of my pain.
I've seen all the expressions of how evil painkillers are (usually said by people not suffering from chronic pain.) I've never gotten "high." I wouldn't even know what an opioid high was like, unless we're talking about taking too much and falling asleep for 12 hours. That's exactly it in terms of any extraneous effects from opioids I've experienced.
But when you're in mind numbing pain, believe me, you will do anything to take the edge off it, and oxycodone does that for me, as long as I'm careful to take minimal doses to avoid the tolerance effect. I've never felt "euphoric." I've never gotten high, no matter how many pills I took.
Having said all that, I agree with Alex about the overprescribing of pain meds. But on the other hand, there are plenty of people in chronic pain who cannot get prescriptions for it because of the folks who take drugs for fun. A legitimate need for drugs apparently isn't good enough anymore. You have to know someone, or like me, be the patient of a doctor who has monitored me since the start of my back injury over 10 years ago.
Why is it that no one does any story on those poor slobs? What happened to Perry was pure evil (but wtf, a freaking horse tranquilizer??) Maybe there are some people who just have a weakness for drugs of this type. It's a shame, though, that people who have a legitimate need for painkillers can't get them because of the ones who take them for the high (something I wish someone would explain to me, because I've never gotten a high off any of these painkillers in my entire life!)
They actually seem to be saying the same thing - which is more control and better doctoring. The first MD admits he (she?) is over his head.
Hearing about so many kids on Abilify these days... don't really know what to think because I never know the whole story, but the side effects of this drug are scary.
I could start a pharmacy with how many drugs have been prescribed to me in the last 5-10 years alone - never took one. I’d research them and say the risk was not worth the benefit. Within days I’d feel better from whatever was ailing me whether anxiety, pain, depression, exhaustion.. I never needed any of them just rest and time and self tlc. If I had taken them all I’d be a mess maybe even where Matthew is.
The problem comes down to The physicians carelessly prescribing and knowing almost nothing about the drugs or real lives /history of their patients.
It truly is an epidemic and tragedy.
Even
Most recently the Covid vaccine and ozempic two carelessly prescribed drugs that are hurting people.
You can get ozempic through Your cosmetic procedure facial cosmetologist- non M.d- that’s insane! Its $$$$$$$
My company created an AI application that could tell from a selfie that a person was becoming addicted to opiates. And then we found out that there is no way to get paid for doing this. There are no CMS codes for preventing addiction. There are CMS codes for treating addiction.
From personal experience, I'm not very fond of pain doctors. Narrow focus. And remember, there's insurance that plays a determinant role. After multiple med tries that were excluded due to side effects, my husband had a trial of a spinal cord stimulator to reduce an 8-9 pain level. The results were stunning in just 24 hours. Then, along came Medicare that denied a permanently installed device. Doctors were quick to accept that and offer opiates as that was all that was left to try. Hubby said no way. It took 4 months, hours and hours of work, and me being less than nice to people who didn't do their jobs properly causing the Medicare rejection. Dispensing opiates was an easy fix. Fighting Medicare was not. I'm pleased to say we prevailed and my hubby's 8-9 pain level is now 2-3 on a daily basis and NO opiates.
I am specialist physician ( gastroenterologist) and in active practice for 41 years. I understand and agree with both physicians and their perspectives. In the 90’s, the government mandated that patient’s pain needed to be addressed and managed for elimination of the pain. For inpatients, several times a day in addition to routine vital signs there was an assessment of pain with subsequent treatment. Since the government controls medical care through public payment, the hospital reimbursement was based on a review of their evaluation and management of patient pain. One of my main tenets of life is “follow the money” and that answers many of life’s questions. The system created an environment that no one was to have pain. The second comment shows that just because a person has a MD doesn’t mean they are an expert in all fields of medicine. I am amazed daily by the complexities and nuances of the human condition that requires specialized care and ongoing with persistent education. It is so easy to just write a prescription especially if the public has been trained to demand it.
As my conflict of interest disclosure , I have written only two narcotic prescriptions in the last 30 years with one for someone dying with cancer and the other for post-op pain for 3 days.
Pain management, the dumping ground for people who suffer chronic pain and need an MD to ration their doses. Pain management also happens to be a cash cow, which can lead to dollar blind justifications.
I doubt it. because the point of this article is the abuse not reality of suffering. Doc 2 is ignoring the abuse taking on a morally superior attitude to ignore the shocking abuse and corruption of his profession. the ultimate outcome of his attitude is that the reforms will be imposed on him to the detriment of his patients who are truly suffering, instead of him being part of the solution.
I am on the other side of the perspective. I worked as a pharmacist for decades until my back pain became unbearable. I am not a candidate for surgery and after years of PT, injections, chiropractors, and anything else I could think of, I was started on opiods. It helps for awhile, but requires increasingly higher doses to achieve pain relief. Then things shifted. My pain management specialist started being persecuted. I have had pharmacies refuse to fill my prescriptions and been treated like a drug addict. I have experimented with more natural modalities and am now off my opiods.
I have heard horror stories about doctors refusing to give pain medications after surgeries and severe physical injuries. That seems inhumane.
I don't know what all the answers are, but letting people suffer doesn't seem like the best way to handle the situation. Too bad the darn pharmaceutical companies can't find a different class of drugs to fight pain. I guess they're too busy making mRNA "vaccines" for every occasion.
Hi Alex: this is in response to the first MD testimonial you quoted.
A factor that I bet has driven over-prescription of opioids is a fear (conscious or unconscious) of malpractice. Sounds at first like a contradiction but hear me out. At its most basic level, a MD (or lawyer or certain other professionals) can avoid malpractice if they behave as a similarly situated reasonable [as measured by an objective standard] MD would. This means that you are presumptively "safe" if you follow accepted community standards of care (i.e. do what everyone else is doing), which in the medical field also includes following guidelines from public health and professional bodies. So a MD will tend to prescribe opioids for certain conditions if it becomes 'accepted practice' to do so, without even thinking too hard about it, as following 'accepted practice' becomes ingrained and habitual.
The potential risks for a MD who deviates from accepted practice are high -- potentially unlimited personal liability, censure, very public humiliation, loss of licensure, increased malpractice insurance premiums, etc. This is not to suggest that doctors go through their days worrying about malpractice (although no doubt some do), it is more that doctors are trained to follow accepted practice and tend reflexively to do so because the risks of not doing so are very high. Indeed, ask most doctors if they worry about malpractice and many will angrily deny it. Moreover, on the other hand, MD's have a lot to worry about -- especially PCP's who can't be expert in all the conditions they are expected to recognize and treat -- so in many respects having accepted guidelines and standards of practice for various conditions and symptoms is necessary and highly beneficial.
BTW, I think these factors materially contributed to how MD's dealt with the COVID pandemic. Once the powers that be came out against (for example) using hydroxchloroquine, only a very brave MD would dare to prescribe it for COVID and most MD's would tend reflexively to dismiss its use out of hand as risky, useless or quackery.
The first physician said something very telling: Sanctions if you do, Sanctions if you don't. The practice of medicine changes and by golly, you'll change too - or we will make you change. Just like all the docs who told Alex during the pandemic, "don't use my name"
Professionals are captives of the guild. Follow the rules or get out of the sandbox. It's simple and it sucks. Truth is a hostage.
I so appreciate both perspectives. My dad was an old school GP/surgeon. Delivered babies, took care of the entire family. He left medicine when in his words, the MBAs took over. It became about the money. What we see now is complicated. We can’t be reductionistic about it. Keep bringing all of the perspectives because we need to hear each other. Thank you for all you do!
Yes, these were great letters. There are times, places, and uses for all these medications. As the one doctor said, character means looking out for the patient's interest, and not everyone does that. My mom got pancreatic cancer about 25 years ago and she was on OxyContin for about 8.5 months until she ran out of options. She was clearly in need and if she got addicted, it didn't matter. Our family belief is to stay off meds unless you absolutely need them.
Good medicine is absolutely the fewest pharmaceuticals a person absolutely needs. One thing I have noticed about good doctors like Doc No 2. They take time with the patient. If they constantly have their hand on the door knob of the exam room trying to to get to the next patient that is not an indicator of a good doc.
My grandmother died of that. It was horrible to watch when even the highest doses of morphine didn’t help. Fentanyl would have been a great option. If she accidentally overdosed, it would have been merciful.
I am a recovering drug addict. I have been clean for 33 years. My wife is also a in recovery (about 9 years now). Doctors were never part of my supply chain. However in the case of my wife they were her main supplier. In retrospect I have found this to be true…I was a drug addict. I always knew this was on me. I knew I was living outside of the law and outside of social norms. So getting my life right was a clear choice. Conversely, for my wife, it was so much more confusing. For the longest time she had no idea she had a problem. Her behavior was 100% inside the bounds of social norms. In the end this was THE single biggest obstacle to her getting clean. It nearly killed her…literally. I nearly gave up…and our relationship barely survived. Finally with that life in our rear view mirror life is so much better. Lastly…a shout out to AA and every affiliated association. Living that life, doing the hard work every day is still the only way out.
Quite an honest confession. Living life pretending to be something we are not is in itself a disease. I believe the Good Lord created all of us uniquely and carefully and we shouldn't mess with His creation.
We are overprescribing for everything and it makes me frustrated and angry. Both myself and my youngest daughter go to a naturopathic doctor now because we want to avoid pharmaceuticals as much as possible. The naturopathic doctor is the only one (after 3 different docs -- two pediatricians when she was younger, and a doc she found when she was 19) who actually diagnosed what was wrong with her digestive system and FIXED IT using diet and supplements. No one other than the naturopathic doctor took blood and stool tests to find out what was wrong. So I'm 99% done with so-called modern medicine. (There are exceptions, of course.) .... My #2 daughter (adult) is on multiple prescriptions including Adderall and anti-depressants and more. I'm distraught over it but she won't talk to me about it because I've always been skeptical about most drugs. I told her I'd pay for her to go to a naturopathic doctor to get off all the prescribed drugs ... but apparently, naturopathic medicine is not allowed in NY.
My daughter has an allergy but failed histamine testing. Her pediatrician said, take singular and prilosec and see how things go. We walked out to the car and I could tell my daughter was angry. We got in the car and she said I don't want to take those to feel better. My answer was, it is probably a food we could do an elimination diet and I'd start with dairy. Girl loves her ice cream and she said "fine." She's fallen off the wagon a few times to unpleasant consequences but at 12 she has no interest in medication to treat her ailments.
Smart girl, smart mother. Good job, both of you.
I had an experience similar to yours, and as a result all my care for the past 20 years has been provided by a naturopathic doctor. I am well into Medicare age, and as a result I must pay for all this care out of my own pocket since Medicare will not cover it. (In a bizarre twist, Medicaid does pay for naturopathic care. ) So every prescribed dangerous opioide on the market is reimbursed by my insurance but safe and natural remedies are not. I include the Federal government and insurance companies among the "pushers".
interesting. i pretty much avoided taking anything stronger than Advil (and not much of that) my entire life. Only exception is statins which i have taken in very low doses and seen good results.
anyway, i m 61 now and starting to have to consider taking some pain management solutions for arthritis and such. every one of the prescriptions sends me to pluto (and i cannot stand being "high") or causes some other reaction. i do not know how people do it with all of these meds. For the most part i just keep making life style changes and deal with the pain.
Turmeric powder.
appreciate the advice though basically most of that stuff, for me, just increases the price of my urine. Thankfully lifestyle changes, no red meat or red wine, changing my workout routines, have been very beneficial.
Try curcumin and boswellia. Check out www.terrytalksnutrition.com for explanations (he is internationally known and not a wacko - you will not find a bad word about him on the internet). His products are available at www.terrynaturally.com. I've used his products almost 30 years.
DMC, check into the research on Turmeric (95% pure curcuminoids,, not the Costco, Walmart, or Sam’s type brands) for arthritis relief. I swear by it—1600-2000 mg pure curcuminoids spread out into four doses per day. Properly processed/prepared curcumin relieves inflammation, go figure!
https://greenmedinfo.com/blog/turmeric-beats-ibuprofen-arthritis-knee
P. S. A friend at church just informed me she takes 2000 mg/day (pure stuff) for her knee osteoarthritis and has been able to avoid surgery, and plans to continue.
Our kid had concussion caused Depression. She was given SSRI's and we accepted it. She got better...tried to get off SSRI...side effects were vertigo and others. Talked with Pediatrician and she looked at the side effects of SSRI and said "vertigo isn't a side effect". After some internet sleuthing and being in science, I explained she probably needed to taper longer. Pediatrician..who we really like...had no idea. This was shocking and goes to show....you MUST be a curious advocate for yourself and your family. Not all docs are clean and some finished at the bottom of their class.
As an orthopedic surgeon, who has recently become more aware of the domination of medicine by Big Pharma, I lean towards the PCP. I do want to acknowledge the pain specialist that there are some patients who are candidates for long term opioids, mainly because nothing else can help them but they are a small minority of patients.
I think the point that the PCP is making, and I think the point you are making, is the overarching influence of Big Pharma on medicine. Did you know that Pfizer is now paying medical school tuition for one of the Houston medical schools?! When Ken Langone does it for NYU, I don't have a problem. However, when Pfizer does it, how can you not feel like they are training dutiful medication prescribers? The recently published evidence showing that depression is not due to serotonin imbalances in the brain thus rendering SSRI's useless (and they have a black box warning!) and that statins are basically worthless for treating cardiovascular disease can really make you skeptical about my profession. And although you disagree with this point, the vaccine schedule! When I was a kid, we had chickenpox parties. Now, we have another vaccine for it as well as for several other diseases that are largely managed with clean water and sanitation while vaccine manufacturers have zero liability for vaccine injuries. It is too much.
Like our politics, it is time for a turning over in medicine.
This guy gets it
I've had experience with opioids for over a decade, and Matthew Perry's kind of reaction to it is something I just don't understand. I experienced a bad (as in highly painful) condition with my spine that nothing short of surgery will help - and considering how only half of the people who get that surgery get any relief, and some actually get worse, I've tried to avoid the knife. I've been on oxycodone for years. The exact same dose (5 mg. twice a day.) I rarely take it that often, mostly because I'm aware that building up a tolerance kills the drug's ability to get rid of my pain.
I've seen all the expressions of how evil painkillers are (usually said by people not suffering from chronic pain.) I've never gotten "high." I wouldn't even know what an opioid high was like, unless we're talking about taking too much and falling asleep for 12 hours. That's exactly it in terms of any extraneous effects from opioids I've experienced.
But when you're in mind numbing pain, believe me, you will do anything to take the edge off it, and oxycodone does that for me, as long as I'm careful to take minimal doses to avoid the tolerance effect. I've never felt "euphoric." I've never gotten high, no matter how many pills I took.
Having said all that, I agree with Alex about the overprescribing of pain meds. But on the other hand, there are plenty of people in chronic pain who cannot get prescriptions for it because of the folks who take drugs for fun. A legitimate need for drugs apparently isn't good enough anymore. You have to know someone, or like me, be the patient of a doctor who has monitored me since the start of my back injury over 10 years ago.
Why is it that no one does any story on those poor slobs? What happened to Perry was pure evil (but wtf, a freaking horse tranquilizer??) Maybe there are some people who just have a weakness for drugs of this type. It's a shame, though, that people who have a legitimate need for painkillers can't get them because of the ones who take them for the high (something I wish someone would explain to me, because I've never gotten a high off any of these painkillers in my entire life!)
They actually seem to be saying the same thing - which is more control and better doctoring. The first MD admits he (she?) is over his head.
Hearing about so many kids on Abilify these days... don't really know what to think because I never know the whole story, but the side effects of this drug are scary.
Great perspectives, thank you!
I could start a pharmacy with how many drugs have been prescribed to me in the last 5-10 years alone - never took one. I’d research them and say the risk was not worth the benefit. Within days I’d feel better from whatever was ailing me whether anxiety, pain, depression, exhaustion.. I never needed any of them just rest and time and self tlc. If I had taken them all I’d be a mess maybe even where Matthew is.
The problem comes down to The physicians carelessly prescribing and knowing almost nothing about the drugs or real lives /history of their patients.
It truly is an epidemic and tragedy.
Even
Most recently the Covid vaccine and ozempic two carelessly prescribed drugs that are hurting people.
You can get ozempic through Your cosmetic procedure facial cosmetologist- non M.d- that’s insane! Its $$$$$$$
My company created an AI application that could tell from a selfie that a person was becoming addicted to opiates. And then we found out that there is no way to get paid for doing this. There are no CMS codes for preventing addiction. There are CMS codes for treating addiction.
From personal experience, I'm not very fond of pain doctors. Narrow focus. And remember, there's insurance that plays a determinant role. After multiple med tries that were excluded due to side effects, my husband had a trial of a spinal cord stimulator to reduce an 8-9 pain level. The results were stunning in just 24 hours. Then, along came Medicare that denied a permanently installed device. Doctors were quick to accept that and offer opiates as that was all that was left to try. Hubby said no way. It took 4 months, hours and hours of work, and me being less than nice to people who didn't do their jobs properly causing the Medicare rejection. Dispensing opiates was an easy fix. Fighting Medicare was not. I'm pleased to say we prevailed and my hubby's 8-9 pain level is now 2-3 on a daily basis and NO opiates.
I am specialist physician ( gastroenterologist) and in active practice for 41 years. I understand and agree with both physicians and their perspectives. In the 90’s, the government mandated that patient’s pain needed to be addressed and managed for elimination of the pain. For inpatients, several times a day in addition to routine vital signs there was an assessment of pain with subsequent treatment. Since the government controls medical care through public payment, the hospital reimbursement was based on a review of their evaluation and management of patient pain. One of my main tenets of life is “follow the money” and that answers many of life’s questions. The system created an environment that no one was to have pain. The second comment shows that just because a person has a MD doesn’t mean they are an expert in all fields of medicine. I am amazed daily by the complexities and nuances of the human condition that requires specialized care and ongoing with persistent education. It is so easy to just write a prescription especially if the public has been trained to demand it.
As my conflict of interest disclosure , I have written only two narcotic prescriptions in the last 30 years with one for someone dying with cancer and the other for post-op pain for 3 days.
Pain management, the dumping ground for people who suffer chronic pain and need an MD to ration their doses. Pain management also happens to be a cash cow, which can lead to dollar blind justifications.
Doc 2 is a great example of a very stupid smart person
If you had the misfortune to experience serious chronic pain you might have a different perspective.
I doubt it. because the point of this article is the abuse not reality of suffering. Doc 2 is ignoring the abuse taking on a morally superior attitude to ignore the shocking abuse and corruption of his profession. the ultimate outcome of his attitude is that the reforms will be imposed on him to the detriment of his patients who are truly suffering, instead of him being part of the solution.
I feel badly for what happened to Matthew Perry.
I am on the other side of the perspective. I worked as a pharmacist for decades until my back pain became unbearable. I am not a candidate for surgery and after years of PT, injections, chiropractors, and anything else I could think of, I was started on opiods. It helps for awhile, but requires increasingly higher doses to achieve pain relief. Then things shifted. My pain management specialist started being persecuted. I have had pharmacies refuse to fill my prescriptions and been treated like a drug addict. I have experimented with more natural modalities and am now off my opiods.
I have heard horror stories about doctors refusing to give pain medications after surgeries and severe physical injuries. That seems inhumane.
I don't know what all the answers are, but letting people suffer doesn't seem like the best way to handle the situation. Too bad the darn pharmaceutical companies can't find a different class of drugs to fight pain. I guess they're too busy making mRNA "vaccines" for every occasion.
Hi Alex: this is in response to the first MD testimonial you quoted.
A factor that I bet has driven over-prescription of opioids is a fear (conscious or unconscious) of malpractice. Sounds at first like a contradiction but hear me out. At its most basic level, a MD (or lawyer or certain other professionals) can avoid malpractice if they behave as a similarly situated reasonable [as measured by an objective standard] MD would. This means that you are presumptively "safe" if you follow accepted community standards of care (i.e. do what everyone else is doing), which in the medical field also includes following guidelines from public health and professional bodies. So a MD will tend to prescribe opioids for certain conditions if it becomes 'accepted practice' to do so, without even thinking too hard about it, as following 'accepted practice' becomes ingrained and habitual.
The potential risks for a MD who deviates from accepted practice are high -- potentially unlimited personal liability, censure, very public humiliation, loss of licensure, increased malpractice insurance premiums, etc. This is not to suggest that doctors go through their days worrying about malpractice (although no doubt some do), it is more that doctors are trained to follow accepted practice and tend reflexively to do so because the risks of not doing so are very high. Indeed, ask most doctors if they worry about malpractice and many will angrily deny it. Moreover, on the other hand, MD's have a lot to worry about -- especially PCP's who can't be expert in all the conditions they are expected to recognize and treat -- so in many respects having accepted guidelines and standards of practice for various conditions and symptoms is necessary and highly beneficial.
BTW, I think these factors materially contributed to how MD's dealt with the COVID pandemic. Once the powers that be came out against (for example) using hydroxchloroquine, only a very brave MD would dare to prescribe it for COVID and most MD's would tend reflexively to dismiss its use out of hand as risky, useless or quackery.
The first physician said something very telling: Sanctions if you do, Sanctions if you don't. The practice of medicine changes and by golly, you'll change too - or we will make you change. Just like all the docs who told Alex during the pandemic, "don't use my name"
Professionals are captives of the guild. Follow the rules or get out of the sandbox. It's simple and it sucks. Truth is a hostage.