tag:blogger.com,1999:blog-7772182113499451603.post3352124520919842254..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: What Do Surgeons and Psychiatrists Have In Common? - DreadGeorge Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7772182113499451603.post-23451030749761753812018-10-15T14:16:31.247-05:002018-10-15T14:16:31.247-05:00Agree with your approach.
There is active ongoing...Agree with your approach.<br /><br />There is active ongoing commentary about the inappropriate intrusions into clinical care by MCOs and PBMs including overruling the clinical judgment of the physician and also massive (90 day prescriptions) the only indication seeming that it saves the mailer postage fees. When I get a history of AD sensitivity, I also go with the lowest dose and review with the patient that they should have a very low threshold for calling me with any side effects. In a young person new suicidal ideation is an FDA warning that I discuss with them.<br /><br />One of the things keeping all of these business intrusions going is ERISA and protection of these businesses from liability. That is why they can afford to strong-arm clinicians.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-1190666463262102842018-10-15T12:46:28.622-05:002018-10-15T12:46:28.622-05:00Consider answering this little "gem" thr...Consider answering this little "gem" thrown at me this AM, Monday AM that is: I saw a 17 year old female early last week, who has a history of sensitivity to meds in general, no psych meds given to her though, and for the sake of space and time, felt she might be a good candidate for fluoxetine (Prozac to readers) and to be on safe side titrate, as I always do, from lowest dose of 5mg and up to 20mg in a few weeks time, by 5mg and wrote, obviously, for tabs. So, the insurer sends a denial and basically writes this is not the first choice of meds and even so should be using capsules and thus start a higher dose.<br /><br />NOT GOING TO HAPPEN, I wrote a challenge of the denial asking for the alleged MDs name and literature to support this claim and how it could impact on suicidality issues in adolescents, and will see if they react as I hope when I wrote about medical necessity and if I have the term right, Respondant Superior in taking on a supervisory role in the patient's care. Curious if you would comment, if not fine as well, but, the point here, insurers are taking on legitimate clinical roles in interfering with care and there has to be a lawyer who can use this as precedent, but, that infers a negative outcome and not being the test case here!<br /><br />Culpability, and liability, sad people have to risk being dragged into court to figure out what is common sense vs convenience, and the latter term of those two last words for the provider and NOT the patient...Joel Hassman, MDhttps://www.blogger.com/profile/18428102819014299270noreply@blogger.com