Comments on: How the demand for Tamiflu and Relenza may kill us all http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html medical blog Sun, 22 Nov 2009 07:50:13 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Rogue Medic http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91179 Rogue Medic Tue, 05 May 2009 23:14:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91179 Anonymous 3:11,<br /><br />You make an interesting point.<br /><br />One of the problems with Tamiflu is that it seems to be most effective at causing resistant strains to develop. This is something that needs to be taken into consideration when prescribing it. Anonymous 3:11,

You make an interesting point.

One of the problems with Tamiflu is that it seems to be most effective at causing resistant strains to develop. This is something that needs to be taken into consideration when prescribing it.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91175 Anonymous Tue, 05 May 2009 20:11:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91175 Is this viewpoint ignoring the downside of the "doctor's office" solution? The current method of delivering Tamiflu to patients appears worse than allowing families to keep a package at home. Tamiflu should be taken immediately upon developing a fever, otherwise if the patient waits 3 days for an opening in the doctor's appointment calendar, Tamiflu becomes useless. When it is ready in the medicine cabinet at home, then it can be used most effectively. Secondly, consider that if the patient must go through the doctor visit procedure to obtain Tamiflu, there is a great chance of spreading the flu to many others - in the doctor's waiting room, and while waiting in line at the pharmacy. In that case Tamiflu may help one person but the process of getting Tamiflu helps to infect 5 others. I believe the real solution is to prescribe Tamiflu ahead of time for home use - but for the medical community to provide much clearer instructions on when exactly it is to be used, and when not to be used. Perhaps patients can go through some kind of basic instruction at the doctor's office on how to recognize the true flu symptoms, and after receiving this basic instruction, it would be ok to keep in the medicine cabinet at home for future use. Is this viewpoint ignoring the downside of the “doctor’s office” solution? The current method of delivering Tamiflu to patients appears worse than allowing families to keep a package at home. Tamiflu should be taken immediately upon developing a fever, otherwise if the patient waits 3 days for an opening in the doctor’s appointment calendar, Tamiflu becomes useless. When it is ready in the medicine cabinet at home, then it can be used most effectively. Secondly, consider that if the patient must go through the doctor visit procedure to obtain Tamiflu, there is a great chance of spreading the flu to many others – in the doctor’s waiting room, and while waiting in line at the pharmacy. In that case Tamiflu may help one person but the process of getting Tamiflu helps to infect 5 others. I believe the real solution is to prescribe Tamiflu ahead of time for home use – but for the medical community to provide much clearer instructions on when exactly it is to be used, and when not to be used. Perhaps patients can go through some kind of basic instruction at the doctor’s office on how to recognize the true flu symptoms, and after receiving this basic instruction, it would be ok to keep in the medicine cabinet at home for future use.

]]> By: Rogue Medic http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91141 Rogue Medic Sun, 03 May 2009 22:50:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91141 anonymous 1:10,<br /><br /><i>They're not sick, but they live with a toddler or elderly family member. They demand Tamiflu. You rightfully decline.</i><i>Maybe this wouldn't win in court,</i>Maybe?<br /><br /><i>Solution? Let the government control distribution. Hell of inefficient, but that way i'm off the hook.</i>Right! Patient care is a little more complicated than avoiding doing anything that somebody might sue for someday. Or doing everything because somebody might sue because you didn't do everything. Why should a physician have any say in it? Let the lawyers fight it out.<br /><br />Government control of distribution has nothing to do with good patient care. It isn't even good economics. Perhaps, this is why you present it as tort reform. anonymous 1:10,

They’re not sick, but they live with a toddler or elderly family member. They demand Tamiflu. You rightfully decline.Maybe this wouldn’t win in court,Maybe?

Solution? Let the government control distribution. Hell of inefficient, but that way i’m off the hook.Right! Patient care is a little more complicated than avoiding doing anything that somebody might sue for someday. Or doing everything because somebody might sue because you didn’t do everything. Why should a physician have any say in it? Let the lawyers fight it out.

Government control of distribution has nothing to do with good patient care. It isn’t even good economics. Perhaps, this is why you present it as tort reform.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91138 Anonymous Sun, 03 May 2009 18:10:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91138 Well here's the problem guys. Let's say someone comes to you worried that they've got the swine flu. <br /><br />They're not sick, but they live with a toddler or elderly family member. They demand Tamiflu. You rightfully decline. <br /><br />Next thing you know you're being served with a lawsuit. Said family member got sick and either died, or was in the hospital and (didn't die) but generated a ton of medical bills. <br /><br />Now of course it's YOUR FAULT you didn't Rx the Tamiflu. <br /><br />Maybe this wouldn't win in court, but I know I'd rather write the Rx than get dragged through the legal process (even if I were to win I'd be out $$$ and now I have to report this everytime I apply for a new job). <br /><br />Solution? Let the government control distribution. Hell of inefficient, but that way i'm off the hook. Well here’s the problem guys. Let’s say someone comes to you worried that they’ve got the swine flu.

They’re not sick, but they live with a toddler or elderly family member. They demand Tamiflu. You rightfully decline.

Next thing you know you’re being served with a lawsuit. Said family member got sick and either died, or was in the hospital and (didn’t die) but generated a ton of medical bills.

Now of course it’s YOUR FAULT you didn’t Rx the Tamiflu.

Maybe this wouldn’t win in court, but I know I’d rather write the Rx than get dragged through the legal process (even if I were to win I’d be out $$$ and now I have to report this everytime I apply for a new job).

Solution? Let the government control distribution. Hell of inefficient, but that way i’m off the hook.

]]> By: GG Freeman http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91132 GG Freeman Sun, 03 May 2009 13:18:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91132 Anonymous' comment reminds me of that line, "The rich stay healthy, the sick stay poor." <br /><br />Sad. <br /><br />In this early stage of the POSSIBLE pandemic, family doctors don't even have the swabs to test for swine flu yet, and we can't and certainly shouldn't send every viral URI to the ER. <br /><br />Of all the people that came to our office with viral URI Sx last week, we gave exactly ONE Rx for Zanamivir. (I thought CDC said Tamiflu was NOT monotherapy!)<br /><br />Why?<br /><br />40-ish year old guy with viral URI and fever of 102+ ... who was as scared as a rabbit at a greyhound convention. <br /><br />That's who you give the stuff too... not just anyone who WANTS to have medicine hanging around... just "in case". Anonymous’ comment reminds me of that line, “The rich stay healthy, the sick stay poor.”

Sad.

In this early stage of the POSSIBLE pandemic, family doctors don’t even have the swabs to test for swine flu yet, and we can’t and certainly shouldn’t send every viral URI to the ER.

Of all the people that came to our office with viral URI Sx last week, we gave exactly ONE Rx for Zanamivir. (I thought CDC said Tamiflu was NOT monotherapy!)

Why?

40-ish year old guy with viral URI and fever of 102+ … who was as scared as a rabbit at a greyhound convention.

That’s who you give the stuff too… not just anyone who WANTS to have medicine hanging around… just “in case”.

]]> By: Rogue Medic http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91128 Rogue Medic Sun, 03 May 2009 05:17:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91128 Is this really that much different from demanding antibiotic prescriptions for every cough, cold, tug at the ear, sinus infection, . . . ?<br /><br />The real difference is the panic, which we experienced with the hoarding of Cipro during the anthrax scare several years ago.<br /><br /><b>The ignorant are determining the fate of the rest of the country.</b> <br /><br />The ignorant, who refuse or delay vaccinations for their children, are also endangering the health of the rest of the country. Those selling books and remedies as alternatives to vaccines are getting rich promoting the deaths of Americans. Deaths that can be safely prevented with vaccines. <br /><br />The same is true for alternative medicine. They make a fortune selling their snake oil, while patients are deprived of effective treatment and some die.<br /><br />We need to be much more critical of this dangerous and deadly stupidity being spread by fraud and scare tactics. <br /><br /><b>These quacks are more lethal than Osama bin Laden, they make fortunes, and are promoted by Oprah, Larry King, the Huffington Post, and other fronts for voodoo medicine.</b> Is this really that much different from demanding antibiotic prescriptions for every cough, cold, tug at the ear, sinus infection, . . . ?

The real difference is the panic, which we experienced with the hoarding of Cipro during the anthrax scare several years ago.

The ignorant are determining the fate of the rest of the country.

The ignorant, who refuse or delay vaccinations for their children, are also endangering the health of the rest of the country. Those selling books and remedies as alternatives to vaccines are getting rich promoting the deaths of Americans. Deaths that can be safely prevented with vaccines.

The same is true for alternative medicine. They make a fortune selling their snake oil, while patients are deprived of effective treatment and some die.

We need to be much more critical of this dangerous and deadly stupidity being spread by fraud and scare tactics.

These quacks are more lethal than Osama bin Laden, they make fortunes, and are promoted by Oprah, Larry King, the Huffington Post, and other fronts for voodoo medicine.

]]> By: Debe http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91127 Debe Sun, 03 May 2009 01:57:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91127 Right on Dr Kevin and shame on you anonymous for your elitist comment. No, one, life is more important than another. I don't care how much money you have. The point of the blog was to inform the public what the consequences might be if the anti viral drugs are taken unnecessarily. All of my patients are VIP's. Right on Dr Kevin and shame on you anonymous for your elitist comment. No, one, life is more important than another. I don’t care how much money you have. The point of the blog was to inform the public what the consequences might be if the anti viral drugs are taken unnecessarily. All of my patients are VIP’s.

]]> By: cathy http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91126 cathy Sun, 03 May 2009 01:36:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91126 Amen, Dr. Kevin. All of the pharmacies in our small town are completely out of Tamiflu with new shipments weeks out - and we have not one single confirmed case of swine flu here. Shame on the doctors who are writing prescriptions to people who clearly don't need them. They're doing a disservice to us all. Amen, Dr. Kevin. All of the pharmacies in our small town are completely out of Tamiflu with new shipments weeks out – and we have not one single confirmed case of swine flu here. Shame on the doctors who are writing prescriptions to people who clearly don’t need them. They’re doing a disservice to us all.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/05/how-demand-for-tamiflu-and-relenza-may.html/comment-page-1#comment-91123 Anonymous Sun, 03 May 2009 00:16:00 +0000 http://clients.emmense.com/kevinmd/2009/05/how-the-demand-for-tamiflu-and-relenza-may-kill-us-all.html#comment-91123 Why shouldn't success confer a survival advantage? Other wise what is it far? The successful are already forced to subsidize the transfer of the reproductive advantage to the so called "disadvantaged". Why shouldn’t success confer a survival advantage? Other wise what is it far? The successful are already forced to subsidize the transfer of the reproductive advantage to the so called “disadvantaged”.

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