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There is literally only a **single** state in the USA where you still control autonomy over your own medical records (prescription drug list) and that is MO!
That means if you are in any other state and ever had a prescription doctors can find out what it was and who prescribed it. That means doctors can find your past doctors without your approval.
The scary part? You also have no control over your medical records. So your PCP can now legally look this up and contact all your past doctors for medical records and you cant do anything about it, you cant legally stop them, you cant purge your records, you cant purge your prescription list.
This is very scary for anyone who has been abused at the hand of a past doctor and moves.. If they have put any negative information about you that might make future doctors hostile towards you or not want you as a patient... there is nothing you can do... that is so scary...
@freemo It also means that if an ambulance finds you unresponsive on the side of the road, they can find out which medicines you're prescribed that could have caused your condition, and which you're allergic to that would put you in further danger.
@freemo And it presumably also greatly helps doctors prevent drug abuse by patients that "shop around" for a prescription.
@LouisIngenthron Which is NOT the place of a doctor... hell he shouldnt even have the right to tell you what you can put in your own body.. bodily autonomy is a sacred right.
@freemo True, but these people aren't always shopping these prescriptions for personal use.
@LouisIngenthron Thats not a problem your doctor should be trying to solve.
@freemo Sure it is. They, as a profession, are responsible for making sure the drugs get to the people who actually need them, not seedy douchebags who want to make a quick buck. That's presumably *why* only they can write prescriptions in the first place.
@LouisIngenthron NO.. their job isnt to be police and figure out if your lying or not to deal drugs... their job is to beleive you, and help you, they work for you.. they are there to do whatever tests or ask any questions to diagnose and then use the evidence they have (not speculation) to decide how its treated... If someone is lying and drug dealing thats for police not doctors..
The idea that you think a doctor should be adversarial and suspicious and try to figure out if your honest or not, even if that may be wrong get in the way of treatment and ultimately kill you is... well.. an astonishing perspective (though a common one).
I take it you have never actually been at the mercy of a doctor and abused by the sound of it.
@freemo No, I don't think they should just give out drugs to anyone who asks. People, especially in large groups, are very dumb. That system would inevitably cause spiraling panics where people buy up the whole stock of a drug because they're scared they'll run out, thus causing them to run out. When stupid games are played like that with toilet paper, it's an annoyance. When they're played with critical medicine, people die.
So, no, our current system isn't perfect, but someone does need to make sure that people who get the drugs actually need them.
No, I don’t think they should just give out drugs to anyone who asks.
I didnt say that… I said a doctor isnt there to play cop and investigate if your lying.. They still need to 1) hear your symptoms 2) do any tests that are possible and 3) give you an evaluation… What they arent there to do is second guess you and decide if your lying.. especially when if doing so puts good people at risk of dying due to wrong assumptions.
People, especially in large groups, are very dumb. That system would inevitably cause spiraling panics where people buy up the whole stock of a drug because they’re scared they’ll run out, thus causing them to run out
You can fix that how I already explained without needing to abuse people.
Have a one-way database… you cant look up what a person has taken in the past or get any access to their history.. but when they go to buy something IF they have bought more than a month’s worth the system will not let the transaction go through…
These are easy enough problems to solve when you actually prioritize someones safety and health rather than allowing abuse at someones discretion.
When they’re played with critical medicine, people die.
Good thing there are easier better solutions then that let people keep their history private AND prevent them from buying up stuff… if anyone cared enough.
So, no, our current system isn’t perfect, but someone does need to make sure that people who get the drugs actually need them.
Sure.. so why instead of using a system that opens people up to massive abuse and death we use a system that actually accomplishes that?
@freemo The problem with that plan is that there is no set amount for “a month’s worth”. It varies by person and condition, hence why we need prescriptions.
@LouisIngenthron Yes there is… what your doctor prescribed you… if your shopping around you have multiple doctors and multiple prescriptions, which would flag you in a one-way fashion (without letting anyone query your history itself)
@freemo So, you’re completely opposed to doctors being able to track you, but pharmacists having that exact same tracking is no problem?
So, you’re completely opposed to doctors being able to track you, but pharmacists having that exact same tracking is no problem?
Not what i said.. its a one-way database, no one can track you.
In other words no one, not even a pharmicist could see your history of medications. All the system tells a pharmacist is if a prescription they try to fill passes or not. It will only fail if they have more than one overlapping prescription. So it prevents buying up or shopping around or drug dealing.. but NO ONE has access to your history or can see it.
@freemo The fact that it’s one-way means they can’t investigate to fix edge cases. Get a new doctor and legitimately get a refill prescription from him? Flagged for the same prescription from two doctors. How do you fix it if nobody has the full picture?
@LouisIngenthron Sure they can, if designed to allow for it.
there can simply be a checkboc on prescriptions that says “override” .. when checked it means the doctor knows there is another overlapping prescription and this prescription is meant to replace it.
That way if someone needs a replacement script they can get it, but they most tell the doctor and show the doctor knew that it overlaps with another.. problem solved, quite easily.
How do you fix it if nobody has the full picture?
The patient has the full picture. in edge cases the patient tells the special case to the doctor, as mentioned above, and the system confirms the information the patient volunteered is correct. As per my example above (which explains that particular edge case)
@freemo But then we’re back to a system that ultimately hinges on a doctor deciding whether a patient is being honest (that this new prescription is replacing the old one), so it’s just a fancy and paperwork-heavy version of “trust me”.
But then we’re back to a system that ultimately hinges on a doctor deciding whether a patient is being honest
No your not… how ya figure.
Typically a doctor doesnt need to trust hte patient at all in the non-override case obviously.. In the case of an override a doctor will only check the box if the overlapping prescription is one he prescribed. If there is a case where a different doctor prescribed it then all he has to do is say “override” and then next to it put the other doctors name (given to him by a patient). The doctor doesnt need to trust him because the system will automatically only override a prescription from the doctor named.
Again every edge case you think cant be solved by a one-way system actually can, and no as I jsut showed it wont require the doctor to trust anyone should the system be designed correctly.
@freemo So what prevents someone from going doctor to doctor, telling each one that they just moved and this is their previous doctor? Then the doctor puts in the name of the last prescriber, marks override, and the system prevents nothing.
Simple, in order for an override to work ALL overlaps must be listed, not just the last one. So if there is a 30 day prescription and they get a second one after one day.. they would need to wait 29 days before that works again or else there will be 3 overlaps not two and the system will not allow it.
See, super easy to address this stuff in a way that protects people.
@LouisIngenthron Then the doctor simply pulls up google and looks it up based on whatever she does happen to remember. Or she brings her paper work in… or she calls back later with the phone number or info of the doctor… or she checks an old pill bottle.
There are like a thousand ways to solve that.
@freemo What if the pills she needs are for a UTI or something that causes her to be unable to even answer those basic questions?
@LouisIngenthron Then the insurance would have her PCP on file who would know the answers.
@freemo So in this system, the insurance companies still track people’s full medical history?
@LouisIngenthron No, it just has your PCP on file, your current one, thats it.
Remember your records are in your control… so her PCP has all the records for the time with the PCP. The patient just has the option to purge those records and/or switch doctors if they request it (And assume the risks for themselves in the process)… but otherwise your current doctor would have all your records, and if you switch doctors he will have your complete history if you didnt explicitly request to purge it or deny it to your doctor.
@freemo Also, what if she changed jobs when she moved and, like most people, gets her insurance through her job? Then she’d have a new policy with no history.
@LouisIngenthron Your policy doesnt have your history at all in this situation… only your current doctor does. Which is obvious because he treated you… so of course he has it… though as i said if you wish to purge it and move doctors you can (And assume the risks to you int he process)
@freemo Right, but your new policy won’t know who your old PCP is.
@LouisIngenthron Why wouldnt they? When you sign up for a new policy you must tell them who you want your PCP to be… so ont he forms you use to apply for a new policy youd explicitly tell them and they would know (unless you wanted to purge that info and not tell them, which again, you do at your own risk)
@freemo Right, but the one they’d have on file would be the one you picked from a list of providers when you signed up, and may have not yet even been visited, not the one in the city you came from who has your medical history.
Not necceseraly… you have two scenarios
1) You change providers and keep your PCP, in which case the PCP listed on the new insurance is the same as the old insurance, he has your history, no issues
2) You change providers and PCP at the same time. In this case the form asks if the PCP you select is a new one or if you are already a patient from your old policy. When you select it is new it then asks if you want to a) list your old provider and authorize a transfer of your records or b) purge your old records and not list the old provider and assume any risk
Again, problem solved…. These seriously arent big issues and easily solved in this system.
@freemo And if an old lady moves and needs heart medicine and can’t remember exactly how her old doctor’s name is spelled?