maybemaybenot
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Joined: 9/22/2005
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Complex question, Katy.
Family MDs have always prescribed sleepers.I really don't have an issue with them prescribing sleepers in most cases. I think that the average person does not realize that MDs do not get a very extensive education in pharmacology. Many do take course after they acquire their MD, but extensive pharmacuetical training is not in the ciriculum < sp>. I was amazed in the prev article to read that 57 million prescriptions were written for Ambien last year. That doesn't include the other hypnotics. Are that many people really suffering from insomnia? If so, it is of epidemic preportions and we need to have fund raisers, new research and a movement for the insomniacs.
My * opinion* is that we as a society have become pill seeking. More bluntly: Lazy. if we are experiencing something uncomfy.... gimme a pill. Can you imagine if some one went to the MD and said, ya know Doc, I can't sleep can you give me something? and the MD responded: I will give you a two week supply and I want you to go to a sleep disorder MD/clinic/program/rehab. I betcha 90% of the folks would say: Nope, can't do it, I'm too busy, don't have time, I just need something to sleep. There are people like you, but in my own experience, those are the rare ones.
As for antidepressants and similar categories, I agree completely. I think one should have, at minimum, a consult with a Psych. and regular monitoring, before any of those meds are given out. I also think there is a widespread belief that an anti depressant will " fix" your problems. People want to take the pill and make it all better. Much harder to actually find the root cause of the depression/mental issue and commit to working with a specialist to correct the root problem and re learn behaviors to promote well being.
The above are only my opinions, and I mean no offense to those battling mental issues. I know I was flip about the sleepers, but those numbers tell me that there is a whole lot of legalized drug abuse with hypnotics.
So those who really have sleep issues, please don't think I don't have compassion, I do. But there is another side of the coin that is a bigget problem, IMO.
HMO's and insurances have changed the way a MD can practice medicine. There has been more pressure put on the internist/family MD to be a jack of all trades. It's a whole nother topic, but let me give you a personal example:
I have a rare kidney disorder. When I first recognized that there was * something * wrong with me, I went to my MD, who is an excellent diagnostician,btw. I underwent two weeks of testing to determine if it was heart, kidney or liver giving me problems. Kidney was isolated. OK, wouldn't you think I should have been sent to a kidney specialist then? Of course, but that isn't how my HMO at the time worked. I spent another month or so undergoing tests to isolate what kidney disease I had. Once it was determined that I had a disease in a very broad category of kidney disorders I was sent to a Kidney specialist for a consult. He reviewed my tests, did a history and physical, and explained what diseases I might have. Biopsy of the kidney was needed so that was scheduled. All tolled, from my going to an MD to diagnosis was two months because of the restrictions of the HMO. I am not saying I was dying or anythig like that, but I was ill and treament was elayed two months and the disease progressd another two months before I could even get the treatment I needed. I have been in remission for 5 years now and all my kidney function and routine kidney tests are monitored and ordered by my Primary Care MD, not my kidney MD. Unless there is a problem I can only see him twice a year, per my HMO. Personally I am OK with my Primary MD monitoring me, I know he is a crackerjack MD, and I am a nurse so I am on top of it too. But in all reality, shouldn't a specialist be monitoring my condition, given that it is rare and not much research or info is available?
What is in the best interest of the patient is not always in the best interest of the HMO, and the HMO wins most times.
This wasn't my MDs fault, it was my HMO's fault. It restricted him from sending me to the specialist he wanted to. Now don't get me wrong and not trying to scare anyone. My illness was not life threatening and if I had gone in with a lump on my breast or bleeding rectally, I would have been sent to a surgeon immed.
But in life, most medical issues are not life threatening and the HMO's know that and for alleged cost containment reasons they are not very generous about sending people to the appropriate specialist.
As for HMO's and mental health, they stink. Most HMO's allow only a few visits to a specialist a period and hospitalization under very strict guidelines. So what happens is it is left in the lap of the family Doc.
There are some very good HMO's out there, but the average workign person has one that is not optimal for whole person health.
Again.. my opinions, my experiences... not to be taken as gospel truth.
mbmbn
_____________________________
Tolerance of evil is suicide.- NYC Firefighter
When tolerance is not reciprocated, tolerance becomes surrender.
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RE: Ambien sleepwalkers???? !!! - 
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