Kevin Keitzman(voice of Kansas City sports) rips Andy Reid as a coach and parent..

[87168]

Ummmm yea so, this radio host lost his job. 

 

Did he also work in pharmaceuticals?

[Hapless Bills Fan]

17 hours ago, Mr. WEO said:

This is my real world.  

 

I don't make more money on a patient visit by prescribing anything.  Also, "sunshine laws" have made most of the pharma junkets for Docs a thing of the distant past.  My university employer doesn't allow me to accept a slice of pizza for a minute with a pharmaceutical rep. 

 

That's because you're a real doctor, who provides legitimate medical care for actual medical conditions.  It's to your credit you don't know more about how this works, actually (and your suggestion in another article for specialized offices to prescribe opiods strongly implies that you actually don't).

There are many doctors who hang up a shingle for "workman's comp claims" or "pain treatment clinic", who make money by seeing as many patients as possible, and writing them narcotic prescriptions.  They make their money by office visits where a cursory medical history is taken, a fee of $200-400 collected (usually in cash), and a prescription issued.   These used to be endemic in S. Ohio,  N. WVa, and Kentucky.  Now they're pretty much limited to Florida and Texas. 

Some used to have an attached pharmacy that fills the scrips for extra profits - I think that's been stopped most places. 

 

Are you one of the 72% or the 28%? 
Are you one of the 53% or the 47%?
(see below)
 

According to Johns Hopkins researchers who surveyed 420 doctors:

• 72% of doctors are aware of prescription drug monitoring databases
• Only 53% of doctors actually use them
• 58% reported that the information takes too long to get to
• 28% said they aren’t easy to use

[Hapless Bills Fan]

22 hours ago, Mr. WEO said:

Physicians are aware of the risks and also of  non-opioid alternatives.  But the risk, for oxycontin as an example, of abuse is .0055 per 100,000 prescriptions.

You can conclude it's a douche move, many have.  I'm just saying it's not a question that can't be asked.  And to answer your question, I bet in retrospect Reid (ANY PARENT) would look back at how his career, etc, could have been altered to have a better outcome for his TWO struggling children.  So it is germaine to this topic. 

His adult sons living in his home needed parenting.  This is clear.

 

To the first sentence:  Given that there are published reviews, featuring data and statistics, that show acetaminophen and ibuprofen may be more efficacious for pain relief after dental surgery procedures such as extraction, yet dentists are STILL providing and even pushing opiod prescriptions on teen patients (BTST), I would have to say that physician and dentist awareness is not what it ought to be.

To the second, can you provide a source please, because that doesn't match the data I have.  But let's take it at face value and see what it would mean, if correct.

.0055 per 100,000 means 550 abused prescriptions.  Since dentists prescribe 12% of the opiods (source: WaPO article linked earlier) if we assume a similar abuse rate across all prescriptions written (probably not a good assumption, but work with it here), that would mean 66 opiod prescriptions written for dental procedures resulted in abuse.  Since opiod addiction is a lifelong and often fatal condition, that would mean per 100,000 prescriptions written for dental procedures, 66 resulted in a lifelong and often fatal condition. 

I think that's a high morbidity rate for something unnecessary. 

That actually hugely understates the actual point of concern- which is while these initial prescriptions may NOT be "abuse", however that is measured, the initial, legitimate and non-abused use of the narcotic drug has a high rate of developing addiction.  " Nearly 6 percent of almost 15,000 people between ages 16 and 25 were diagnosed with opioid abuse within a year of receiving initial opioid prescriptions from dentists in 2015, a JAMA Internal Medicine analysis finds. In comparison, 0.4 percent in a similar group who didn’t get dental opioids were diagnosed with opioid abuse. "  6/.4 = 15.  15x more likely to become addicted to opiods within a year after receiving an initial (non-abused) prescription.

I can only SMH for the latter part.  The parents agreement is NOT germaine to the argument about whether or not it's a douche thing for the radio dude to bring up, because DURRR, parents of dead children inevitably blame themselves and believe they should have done better.  They are in a hell of pain and self-blame is part of that hell.  Thus we need to assess the douche-iness or appropriate nature of the radio guy's remark independent of what Reid self-believes.  What he believes is not germaine to the discussion because it is given.

I pray God I never see it myself, but I have seen it with friends: you can not parent adult children who do not wish to be parented, whether it's for a medical condition or a mental health condition.  [Likewise as an adult child, you can not provide services to parents (deemed mentally competent) who do not wish to accept them (I am living this)].   Reid's choices may have been limited to "kick his sons out, or allow them to continue to have a safe place to live".  Addicts are notorious for being far cleverer at finding and concealing drugs in a home than parents are at keeping drugs out.  That's what I mean by saying I'd have to have far more detail than was provided in the newspaper clipping to make a judgement.  The house was "searched and found to be filled with prescription narcotics", does that mean sitting on the kitchen counter and the coffee table, or behind the light switch plates, under dresser drawers, beneath the toilet tank, in the gaming console, and other places experienced searchers know to look?

 

[Mr. WEO]

55 minutes ago, Hapless Bills Fan said:

 

That's because you're a real doctor, who provides legitimate medical care for actual medical conditions.  It's to your credit you don't know more about how this works, actually (and your suggestion in another article for specialized offices to prescribe opiods strongly implies that you actually don't).

There are many doctors who hang up a shingle for "workman's comp claims" or "pain treatment clinic", who make money by seeing as many patients as possible, and writing them narcotic prescriptions.  They make their money by office visits where a cursory medical history is taken, a fee of $200-400 collected (usually in cash), and a prescription issued.   These used to be endemic in S. Ohio,  N. WVa, and Kentucky.  Now they're pretty much limited to Florida and Texas. 

Some used to have an attached pharmacy that fills the scrips for extra profits - I think that's been stopped most places. 

 

Are you one of the 72% or the 28%? 
Are you one of the 53% or the 47%?
(see below)
 

According to Johns Hopkins researchers who surveyed 420 doctors:

• 72% of doctors are aware of prescription drug monitoring databases
• Only 53% of doctors actually use them
• 58% reported that the information takes too long to get to
• 28% said they aren’t easy to use

 

23 minutes ago, Hapless Bills Fan said:

 

To the first sentence:  Given that there are published reviews, featuring data and statistics, that show acetaminophen and ibuprofen may be more efficacious for pain relief after dental surgery procedures such as extraction, yet dentists are STILL providing and even pushing opiod prescriptions on teen patients (BTST), I would have to say that physician and dentist awareness is not what it ought to be.

To the second, can you provide a source please, because that doesn't match the data I have.  But let's take it at face value and see what it would mean, if correct.

.0055 per 100,000 means 550 abused prescriptions.  Since dentists prescribe 12% of the opiods (source: WaPO article linked earlier) if we assume a similar abuse rate across all prescriptions written (probably not a good assumption, but work with it here), that would mean 66 opiod prescriptions written for dental procedures resulted in abuse.  Since opiod addiction is a lifelong and often fatal condition, that would mean per 100,000 prescriptions written for dental procedures, 66 resulted in a lifelong and often fatal condition. 

I think that's a high morbidity rate for something unnecessary. 

That actually hugely understates the actual point of concern- which is while these initial prescriptions may NOT be "abuse", however that is measured, the initial, legitimate and non-abused use of the narcotic drug has a high rate of developing addiction.  " Nearly 6 percent of almost 15,000 people between ages 16 and 25 were diagnosed with opioid abuse within a year of receiving initial opioid prescriptions from dentists in 2015, a JAMA Internal Medicine analysis finds. In comparison, 0.4 percent in a similar group who didn’t get dental opioids were diagnosed with opioid abuse. "  6/.4 = 15.  15x more likely to become addicted to opiods within a year after receiving an initial (non-abused) prescription.
 

 

 

 

Linked it above.

 

No one is arguing that opioid addiction is not a crisis at this point.  Your data says what every already understands.

 

You should credit me for knowing exactly how this works.  Pill mills and comp shops are done.  Prescribers script writing patterns and behaviors are monitored---specifically because of the crisis.  Having a monitored specialty prescribing practice would solve many problems.

 

If the Johns Hopkins had surveyed physicians (at least those who prescribe meds)  in NYS, they would have found that 100% are aware of the prescription monitoring database and 100% (since 2013) use it when prescribing narcotics.  It's not optional. the ISTOP program requires any prescribing provider to log on to the site before sending an electronic script (no more paper prescribing allowed) to see the patient's narcotic prescription history.  The majority of states have a similar program.

 

Also incorrect is the assumption that, because a relatively tiny number of providers ran pill prescribing shops, then all narcotic prescribing is corrupt and dangerous.  You couple this with the claim that, because 550/100,000 scripts will result in abuse, that narcotics are too dangerous for general use. 

 

If 94% of people between 16-25 can experience safe appropriate pain management therapy without abuse and addiction, would you withhold that effective therapy because 6% will become abusers for the meds?  Your answer will be based on another fallacy---that most (all??) patients can have better relief of pain with Tylenol and motrin.  Some will, others won't.  This is well known.  In surgery we are "pushing" enhanced recovery protocols that, in part, seek to eliminate narcotic use inside and after the operating room.  But we all understand that some will not have appropriate pain relieve---and they will get narcotics, because we know that the vast majority will not go on to become addicted to or otherwise abuse these substances.