tag:blogger.com,1999:blog-26666124.post5153012615662632121..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Small Town Shrink with Insights From Guest Blogger MellowdeeUnknownnoreply@blogger.comBlogger8125tag:blogger.com,1999:blog-26666124.post-69450350231425407802007-03-08T16:27:00.000-05:002007-03-08T16:27:00.000-05:00Michael, you bring up an issue that bothers me als...Michael, you bring up an issue that bothers me also. I think that there should be a requirement for obtaining informed consent when off label doses are prescribed. There is a mountain of paperwork required during a clinical trial, yet no informed consent is required when a doc prescribes off label doses of a drug that is already on the market. Why?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-52856976678640003402007-03-05T22:56:00.000-05:002007-03-05T22:56:00.000-05:00"4. Prescribing off label doses (standard practice...<I>"4. Prescribing off label doses (standard practice since I get the sickest of the sick) of the one medicine the patient has responded to, which, even though I take the time to fill out the proper paperwork, the insurance refuses to pay for."</I><BR/><BR/>Boy, I'm glad I don't have a doctor like this.<BR/><BR/>So how often do you prescribe off-label to be able to say which is the "one medicine the patient has responded to"?<BR/><BR/>How many off-label scripts do you usually try before you get a response?<BR/><BR/>How long a lead-in, tapering and wash-out for the drugs that don't work?<BR/><BR/>And how much damage do you do by using your patients as guinea-pigs for unapproved drug treatments?<BR/><BR/>I'm not usually one to support insurance companies, but if their refusal to pay is reducing this sort of irresponsible behaviour, more power to their (claims dismissal) arms.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-33317520763218620342007-03-04T09:42:00.000-05:002007-03-04T09:42:00.000-05:00When I was in medical school, they had this progra...When I was in medical school, they had this program where 1/3 of the class spends their first year of medical school in a rural area. The hope was to recruit more physicians to rural areas.<BR/><BR/>Now if you're a family doc or a general pediatrician or internist I can see how a rural area would be great in some ways, professionally. What I came away from the experience with was knowlege that I didn't want to practice somewhere where 1) everybody came up to me in the grocery store to talk about their medical stuff and 2) my patients who needed specialized care would often be stuck having to drive 2-3 hours to find the nearest oncologist, psychiatrist, pulmonologist, etc.<BR/><BR/>Now, with my specialty, I simply can not practice in many rural areas. They don't have the facilities to take care of the kinds of babies I deliver or the medical illnesses of the moms I deliver. So, I basically can't practice in a rural area now.<BR/><BR/>They do have their advantages. My cats had a great vet, it was pretty, the hustle and bustle were less; but it isn't for me.Midwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-61204304481157735672007-03-03T03:25:00.000-05:002007-03-03T03:25:00.000-05:00I grew up in a town of less than a thousand. My mo...I grew up in a town of less than a thousand. My mom was a teacher. Your post cracked me up! <BR/><BR/>People would go to our pastor or the school principal and tell them that they didn't think she should let us wear a certain style of clothing. <BR/><BR/>Good gravy! It was absurd. Maybe I'm not as homesick as I thought I was! You've just cured me!Dreaming againhttps://www.blogger.com/profile/15717590226520457326noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-59960266221083240522007-03-03T00:03:00.000-05:002007-03-03T00:03:00.000-05:00I know someone who, as a faculty member at a small...I know someone who, as a faculty member at a small college in a small town, got a phone call from their college president, warning them that he'd gotten a call from a community member complaining that they'd bought a bottle of wine at the grocery store.<BR/><BR/>Birth control for single women? Anti-depressants? We would have been totally stupid to try to get anything like that prescribed or purchased in town. <BR/><BR/>Vet care's usually great in rural areas, though!Bardiachttps://www.blogger.com/profile/11846065504793800266noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-62723668915656762562007-03-02T15:18:00.000-05:002007-03-02T15:18:00.000-05:00Great post. That is exactly the reason that I've s...Great post. That is exactly the reason that I've stayed in a large city thus far... too many confusing, potential problems to even think about.Rachhttps://www.blogger.com/profile/11897760883997811787noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-62493811414526473342007-03-02T04:22:00.000-05:002007-03-02T04:22:00.000-05:00I lived for years in a small town with one psychia...I lived for years in a small town with one psychiatrist: He was the big kid down the block when I grew up and a good friend of mine; I was also his patient as he was the only one in town who might be able to figure out a solution to my sleep problems. His wife was my boss.<BR/><BR/>Then they split up ... OI VEI! What a mess.Unknownhttps://www.blogger.com/profile/06334510427120204285noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-17322024441694988242007-03-01T21:19:00.000-05:002007-03-01T21:19:00.000-05:00And what if he needs psychotherapy-- who does he t...<I>And what if he needs psychotherapy-- who does he talk to? </I><BR/><BR/>Umm, see a psychologist like me. Which is what the psychiatrists I have seen in my practice have done. And I live in a small town.Anonymousnoreply@blogger.com