Do Drs offices get incentives for prescribing certain medications?

[princessmorgan]

I'm starting to not trust my children's pediatrician, well one doctor in particular. I am no doctor by any means nor do I have any medical training. However we started going to a new doctor about a year ago when we moved. This one Dr in particular at the practice always prescribes a certain antibiotic that is more expensive than amoxicillin. I know some are better for certain things than others, so I just went with it. If DD's have ear infections, sure no problem. However they thought DD have a UTI, but the test came back negative, Dr. put her on it anyway "just in case." Well the more extensive test came back negative, so DD was on antibiotics for nothing.

Now today, DD (almost 3), had a fever of 105. I called the on call doctor last night. She said if DD can sleep and you can get the fever down a little then wait until morning. The fever finally broke around 5 a.m. I took her into the Dr. anyway. DD's fever was 100.8. Strep test-negative, flu test-negative. Dr. says to go to hospital for lab work and a chest x-ray to check for pneumonia. DD has no other symptoms, no cough, no runny nose, nothing. I go, because I don't want to take any chances, though I thought the x-ray was unnecessary. They make it sound very urgent. I ask them if I can wait 30 minutes so DH can get home, so I don't have to take all 4 kids. No, they say. Make him meet you at hospital. Anyway, they never call me for lab results. I finally call them at 4. they said negative on pnuemonia and lab work is inconclusive. Then they prescribe said antibiotic again.

Sorry for this novel, so now I'm wondering if Drs. receive anything for prescribing certain antibiotics. It just makes no sense to prescribe an antibiotic for DD's high fever when all the bacterial test came back negative. Am I just being paranoid or is it time to find a new Dr.? This medicine costs about $60 each time we get it.

 

[Mom2m&k]

In my opinion it is time for a new doc! I work in a family practice. Our docs do not get compensated for giving certain meds. I have however come to the conclusion that not all docs are created equal! A doc that is not confident in themselves or their ability to diagnos will often order lots of tests and then give meds...just in case. Hope that helps!

 

[Meshell2002]

I've worked for 3 different peds. None get any kind of "kick back" for certain prescriptions...lately drug reps aren't even allowed to bring in pens with their names on it. They may be allowed to leave written info about their drug and a plate of cookies, but that wouldnt be enough to make me write a Rx for a certain drug. Assuming your child doesn't have a bunch of allergies....I would let the dr know that your insurance is not covering his...err...favorite med. Many docs write the same 5-6 meds all day because they are familiar with them and they are pretty busy (and maybe just havn't read the chart back enough to realize that your child has had that med...multiple times)....if he still doesn't change his ways I would consider switching docs.

By the amount of testing it sounds like either your child APPEARED very ill to the doc AND/OR he is scared of missing something so he is covering all his bases...hence all the tests.

Hope your LO is feeling better.

 

[npmommie]

I'm starting to not trust my children's pediatrician, well one doctor in particular. I am no doctor by any means nor do I have any medical training. However we started going to a new doctor about a year ago when we moved. This one Dr in particular at the practice always prescribes a certain antibiotic that is more expensive than amoxicillin. I know some are better for certain things than others, so I just went with it. If DD's have ear infections, sure no problem. However they thought DD have a UTI, but the test came back negative, Dr. put her on it anyway "just in case." Well the more extensive test came back negative, so DD was on antibiotics for nothing.

Now today, DD (almost 3), had a fever of 105. I called the on call doctor last night. She said if DD can sleep and you can get the fever down a little then wait until morning. The fever finally broke around 5 a.m. I took her into the Dr. anyway. DD's fever was 100.8. Strep test-negative, flu test-negative. Dr. says to go to hospital for lab work and a chest x-ray to check for pneumonia. DD has no other symptoms, no cough, no runny nose, nothing. I go, because I don't want to take any chances, though I thought the x-ray was unnecessary. They make it sound very urgent. I ask them if I can wait 30 minutes so DH can get home, so I don't have to take all 4 kids. No, they say. Make him meet you at hospital. Anyway, they never call me for lab results. I finally call them at 4. they said negative on pnuemonia and lab work is inconclusive. Then they prescribe said antibiotic again.

Sorry for this novel, so now I'm wondering if Drs. receive anything for prescribing certain antibiotics. It just makes no sense to prescribe an antibiotic for DD's high fever when all the bacterial test came back negative. Am I just being paranoid or is it time to find a new Dr.? This medicine costs about $60 each time we get it.

No there is no compensation for prescribing certain meds. Some docs have their reliable meds they have seen good results with so they usually will stick with those.
but I think its time for a new doc. It is so against the current thinking to throw an antibiotic at everything.
This is why there are so many drug resistant strains of bugs out there.
what is the med he keeps prescribing if you don't mind me asking

 

[princessmorgan]

Thanks, that does help! Now, I'm trying to decide whether I should pick up the antibiotics or wait it out another night.

 

[ellone]

Thanks, that does help! Now, I'm trying to decide whether I should pick up the antibiotics or wait it out another night.

I'd say wait it out. It sounds like your DD has been on antibiotics too much already. I wouldn't use a doctor that puts kids on antibiotics 'just in case.'

 

[piperdown]

Found an interesting article from the NY Times a few years back.

Looks like several drug companies got in some hot water, and some changes have been made. However, I still believe that this is going on, just in a more hidden fashion.

My doctor discourages the use of antibiotics for ear infections, and fevers if there is little evidence that it is bacterial and I support this course of action.

 

[princessmorgan]

No there is no compensation for prescribing certain meds. Some docs have their reliable meds they have seen good results with so they usually will stick with those.
but I think its time for a new doc. It is so against the current thinking to throw an antibiotic at everything.
This is why there are so many drug resistant strains of bugs out there.
what is the med he keeps prescribing if you don't mind me asking

Omnicef

 

[princessmorgan]

Thanks for the replies; it's good to know there's no compensation for prescribing certain meds. Maybe it is just a preference.

 

[Soon2B4]

Both of my sons had random fevers this summer with no other symptoms. It last a day or two and is gone. I did take the first to Urgent Care b/c at one point I couldn't get his fever to come down with Tylenol and a tepid bath. It stayed up around 104. BUT, they would not give antibiotics b/c they had no reason to. All tests were negative. Drs around here will not give them for any old reason. They wait for test reasults unless it is obvious like the initial strep test. The same goes for me with my family dr, but we are all in the same system , the Cleveland Clinic. I would if you aren't happy, switch. Don't worry about hurting feelings or anything like that with the doctor's office. My son had some serious health issues that went undiagnosed. I wished I had pushed harder as a parent. Since then, I question more and go with my gut. HTHs!

 

[princessmorgan]

Found an interesting article from the NY Times a few years back.

Looks like several drug companies got in some hot water, and some changes have been made. However, I still believe that this is going on, just in a more hidden fashion.

My doctor discourages the use of antibiotics for ear infections, and fevers if there is little evidence that it is bacterial and I support this course of action.

Hmmm, that is an interesting article. The thing is, it's only one doctor in the practice. I brought another DD in two weeks ago for the same thing, except her fever only got to 103. This doctor tested her for strep, it came back negative, and she sent us on our merry way and said drink some fluids. She wouldn't even do a flu test, because she said she had no other symptoms and it wasn't going around. She has a lot more experience though.

 

[furb & dez]

What do you call a doctor who graduates at the bottom of his class? Doctor.
What do you call a doctor who graduates at the top of his class? Doctor.

Get a new doctor.

 

[StitchandPooh'sMom]

Omnicef

I am not a doctor, so this is just my personal opinion. My DD8 has been on omnicef a few times. It is a broad spectrum antibiotic that seems to work on a lot of childhood illnesses - ear infections, bronchitis, maybe strep?

DD8 has a history of ear infections. Amoxicillin doesn't touch them. If I take her to her regular doctor or to an ear specialist, they both prescribe Cefzil (a cephalosporin like omnicef) and it knocks out her ear infection. If I take her to urgent care or to the after hours care at our doctor's office, they always want to start with amoxicillin. In every case that she has started with amoxicillin, she has required two to three rounds of antibiotics to get rid of her ear infection. She typically has a lot of pain when she has an ear infection, so her primary care doctor won't prescribe amoxicillin for her anymore because it results in an extra week of pain and treatment when it doesn't work and something else has to be prescribed. I have learned to tell the urgent care people that they need to prescribe something other than amoxicillin for her so she doesn't suffer any longer than she has to.

The point of all this is that omnicef is fairly potent and it treats a lot of things, so it is generally a safe choice as long as your child tolerates it. It doesn't sound like your DD needed an antibiotic in this case, but if they suspected pneumonia (which both of my DDs have had ), amoxicillin wouldn't be the first choice. (I'm not sure omnicef is the preferred antibiotic either - I think my kids had a z-pack for pneumonia, but I might be remembering wrong.)

I'd still probably look for another doctor - one you have confidence in and one who has confidence in his ability to diagnose. But prescribing omnicef is not way out there in terms of appropriate medical advice, assuming there is a need for an antibiotic in the first place. With all the choices, though, the doctor should check your insurance plan to see which antibiotics are preferred. Before our allergist prescribes anything, he checks our plan to see which drugs will be less expensive for us.

The bigger issue than prescribing an expensive antibiotic is prescribing any antibiotic if there is nothing that warrants it.

 

[RichieTruxillo]

No, there is no monetary compensation for writing a certain medications.

 

[tink_lover]

This is not entirely true.... Offices get reimbursed a dollar amount depending on the drug used, or procedure done. In some cases, the office can make money. Is this physician part of a practice that is non-profit? Or is there profit sharing that occurs?

 

[lizabu]

I saw this movie about Viagra when it was just getting started (it has Anne Hathaway in it) I think it's called "love and other drugs". In the movie they gave the doctors all kinds of free stuff, gifts, trips etc as a bribe for prescribing their drugs. Its just a movie of course but I'm sure movies never have a grain of truth in them

 

[princessmorgan]

This is not entirely true.... Offices get reimbursed a dollar amount depending on the drug used, or procedure done. In some cases, the office can make money. Is this physician part of a practice that is non-profit? Or is there profit sharing that occurs?

I'm pretty sure their office is for profit.

 

[princessmorgan]

I saw this movie about Viagra when it was just getting started (it has Anne Hathaway in it) I think it's called "love and other drugs". In the movie they gave the doctors all kinds of free stuff, gifts, trips etc as a bribe for prescribing their drugs. Its just a movie of course but I'm sure movies never have a grain of truth in them

Oh I heard about that movie, but I never saw it. I didn't know it was about that though.

 

[tink_lover]

Well, unless the drug is used in the office or the procedure is done in the office, that might be a moot point. However, you don't know if that doctor is a speaker for the product/company or a stock holder.

One more question, are you filling the antibiotic prescription at the office or at the local pharmacy or drug store?

 

[princessmorgan]

Well, unless the drug is used in the office or the procedure is done in the office, that might be a moot point. However, you don't know if that doctor is a speaker for the product/company or a stock holder.

One more question, are you filling the antibiotic prescription at the office or at the local pharmacy or drug store?

No, the prescription is filled at the pharmacy, and I can tell them which one to call it into.