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Latest Posts

Should Halloween Contact Lenses Be Prescription-Only?

That depends on if you can afford to get them.  Costume lenses are all the rage for Halloween by adding an exciting dimension to the costume wearer.   But did you know it’s illegal to market them as over the counter?

Many consumers do not realize that they are FDA- regulated medical devices, and that recent legislation has made it illegal to market them as over-the-counter products. Still, they are commonly available in costume shops, beauty shops, convenience stores, novelty shops, and other places that people shop for Halloween items, as well as over the Internet.

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*This blog post was originally published at A Happy Hospitalist*

Strange Prescriptions: Tax Free In Texas

From an old HS buddy (also a Navy Man) now in healthcare:

Texas law makes almost any item with a doctors prescription exempt from
sales tax.

(most details at : RULE §3.284 Drugs, Medicines, Medical Equipment, and
Devices (Tax Code §151.313) Item 11 is the sort of catch all.

What is most odd item you have been asked for a prescription for purely for
tax-free purposes?

Sellers of the Select Comfort beds, and hot tub/spa dealers are very aware
of this law. Presciption needed for bed, letter and presciption needed for
hot tub/spa.

Oddest request received at clinic where I work: one for in ground pool,
heated and deep enough for water aerobics.

While I don’t notice it on that list, food for helper animals is exempt
from sales tax.

Interesting also, repair parts for devices are exempt, but not
*improvements*. If you replace like for like wheel on a walker, it is tax
free. Replace with improved wheel-taxable.

I’ve never been asked to write a prescription for anything like that in the ED, but I’d be willing to bet my office-based colleagues have.  Care to share?

*This blog post was originally published at GruntDoc*

Patient Bites Off Doctor’s Finger

Allegedly for “not writing a prescription”…

news-press.com

Dr. Paul Arnold turned his back for a moment on a patient who was upset because the doctor wouldn’t write him a prescription.

That’s when the patient, Gregory S. Powell, 45, of Fort Myers, allegedly attacked Arnold, 65, biting off part of one of the doctor’s fingers.

As my tipster says “…probably wasn’t about refusing an amoxicillin script…”.

In custody; no word on the doc, and best wishes.

Thanks to Glenn (a true homie) for the tip.

*This blog post was originally published at GruntDoc*

Physicians Under Pressure To Prescribe Narcotics

When it comes to opiate drugs, like morphine, there is a bitter debate between patients who are in chronic pain, and the doctors who are vilified for under or over-prescribing these medications.

But there are some other subtle influences that push doctors to prescribe these drugs, in some cases inappropriately. An ER physician talks about the issue, saying, “when dealing with a patient who is in pain, or appears to be, it can be impossible to sort out when a patient needs opiates for legitimate reasons, and when it is merely feeding a long term addiction. We are trained to provide comfort and relief from suffering to our patients, and we generally will err on the side of treating pain, rather than withholding addictive medications.”

There is also the pressure to provide “patient satisfaction,” and indeed, low scores in this area can place a doctor’s job in jeopardy. Taking a stand against those who inappropriately request opiates will result in low patient satisfaction scores, and “will often times result in arguments, profanity, and calls and letters to administration.”

What’s the answer? Perhaps a little less reliance on these scores, since a good patient satisfaction score is not necessarily correlated with proper medicine.

*This blog post was originally published at KevinMD.com*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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