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Whit Gray's avatar

I thought of a silver lining for the deterioration of "official standards." In a world where licensing has become a bureaucratic nightmare this can allow people to move away from the captured standards. I have been operating outside of the mainstream medical world to deal with my MS for decades. Nothing effective is covered by insurance. I already have no respect for the letters "M.D." and my life is better for it. Let all these antiquated institutions fall and let the more competent, affective practitioners make the money. A robust review system will keep the incompetents in their place.

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The Radical Individualist's avatar

I get your point, except for the last sentence.

What robust review system? What if the review system is more incompetent than the incompetent? What if the review system is weaponized for political purposes. And generally, the review system IS weaponized for political purposes. That's what DEI really comes down to.

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Whit Gray's avatar

I meant a robust independent review system, not a sanctioned review system. Because you are totally right about weaponized review systems.

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The Radical Individualist's avatar

Do you have any specific thoughts about what an independent review system would look like?

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Whit Gray's avatar

People would have to pay to leave reviews

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Bobby Lime's avatar

For some time, I have had the close to anarchic idea that doctors shouldn't necessarily even have the power to prescribe, just to advise. Unfortunately, the insurance companies would not be pleased.

I'm in a position to know that many veterans who have blast induced traumatic brain injury have been able to ditch dozens of prescribed medications ( forty - two different ones in a case I know of, and he's not unusual ) because of cannabis use. The VA will pay for the forty - two medications, but not for the cannabis, never mind that a veteran could lose all of his benefits if caught.

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Whit Gray's avatar

That is such a good idea to advise but not prescribe! The VA is soooo f’ed up. Perfect example of how badly things can go.

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Bobby Lime's avatar

We shall not live to see such days, although Americans should have become accustomed to the fact that doctors don't have superpowers.

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Susan's avatar

I'm a little confused. Who would prescribe medication, then, if not doctors?

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Bobby Lime's avatar

No one. As I implied, it's waaaay beyond libertarianism, and it isn't going to happen. I said it out of disgust with my own situation. I need 80 mgs of Ritalin every day, and was able to get it until eight years ago, when the state Board of Medical Licentiaure, or whatever it's called in my backwater of a state ( Indiana, which does have some things going for it ) went on what my primary care physician called "a reign of terror," yanking medical licenses in a manner that seemed arbitrary to doctors.

It was intentional terrorism, of course, and it worked. Its purpose was to intimidate doctors to keep them from prescribing large doses of medications, never mind that a patient might need them. I doubt there's a doctor in Indiana who would prescribe the amount of Ritalin I need, or, for that matter, the 4, sometimes 5, mgs of Klonopin which I need in the evenings to get to sleep. And who can blame the doctors? They worked their posteriors off to become doctors. I don't doubt that my current primary care doctor would prescribe what I need if she could, but she knows I understand why she can't.

The inane and destructive Board doesn't recognize rare cases, such as mine. I'm an explosive blast induced pediatric, now adult, traumatic brain injury survivor. It's quite rare in the United States, of course, still, it happened to me. As a great doctor back in the 1940s said to his residents as he was leading them on Grand Rounds one day, "Remember, gentlemen, a disease may be rare, but it isn't to the patient who has it."

But as I say, he was a great doctor, and state boards tend to be composed of medical bureaucrats. I can't get the treatment which would work best for me, so must experiment by adding Wellbutrin gingerly, or maybe Intuniv, or perhaps spacing the 60 mgs of Ritalin I am allowed differently. It's all ad hoc, and maddening. Sometimes, it works well enough. Other days, it creates a nasty smashup in my system.

In my ideal scheme of things, no one would prescribe. Doctors would be advisors only, and, of course, most patients would follow their advice. Some would choose to experiment. And as I said, it isn't going to happen.

I suppose the real answer would be to get outstanding men and women to serve on these licensing boards instead of mediocrities.

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Susan's avatar

I am terribly sorry for what you are going through. Dear God. I know my daughter's case is trivial next to yours, but she also struggles with the shortage of ADD meds in this country. It is sad to see her lying in bed all day because it's a "bad week" and she cannot find a CVS with her medication in stock. (I must confess to still being puzzled, though, because you clearly need medication, and somebody needs to subscribe it..?)

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Bobby Lime's avatar

Thank you, Susan. That's very kind of you. I'm so sorry about your daughter. Does she have a TBI? The ADD medication shortage is infuriating and mystifying. A pharmacist said to me that it happened because the drug companies let their paperwork slide during the pandemic, which makes no sense whatever to me.

Yes, I need an extra 20 mgs of Ritalin LA every day, and even if it's available, doctors are terrified of losing their licenses, and won't prescribe it. I'm close enough to another state that I have thought of trying to find a doctor there who would prescribe it. Of course, I couldn't use Medicaid there.

There is a doctor in my church who lives and practices across the border, in that other state. I have wondered if he might do it, or at least prescribe that extra 20 mgs.

Yes, I need it, but tough luck, as your daughter is having currently.

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Susan's avatar

No, no TBI, but she has a cluster of "things" going on that she has struggled with, or is struggling with, including depression, anxiety, ADD, possibly undiagnosed autism, OCD, and an eating disorder (the last 2 are MUCH better, thankfully.) That is a strange and unconvincing explanation for the drug shortage. Every single month it is a scramble for so many to get the medication they need. It's practically a part time job.

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Justine Fox's avatar

I use kratom and thc for both mental and physical therapy. Works better than the 20+ different medications I tried. I use Effexor as well, but that alone wasn’t enough.

Doing your own research, if you know how to read scientific journals,is something I’d recommend to anyone who can’t get relief from prescriptions alone.

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Bob Hannaford's avatar

Another good job waking us up to the scary world we live in. I really don’t know what to do about it, but at least I can pray.

You may know something I don’t about Mr. Lemon which causes you to think he is not that stupid. But I definitely didn’t get the same impression.

I just have a hard time believing that someone would allow themselves to look that stupid unless they really were that stupid and couldn’t see it.

This dovetails with the whole licensing issue. Because I’ve decided that if I ever become king of the universe, people are going to have to be licensed to speak in any kind of public forum. The only requirement would be an IQ above 120.

Again, I have greatly restrained myself in the length of my comments out of consideration for your time.

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silverspur's avatar

Look on the bright side! If cops cannot physically get to criminals and ideologically cannot get them sentenced...there is little to no chance your trip to the emergency room will see you taken care of by a felon!

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George Romey's avatar

Finally got to your show. Madonna like so many others built a facade, a character. But when age catches up they have no where to go in their heads. So they regress into the past and hope everyone goes along.

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