Health Boards
Mon-09-03-2015, 14:36 PM
Thanks for starting this thread Fred, interesting conversations on this I will imagine.
Here are my thoughts from an American standpoint.
Insurance - Most pay high amounts for insurance (other than those who are eligible for government assistance) but prescription costs have gone up while coverage for prescriptions seems to have declined. For psoriasis medications, even with your prescription plan, it is expensive. My plan pays 80%, but when the prescription gets up into thousands..... it still takes quite a bit of money to maintain staying on expensive meds.
Doctors - Doctors here have protocols on how they prescribe meds (as I've noticed this is also done elsewhere.) My dermatologist does the topicals first, oral meds next, then biologics. So here you most likely will get a topical and UV treatment first, then they'll try orals and the biologics are used as a last resort. I think this comes down not to what is best, but the insurance companies control too much and they will want you on the least expensive treatment. We (mistakenly at times) then tend to think of this as doing the least invasive first.... topicals being the safest choice, oral meds being the next safest and biological being the strongest (therefore most risky) treatment. Notice I said MISTAKENLY! It's not just for psoriasis, I've had to do physical therapy before prior to surgery. Yes, the doctors say things like we'll see if therapy works before an invasive surgery (and at times that can certainly be true) but there are times I think doctors know the therapy won't work but send you there first so they can tell the insurance company it didn't work before doing a costly surgery. Some instances, insurance companies require it before they'll approve a surgery (which is stupid at times as then they are paying for therapy that doesn't work on top of the surgery, usually followed by additional therapy after the surgery.) Insurance companies here pretty much call the shots and there is protocol in place that doctors must follow to get your insurance approved for what you actually need. Point being, we keep getting told that we need to try the LESSER treatment first, which starts to change the way of thinking to what is the "less" amount that one can use to treat something, when in actual fact we are not considering that the reason doctors (via insurance companies) take that route not because it is necessarily the best way to go, it has just become the standard way to go. This isn't necessarily true of all circumstances, I'm am taking liberty at saying this is a regular view of a lot of circumstances.
Lifestyle - Everything here is all about going back to natural. Not a bad thing at all, but sometimes overkill. I'm not sure there is anything that is "good" anymore. Don't eat too much sugar.... so they have substitutes... wait! don't eat those they're bad for you... Now we are suppose to use natural sweeteners such as honey. Oh but wait, do not give honey to small kids and also it has the same amount of fructose and glucose as sugar and more calories than sugar....that is one quick example of a thousand examples. So, you add the going back to naturals to the misconception that topicals are closer to the low end of meds (as far as being bad for you) and you get people who are willing to try to do what SOUNDS like the "better" way to go with medication.
Myself, I am not willing to mess with my meds. I'll use over the counter (not all of them even) treatments such as oils, creams etc that do no harm in an effort to feel better. Same as I will use hot tea (and sometimes a bit of whisky and honey) to soothe a cough. When it comes to prescriptions, I will try to follow doctors orders unless I feel strongly about NOT using something. The reason is that I am always hopeful to find a good doctor that will try to do what is best and if it gets to the point I disagree with them, I will find another doctor that I feel comfortable with. I'm paying them for their knowledge after all and if I'm going out on my own then I'm wasting my money with doctors. But here we are at the mercy of insurance companies (and doctors are as well to some extent) in what treatments we can get. The good part is that I CAN find my own doctor. So there is some good to go with the bad.
But, I digress. I think Americans (or at least myself) don't so much think we can just try out what we want, but that we have fallen into an idea that we should take charge (which I'm for.... to a point) and so we search and search on our own and when we see something that sounds like it is less harmful to our bodies, we perk up and listen. We hear it over and over again. The problem is that when we combine the medical practices (which follow insurance guidelines) we sometimes start thinking that we should always try (for example psoriasis) natural......then topicals........then meds. If natural works then that's terrific! I admire those that have the diligence and the willpower to moderate their diet to stay healthier and help with medical issues! I also believe that for some people going that route isn't the answer, they need meds. And topicals are meds, they are not necessarily the best for ones overall health, but it SOUNDS better so it's easy to fall into thinking you're not putting something into your body (even though you are as it is absorbed) So, I don't think it's that we want to experiment, only that we are always looking for a way to be healthier and we are often mislead as to what that is.
Editing this to add:
I said that I would not go out on my own for meds, which is true. I will, however, discuss with a doctor the possibility of trying something to see what they think.
I guess what sums up how I feel about doctors is this:
My hand therapist told me I should TELL my doctor something regarding treatment (don't remember what it was) She said, it's your body and you are "captain of the ship". My reply best describes how I feel about doctors. I told her I am not qualified to be captain, hence why I hire the doctors for that job. I am "owner of the ship" but I hire out the captain job.
Here are my thoughts from an American standpoint.
Insurance - Most pay high amounts for insurance (other than those who are eligible for government assistance) but prescription costs have gone up while coverage for prescriptions seems to have declined. For psoriasis medications, even with your prescription plan, it is expensive. My plan pays 80%, but when the prescription gets up into thousands..... it still takes quite a bit of money to maintain staying on expensive meds.
Doctors - Doctors here have protocols on how they prescribe meds (as I've noticed this is also done elsewhere.) My dermatologist does the topicals first, oral meds next, then biologics. So here you most likely will get a topical and UV treatment first, then they'll try orals and the biologics are used as a last resort. I think this comes down not to what is best, but the insurance companies control too much and they will want you on the least expensive treatment. We (mistakenly at times) then tend to think of this as doing the least invasive first.... topicals being the safest choice, oral meds being the next safest and biological being the strongest (therefore most risky) treatment. Notice I said MISTAKENLY! It's not just for psoriasis, I've had to do physical therapy before prior to surgery. Yes, the doctors say things like we'll see if therapy works before an invasive surgery (and at times that can certainly be true) but there are times I think doctors know the therapy won't work but send you there first so they can tell the insurance company it didn't work before doing a costly surgery. Some instances, insurance companies require it before they'll approve a surgery (which is stupid at times as then they are paying for therapy that doesn't work on top of the surgery, usually followed by additional therapy after the surgery.) Insurance companies here pretty much call the shots and there is protocol in place that doctors must follow to get your insurance approved for what you actually need. Point being, we keep getting told that we need to try the LESSER treatment first, which starts to change the way of thinking to what is the "less" amount that one can use to treat something, when in actual fact we are not considering that the reason doctors (via insurance companies) take that route not because it is necessarily the best way to go, it has just become the standard way to go. This isn't necessarily true of all circumstances, I'm am taking liberty at saying this is a regular view of a lot of circumstances.
Lifestyle - Everything here is all about going back to natural. Not a bad thing at all, but sometimes overkill. I'm not sure there is anything that is "good" anymore. Don't eat too much sugar.... so they have substitutes... wait! don't eat those they're bad for you... Now we are suppose to use natural sweeteners such as honey. Oh but wait, do not give honey to small kids and also it has the same amount of fructose and glucose as sugar and more calories than sugar....that is one quick example of a thousand examples. So, you add the going back to naturals to the misconception that topicals are closer to the low end of meds (as far as being bad for you) and you get people who are willing to try to do what SOUNDS like the "better" way to go with medication.
Myself, I am not willing to mess with my meds. I'll use over the counter (not all of them even) treatments such as oils, creams etc that do no harm in an effort to feel better. Same as I will use hot tea (and sometimes a bit of whisky and honey) to soothe a cough. When it comes to prescriptions, I will try to follow doctors orders unless I feel strongly about NOT using something. The reason is that I am always hopeful to find a good doctor that will try to do what is best and if it gets to the point I disagree with them, I will find another doctor that I feel comfortable with. I'm paying them for their knowledge after all and if I'm going out on my own then I'm wasting my money with doctors. But here we are at the mercy of insurance companies (and doctors are as well to some extent) in what treatments we can get. The good part is that I CAN find my own doctor. So there is some good to go with the bad.
But, I digress. I think Americans (or at least myself) don't so much think we can just try out what we want, but that we have fallen into an idea that we should take charge (which I'm for.... to a point) and so we search and search on our own and when we see something that sounds like it is less harmful to our bodies, we perk up and listen. We hear it over and over again. The problem is that when we combine the medical practices (which follow insurance guidelines) we sometimes start thinking that we should always try (for example psoriasis) natural......then topicals........then meds. If natural works then that's terrific! I admire those that have the diligence and the willpower to moderate their diet to stay healthier and help with medical issues! I also believe that for some people going that route isn't the answer, they need meds. And topicals are meds, they are not necessarily the best for ones overall health, but it SOUNDS better so it's easy to fall into thinking you're not putting something into your body (even though you are as it is absorbed) So, I don't think it's that we want to experiment, only that we are always looking for a way to be healthier and we are often mislead as to what that is.
Editing this to add:
I said that I would not go out on my own for meds, which is true. I will, however, discuss with a doctor the possibility of trying something to see what they think.
I guess what sums up how I feel about doctors is this:
My hand therapist told me I should TELL my doctor something regarding treatment (don't remember what it was) She said, it's your body and you are "captain of the ship". My reply best describes how I feel about doctors. I told her I am not qualified to be captain, hence why I hire the doctors for that job. I am "owner of the ship" but I hire out the captain job.