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Physician Dispensing and Arguing with Idiots

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I got into one of my more animated debates yesterday with a fellow on LinkedIn over the issue of physician dispensing. This particular person appears to be a PR rep hired by a dispensing physician in an attempt to scrub the indelible stain on the soul that prescribing for fun and profit undoubtedly brings.

As we went back and forth with our points, this guy actually said at one juncture that I was  missing "key opportunities and issues" as I was only "focusing on being right when this a very multilevel issue."

Well, yeah. I do kind of focus on being right. Not many of us spend a great deal of time trying to hone the skill of inaccuracy. Well, those of us who are not PR guns hired by dispensing physicians, anyway. 

This morning I got an email from a LinkedIn friend who had seen this exchange, and it said, "Don't waste your time arguing with this guy. He is an idiot."

But.... Tilting at windmills and arguing with idiots is what I do. I can't help myself. It says right in my bio (below) that, while I am not always right, I am never in doubt. Therefore people of such unquestioned confidence must indeed argue with idiots. We're like moths drawn to the flame.

A very dim, ignorant, vacillating flame.

To be fair, this person probably isn't an idiot. He is a guy hired to defend a position that is impossible to defend. In our exchange he posted links to articles he said supported the noble, altruistic cause of physician dispensing. I pointed out those articles were on very biased trade organization websites - organizations that lobby for physician causes and profitability. To me that is kind of like going to a Chinese government website to read that they lead the world in human rights practices. He was unable to cite any credible, unbiased data to support his positions. 

And in the interest of full disclosure, he only posted those links as a defense because Joe Paduda had already devoured him prior to my arrival on the scene. I was just picking table scraps from the remnants of Joe's lunch. Paduda, who long ago set the standards for arguing with idiots (at least that is what he tells me when we are engaged in our politically opposing discourse. Not a compliment, now that I think about it), had already challenged this man's assertions, calling them "absolute nonsense".

And he was right. The defenders of physician dispensing will tell you that it is an efficient, affordable method for delivering critical medications to those who desperately need it. They are doing all of us a favor. Their intent is purely to provide outstanding medical care, and they only dispense in the best interests of their patients. 

Their patients, that is, whose bills are being paid for by workers comp or liability insurance policies. All others it seems need to make that nearly fatal trek to the pharmacy. It seems altruism isn't cheap. 

I am reminded in all of this of Mark Twain's assertion that "There are three kinds of lies: lies, damned lies, and statistics". As the debate over physician dispensing rages on, people will use all manner of fact and interpretation to make the case that supports their cause. In the end, however, the overwhelming statistics regarding this matter will rule the day, and it will not be in favor of those filling their coffers by fulfilling prescriptions.

And knowing that makes arguing with idiots all the more fun.

 

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Robert Wilson is President & CEO of WorkersCompensation.com, and "From Bob's Cluttered Desk" comes his (often incoherent) thoughts, ramblings, observations and rants - often on workers' comp or employment issues, but occasionally not.

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Subscribe to comments feed Comments (5 posted)

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Louise Moore 02/21/2013 05:01:42
As a field case nurse I have had to tell numerous docs on numerous occasions that my claimant can not get his Rx filled at their in house pharmacy. Some are okay with it and some are downright indignant. Some try to shame me (and therefore the insurance carrier I "represent") in front of the claimant. Some try to give me the same malarkey you have already mentioned in your article. "Altruism doesn't come cheap". I will definitely have to use that line, by the way.
In a very calm manner I have stated the following:

1. Insurance carriers actually have companies bid for their pharmacy business and you might want to try that, doctor.
2. It's their money and they can spend it with whom they choose.
3. If you only knew how out of line your drug prices were you would understand.
4. This could be seen as a conflict of interest (and then I duck).
5. Pretend it's YOUR money being spent.

If that doesn't work and my claimant walks out the door with a white bag full of meds, I also let them know that there is a good chance they won't get paid. After a couple months of that, I think they'll either stop dispensing meds or stop seeing the IW.
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Howard Deever 02/25/2013 05:22:03
When I was a young adjuster learning the auto BI ropes, dealt with a particular family practice doc widely known in the area as a favored stooge of contingency fee lawyers. Among his standard tricks was that, rather than sending 'patients' to a drugstore for 200mg motrin he'd dispense Rx-only 800mg in order to help fatten the specials AND put a little extra cash in his own already overflowing pockets. Seems almost laughable, now, at this many years' distance & in light of our present opioid abuse pandemic but that was my simple intro to the evils of doc-as-dispensary...
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Elise Farnham 03/04/2013 05:46:25
There is a bona fide conflict inherent in physician dispensing. Has the medical community as a whole take a stand on this issue?
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Bob Wilson 03/04/2013 07:50:41
Elise, While there are physicians who oppose dispensing primarily on ethical grounds, there are very active medical associations that support the physicians right to dispense. It does represent a complete conflict of interest, but the medical community seems to be siding in favor of it.
avatar
Paul Hooper 03/06/2013 07:41:14
I write a blog for CID Management, http://cidreview.cidmcorp.com/. The other day I posted about the issue of physician-dispensing. I cited a study that was done by the California Workers' Compensation Institute. The article looked at outcomes of physician-dispensing. It would appear that the principle outcomes involve higher prices for the drugs and longer return to work for the injured worker. It's hard to be a supporter of such a practice.
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