Rx Without A Doctor

In the continuing saga of physician disrespect, the FDA is looking at more ways for patients to get prescriptions without seeing a doctor.   This is the same country where many states don’t allow doctors to do telemedicine across state lines.  So, in the latter case, doctors can’t give prescriptions but patients would be able to self-diagnose and get the prescription on their own.  Huh?  The new model, as explained here in the American Medical News, being considered by the FDA would do the following:

  • Allow some drugs for chronic conditions, such as asthma and allergies, to be sold under “conditions of safe use,” a proposed category that would describe prescription drugs sold over the counter.
  • To determine whether patients meet conditions of safe use of the drug, the FDA is recommending the development of new technology to help diagnose and assess patients’ needs.
  • Under the proposal, criteria of safe conditions would be measured using technology such as patient kiosks, remote diagnostic tools and online questionnaires that determine patients’ needs and help match them to the right medication.
  • The proposal also would expand the role of pharmacists, who would help determine patients’ needs for certain medications and help verify their self-diagnoses.

Just another way to break up the physician-patient relationship.  Isn’t it amazing that others are always trying to replace doctors with something –  new technology, pharmacists, grand-aides, NPs, PAs and on and on.   Will this crap never end?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Rx Without A Doctor

  1. Anatol Arber
    May 20, 2012 at 1:39 am

    Never end! you are right.There are always will be attempts to substitute the doctor. But they will never succede. Doctor will be always present real or virtual. The nature of the human being will never allow him to die

  2. May 18, 2012 at 10:05 pm

    Over the top, Doug. I don’t know if there’s any valid future for machines like this, BUT NEITHER DO YOU. Doesn’t make sense to imply there’s no replacement for every instance of dr-patient interaction. We all have too many war stories to prove otherwise.
    We need to keep Semmelweis in mind-his fellow docs knew it was crazy and job-threatening to wash their hands.

  3. Iowadoc
    May 18, 2012 at 9:31 am

    Doug,
    The vitriol expoused by the NP shows you need to restrict this site to physicians. Second, if the NP wants to get into a pissing match, I can state just this last week I dealt with an NP who spent 6 months doing dressing changes, and expensive modalities on a 4 cm 3rd degree burn that could have been cured in 1 week with a skin graft (and eventually was).

    The problem will be that the primary care doctor will be told he is to review the patients self prescriptions (for no reimbursement of course) somewhere down the line, and if the patient health is poor he also will be reprimanded for it. Lastly, then the patient will come in for a visit, after 5 self prescription visits, and expect for $75 to review all his health problems for the past year, adjust his medications, and mistakes and send him on his way.

  4. Rich
    May 18, 2012 at 4:52 am

    So, I’m “crap” now, huh? It’s bad enough, with all the garbage I deal with, from outdated state laws, CMS bullsh*t, and serious cases of Arrogant Physician Disorder, but now you’re calling my profession “crap”? Give me a break, Doug….it wasn’t MY profession that self destructed via elitist monoplizing of patient care, and failure to recognize the expertise of other disciplines. It was YOURS. It’s time for physicians to learn that they are also responsible for their loss of prestige and respect….it’s comments like yours that illustrate my point. There is a reason why less than 2 percent of new medical school grads go into primary care…..YOU ABANDONED IT. It doesn’t make you money, so you abandoned it. You bent over and let lawyers screw you over, and NOW it is a crisis? Physicians allowed your profession to self destruct, and you refuse to accept responsibility for it, and instead, you whine about “mid levels” and tort reform…..I am a member of an IPA, and I watch the garbage that physicians pull. I see how self interest precludes patient care at every twist and turn, and how physicians created the 800lb gorilla in the room. I’m not crap, Doug…..I’m the lucky NP who gets to clean up your mess. I used to respect you, and Placebo Journal, Doug. But now, you’ve become something else….a bitter, disenfranchised reactionary. Sad, too. PJ used to embrace NPs, and now….we’re just “crap” to you. Consider me unsubscribed, Doug. Great way to be an activist, by alienating supporters. Good luck with that. I’ll get back to my full appointment calendar now, full of people who need to e taken care of….a task *I* won’t abandon.

    • Doug Farrago
      May 18, 2012 at 8:07 am

      I did not specifically call you crap, idiot. I called the constant move to replace doctors, crap. And you are absolutely delusional. We monopolized patient care? We WERE patient care. We were all there was. Idiot. I did not abandon primary care, moron. I have treated over 100,000 patients as a family doc. And how dare you claim that physicians’s self interest compromised patient care. YOU HAVE NO PROOF of such libel but you use it to better YOUR situation. Is there a need for midlevels? Yes. Are they are equal in training and experience. NO. Did we doctors screw a lot of things up? Yes. Of course we did and I get that but let me tell you this. Please don’t pull the “Oh, I am so offended” line. I ripped on NPs, PAs and family docs in PJ. I rip on my own profession today (especially family medicine) more than anyone, including midlevels. What pisses me off is when NPs (and yes, it is mostly NPs) go crazy if somehow I criticize them. That is a self esteem issue that makes you so sensitive. It is because you are not doctors that it drives you crazy when anyone points that out. That last line, about not being doctors, is very important. There is nothing, other than going to 4 years of medical school and 3+ years of residency, that will make you a doctor. Get over it.

    • Pat
      May 18, 2012 at 8:50 am

      I abandoned PriCare, and proudly so – the pay for the effort expended IS crap, after one puts up with an ever-rising tide of regulation, malpractice threats, debt, and constant, constant whining over the most trivial complaints (oh, and increased competition from the cut-rate and the lesser-invested). The mindset of institutional PriCare is one of masochism, hungrily satisfied by a panoply of carrion eaters all parading around in the cloth of compassion. Yes I left because of my own self-interest, and not because of some imagined “debt” to patients I had not yet treated or even met; I left contrary to a society that has trained itself to believe that a set of initials must equate not to principles, but to whatever attitude the popular will demands. Unlike those whose self-worth must apparently be measured by the accolades of others in lieu of honest remuneration, I have the comfort of knowing exactly who I’m working for. Do you realize that you are attacking those you have tried to emulate? There is a doctoral’s worth of pathology worth examining in your desperate cry for validation. You could come see me at the ER if it gets to you, but the lines are growing longer and I’m sure there’s a mid-level around the corner with fistfuls of SSRI’s , just raring to go.

  5. (The Rev.) Louisa Braley
    May 17, 2012 at 8:55 pm

    Hot Digs! Bring on the Amoxicillin >:-)

  6. Sheila Chambers
    May 17, 2012 at 3:02 pm

    It’s just a continuation of a trend that’s cost so many of us our jobs and self respect, automation!
    Big business want’s to eliminate as many workers as possible and now, their turning of Physicians.
    In the future we will go to a Kiosk and punch in our symptoms, hook up to a diagnostic sensor and presto, there is our diagnosis and prescription.
    Soon we will all be unemployed and all those shiny Chinese machines will sit unused IF we can still generate the electricity to run them.

    Love your posts Dr.Doug!

  7. May 15, 2012 at 10:35 am

    Very simple Doug- if a physician is prescribing across state lines, then he stands to see some profit, and the state doesn’t want to corrupt the selfless purity of physicians (who are all such money-grubbing, golf-playing, uncaring bastards that they cannot even be trusted to accept a pharmaceutical lunch). But if the patient can get what they want and bring any subsequent complication to the afore mentioned noble/untustworthy doc, then that would certainly confirm the good intentions of those in charge of promoting such schizophrenia.

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