Comments on: Should docs be paid for switching patients to generics? http://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html Tue, 14 Feb 2012 22:04:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83052 Anonymous Fri, 25 Jan 2008 06:24:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83052 I don't know whether this is ethical or not, but it's not illegal. <br/><br/>Nevertheless, if its ok to pay docs to switch to generics, it should be ok for drug companies to pay doctors to switch back! I don’t know whether this is ethical or not, but it’s not illegal.

Nevertheless, if its ok to pay docs to switch to generics, it should be ok for drug companies to pay doctors to switch back!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83041 Anonymous Fri, 25 Jan 2008 02:23:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83041 Same goes with the high cost of implants. If there is no financial incentive, I don't care I'm putting in the Mercedes everytime when a Chevy will do. Why would I do anything otherwise. Is it unethical to put the absolute best in every patient, damn the costs. Or is it more ethical to save the hospital administrator's bottom line. If you want to encourage behavior you have to pay for it plan and simple. Same goes with the high cost of implants. If there is no financial incentive, I don’t care I’m putting in the Mercedes everytime when a Chevy will do. Why would I do anything otherwise. Is it unethical to put the absolute best in every patient, damn the costs. Or is it more ethical to save the hospital administrator’s bottom line. If you want to encourage behavior you have to pay for it plan and simple.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83033 Anonymous Fri, 25 Jan 2008 00:45:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83033 Some doctors are motivated primarily by financial incentives---most have other values at stake as well. And as professionalism is defined by an ethic of putting the patients first, I would say that the doctors who respond only to financial incentives are really physicians at all, license notwithstanding. Some doctors are motivated primarily by financial incentives—most have other values at stake as well. And as professionalism is defined by an ethic of putting the patients first, I would say that the doctors who respond only to financial incentives are really physicians at all, license notwithstanding.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83032 Anonymous Fri, 25 Jan 2008 00:12:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83032 Funny...<br/>The insurance company has a financial incentive to switch, and no one has a problem with that.<br/><br/>The patient has a financial incentive to switch, and no one questions it.<br/><br/>However, the doctors are given a financial incentive, and all of a sudden it's unethical.<br/><br/>My office is completely bogged down with scrip refill requests due to formulary changes, prior auths, etc; these time consuming efforts should absolutely be compensated.<br/><br/>Underpaid in Upstate New York Funny…
The insurance company has a financial incentive to switch, and no one has a problem with that.

The patient has a financial incentive to switch, and no one questions it.

However, the doctors are given a financial incentive, and all of a sudden it’s unethical.

My office is completely bogged down with scrip refill requests due to formulary changes, prior auths, etc; these time consuming efforts should absolutely be compensated.

Underpaid in Upstate New York

]]> By: Gasmanhttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83028 Gasman Thu, 24 Jan 2008 21:31:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83028 "You can talk about professionalism all you want, but the reality is that physicians really only respond to financial incentives."<br/>Not a sound interpretation Kevin.<br/>1) They did save their patient's money too. Would you have condemned the docs if they had steadfastly refuse to allow their patient's this savings.<br/>2) You conclude that docs 'only' respond to financial incentives, when there is no evidence to support this. While it is probable that they did respond to financial incentive, no evidence is available to conclude that nothing else would have moved them.<br/>3) If docs respond to financial incentives, and it is not contrary to patient interest (nowhere in the story is it supported that patient interest was compromised), then it merely means that docs are indeed still human and respond to their environment, financial and otherwise.<br/><br/>The only caveat in all this is to remember that everyone, regardless of their intentions, will be swayed to some extent at some degree of incentive/pressure. It is appropriate to keep light upon insurer policies such as this to ensure that incentive programs do not become so strong oor counter to patient interest that the inevitable harm does occur. The business side of medicine knows business and how to manipulate people to get what it wants; its principal tool is money and what it wants is money. “You can talk about professionalism all you want, but the reality is that physicians really only respond to financial incentives.”
Not a sound interpretation Kevin.
1) They did save their patient’s money too. Would you have condemned the docs if they had steadfastly refuse to allow their patient’s this savings.
2) You conclude that docs ‘only’ respond to financial incentives, when there is no evidence to support this. While it is probable that they did respond to financial incentive, no evidence is available to conclude that nothing else would have moved them.
3) If docs respond to financial incentives, and it is not contrary to patient interest (nowhere in the story is it supported that patient interest was compromised), then it merely means that docs are indeed still human and respond to their environment, financial and otherwise.

The only caveat in all this is to remember that everyone, regardless of their intentions, will be swayed to some extent at some degree of incentive/pressure. It is appropriate to keep light upon insurer policies such as this to ensure that incentive programs do not become so strong oor counter to patient interest that the inevitable harm does occur. The business side of medicine knows business and how to manipulate people to get what it wants; its principal tool is money and what it wants is money.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/should-docs-be-paid-for-switching.html#comment-83022 Anonymous Thu, 24 Jan 2008 18:37:00 +0000 http://clients.emmense.com/kevinmd/2008/01/should-docs-be-paid-for-switching-patients-to-generics.html#comment-83022 In a word, no. If there is a sound medical reason to switch a patient to a generic, or even an OTC drug, then that should suffice. Equal efficacy at lower cost without unacceptable risk of side effects is a sound medical reason. Bribery is not. In a word, no. If there is a sound medical reason to switch a patient to a generic, or even an OTC drug, then that should suffice. Equal efficacy at lower cost without unacceptable risk of side effects is a sound medical reason. Bribery is not.

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