Watch out with cold meds if on BP meds

[ToadHill]

Soundguy

"so i can make it thru the winter months when i'm more prone to nasal congestion."

Winter in central Florida, you mean early fall.

 

[N80]

I take nothing and am going to take nothing if at ALL possible. No chemicals for me.

Water is a chemical.

You take 'chemicals' when you need them.

I think someday our great great grandchildren will look back on this era of over prescribing drugs as a time as dark and counterproductive to health as bloodletting once was.

Sure, in time we will look back and see that we were doing things wrong. Has that EVER not been true. Each generation does the best it knows how to do and to the next generation it make look silly. That does not mean it was silly at the time.

But, the fact is, as a nation we're living longer, healthier lives than ever before....and just so no one gets confused, that has NOTHING to do with eating better and exercising more. Statistically speaking NO ONE does that.

It has everything to do with controlling blood pressure, cholesterol and diabetes (with 'chemicals'), wearing seatbelts and not smoking.

No one likes to take medicines (well, there are the hypochondriacs). But when you can take something that keeps you alive....it starts to look better than the alternative.

 

[N80]

Guys, reading over this thread all I can say is there is some good information and there is some misinformation about cold medicines, blood pressure medicines and what they all do and why.

Just make sure that if you need information about any of these, get your it from your doctor or pharmacist...... not a tractor web site.

 

[N80]

I've always thought it might be nice to have the option of a 'call-in' visit / consultation for some things.

Well, we do return phone calls, all the time, at no charge. But it is clearly not the best use of our time.

And a lot of people don't understand what is involved in this process. With every call someone has to find and pull the patients chart. Then I have to review it and call the patient back myself (which usually involves several calls, answering machines, etc) or have the nurse call the patient back (same hassles) then we have to document the discussion on the chart. Then the chart has to be picked up and re-filed.

There are 8 doctors in my office. We have employees that do nothing but answer phones. There was a day several months ago in which we logged 900 calls in 12 hours. So if the process I described above sounds trivial, just multiply it by say, 10-20 calls a day, on average, per doctor, that need a call back.

And ALL of the calls are answered by a human being, not a machine. And there is never a charge.

I agree, that for many things.. the healthcare provider needs to see you.. however.. some things... maybee not. like refilling a routine prescription that you take all year.. for instanc.. my alergy meds.. like alegra. If no other medical issues 9 that I'm aware of ) have come up.. This looks like a prime area for a 'micro' call in visit, perhaps a reduced fee vs the office visit fee.. etc.

Nah, I honestly don't mind doing that sort of thing for free. It as still takes time and calls to the pharmacy, but for cases like that we can really stream line the process.

On the other hand, sorting out BP meds, cold meds, potential interactions, answering lists of questions and all the 'why?'s and 'how comes?' that take time AND require a certain level of expertise....those just need a visit.

Now, as you can see, I'm a pretty prolific emailer. I'm looking forward to the day when such mini-consults can be done via email. The advantage is, it can be done when I have time and doesn't tie me or the patient up at a set time. I can see where a fee schedule might come into play for more involved consults. But not for an Allegra refill, that's still quick and easy.

 

[N80]

They will talk to you answer your questions it's all free and actually a pharmacist knows as much or more about a medication than does a doctor.

Free? Not for long. Many drug stores are opening 'Minute Clinics' staffed by nurse practioners. The pharmacists in those places are going to refer you to them.

Now, around here, I can't even get a pharmacist on the phone myself (a doctor) and most of the pharmacies are staffed by pharmacy techs.

Does a pharmacist know more about drugs than a doctor? Depends on the pharmacist and the doctor. Pharmacists tend to know the 'package insert' data and have computer databases of interactions etc. What they lack is experience actually prescribing medicines and seeing their effects first hand. They also do not know all the details about patients the way a good doctor does. For instance, a patient sees me and needs to be on a penicillin drug and he says he's allergic to penicillin. I can ask what kind of allergy and if he says a minor rash or upset stomach I can reasonably determine that he has had a side effect and not an allergy and then put him on a penicillin derivative with little or no risk. A pharmacist can't and won't provide that sort of capability.

 

[Soundguy]

Now, as you can see, I'm a pretty prolific emailer. I'm looking forward to the day when such mini-consults can be done via email. The advantage is, it can be done when I have time and doesn't tie me or the patient up at a set time. I can see where a fee schedule might come into play for more involved consults. But not for an Allegra refill, that's still quick and easy.

Hey now.. that's just what I'm talking about. The email doesn't even require a real time connection like a phone call.

I imagine, in the future.. for routine stuff, for an established patient.. that may be something that catches on.

Soundguy

 

[Soundguy]

Hey.. that miniute clinic stuff looks like it will have a good niche audience. those patients that have minor issues that need fast care.. but not with a difficult problem.. they won't be seeing liver cancer patients.. but rather.. perhaps a person with an alergy.. or a minor skin infection.. booster shot... etc.. tetnous shot.. etc.

Soundguy

 

[N80]

You just have to remember that you will not see a doctor. It will be a nurse practitioner or a physicians assistant (unsupervised by a physician). For those who are comfortable with that it will be a good thing.

 

[Soundguy]

I used to see a PA, and now see a nurse practitioner that is in school to get her md.. To tell you the truth.. i feel comfortable with either. in fact.. the last time I saw a 'real' MD ( was at the office i normally saw a PA.. but happened to get the MD that tiem.. ).. he scared the heck out of me.. in fact... I changed Dr' offices after that. No bedside manner.. a real whackjob... I went in to ask about getting an xray or examination because I had just been kicked by a horse inthe shoulder, was in pain.. etc.. Got there.. sat int he waiting room for 4hrs even though i had an appt.. got in to see the doc.. he walks in, says xray just closed.. to which i got a little miffed after setting there half the day.. so he then decides i'm to excited, and says i should go on zanax to calm down, and then scheduled me for a bunch of blood workup.. got up and left... didn't even look at my swolen red puffy sore shoulder I had come in for!!!!! Excited? sure i was.. a 1200# horse kicked me and it hurt! and I wanted medical attention! I left there and got an appt next day where my wife went.. saw a NP efter a good exam and pics decided it was probably all soft tissue, told me how to take care of it.. etc. since then i had my records xfered over there.. the NP gets to see me for about 2-3 farm injuries a year now So yeah.. no offense to all the good MD's out there.. but NP / PA is fine for me. ( PM me for another even worse (true)story! )

Soundguy

 

[N80]

There are as many kinds of doctors as there are kinds of people (I've known more than a few nutty MDs! Heck, I might be one myself!). But, the same is true for NPs and PAs. In the end, you have to find the right person for the right job. And you have to find someone you are comfortable with who treats you right.

And I have no problem with NPs/PAs. I supervised a whole group of them while I was in the Air Force. All of them great and great at what they did. But no one should kid themselves, the difference in the levels of training between any residency trained MD and PA/NPs is vast.