Just went to a new doctor

[[Buddie]]

No worries, no offense taken. Seems incomprehensible unless you/your close friend/family have seen it firsthand. *Caveat- Not everyone is a crook. Some are humans just trying to get by and make a living like the rest of us. Just know that the doctor/hospital side of the equation is a top down, authoritarian system. Doctors in general need hospital privileges in order to admit patients, order tests, and see/treat their patients outside the office. It's rare to find someone who doesn't have this tether.

I just looked for these particular cases, and it seems the PTB will not return results. During the pandemic,  Pharma companies and hospitals have become a sacred cow devoid of oversight and rife with politics. I imagine most stuff has been scrubbed. Apologies, you might have to take my word for it that these cases exist; however, I am providing examples of numerous kickback prosecutions, some for drugs, others for admitting patients.

Hospital systems have been shut down and fined by state attorney generals for doing kickbacks. In any given city, a certain hospital will use one antibiotic exclusively while another will use a different one- all within blocks of one another. Since most area doctors would have privileges at both places, that's statistically impossible. The kick back is based on the number of scripts written and filled there.

Here's proof of odd prescribing patterns.
    "Larkin and his colleagues compared the prescribing patterns of more than 2,100 doctors at 19 hospitals with restrictions on sales calls against more than 24,500 matched doctors at hospitals with no such restrictions.

     Market share for brand-name drugs decreased at hospitals with sales restrictions, while market share for generics increased, researchers found."
https://www.cbsnews.com/news/doctors-receive-money-gifts-from-drugmakers-pharmaceutical-companies/

Worker's Comp is another profitable arena as the doctor's can only prescribe the drugs within their protocol.  Each state's WC board decides what that will be. You have to specifically agree to be a WC doctor and use their treatment guidelines exclusively, even if otherwise in your practice, you might do things differently for the same diagnosis.

The reason these groups get caught is often because of their Medicare and Medicaid billing profiles which have state and Federal monies. The Stark Law is designed to keep this profiteering from happening. Yet, it continues.

How kickbacks work with specific doctors.
https://medslawsuit.com/frauds/what-is-a-pharmaceutical-kickback/

Cases involving hospitals, pharmacies, nursing homes, laboratories, prisons, and even a software firm with all kinds of kickback schemes:

This one is hospitals receiving funds.
https://www.healthleadersmedia.com/strategy/olympus-corp-fined-646m-paying-kickbacks-hospitals

      "Even fifteen years after their colossal 2002 payout, which is still recognized as the largest fraud settlement in United States history, Hospital Corporation of America (HCA) remains a frequent topic of discussion at the Department of Justice. Surely, it’s not hard to see why; HCA owns and operates 162 hospitals and 113 surgery facilities, the majority of which are located in the US – and with the ever-growing healthcare fraud crisis that seems to plague the nation, HCA and its subsidiaries commonly find themselves in hot water.

    At the heart of the ever-present scrutiny that HCA faces lies their infamous and lengthy fraud allegations stemming from a 1997 investigation, among which were countless examples of upcoding, kickbacks, and record falsifications. The complaints, many which were brought forward by whistleblowers within the company, were filed in five separate federal court districts in Texas, Georgia, Florida, and Tennessee, and resulted in a massive discovery of the various fraudulent schemes occurring in the facilities."

https://whistleblowerjustice.net/nations-largest-healthcare-fraud-settlement-doesnt-stop-medical-behemoth/

These are all from one source:
-  "A medical laboratory was accused of paying kickbacks to physicians and patients to induce the use of its blood-testing services. It had been paying doctors a “processing fee” for referrals and also waiving co-payments owed by patients, according to the DOJ. The lab paid $6 million to settle the case, which was brought under the False Claims Act."

-   "A nursing home pharmacy agreed to pay $28 million to settle allegations that it got kickbacks from a drug maker that had disguised its payments as “grants” and “educational funding.” In return, the pharmacy ordered more of the company’s drugs for nursing home patients, according to the DOJ. The case was related to FCA claims that were settled by the drug maker, Abbott Laboratories."

-  "A prison healthcare provider paid an administrator at the U.S. Bureau of Prisons for confidential information that helped it win contracts, according to the DOJ. The company settled the case for almost $2.5 million. Again, the case was brought under the FCA."

-   "An operator of New York hospitals improperly compensated doctors for referrals, in part by providing them with favorable office leases, the DOJ alleged. The hospital operator paid $4 million to settle the case, which was filed under the False Claims Act."

-  "A California hospital overpaid its own chief of staff, in effect giving him an illegal incentive, and had unwritten or otherwise invalid financial arrangements with dozens of local doctors and practices, according to the DOJ. The hospital paid almost $3.3 million to settle the case, which also invoked the FCA."

-  "A hospital system in Georgia provided excessive salary and directorship payments to one of its doctors, in violation of the Stark Law and the FCA, according to the DOJ. The hospital system agreed to pay up to $35 million to settle the case, while the doctor himself paid $425,000."

https://www.employmentlawgroup.com/in-the-news/articles/kickbacks-medicare-fraud/

Healthcare software firm doing it for opioids.  Where do you think the funds came from?
https://healthcareweekly.com/practice-fusion-fined-for-opioid-kickbacks/

Big Pharma--
2018 list of amounts given by Pharma to doctors and teaching hospitals for speeches, etc.
https://projects.propublica.org/docdollars/

$43 million fine on Pfizer for reporting false and misleading information intentionally to sell Lyrica & Zyvox.
https://consumerist.com/2012/12/12/pfizer-hit-with-43-million-settlement-for-misleading-marketing-of-drugs/

Not trying to go on and on, but to provide information to educate on the scope of the issues. As for trauma care, we have a great system between 911 calls, ambulance/ paramedic care, then ER care. It's what happens after that's messed up. Hope it's not too scary for posting.

[[Buddie]]

[...] - Thank you very much.  I am now armed with solid information.  I have suspected this but did not have concrete info.  I had a psychiatrist heavily push me to go on Lyrica rather than the gabapentin that I was (and unfortunately still am) on.  I can not understand for the life of me why doctors jump to the Fluoroquinolone antibiotics which can have such severe adverse effects rather than safer ones.

Another thing I wonder about is how much of a hand pharmaceutical companies might have in nursing homes, in terms of ownership or at least prescribing guidelines?

[[Buddie]]

Meanwhile, how to get us some help. Try a neurologist. Worked for me.

[[Buddie]]

Sorry to deviate from the topic but glad I did because the information is valuable.

Neurologists were useless for me.  My regular long-time M.D. cooperates with me.  If I had an uncooperative doctor I would keep trying until I found one who supports Ashton.   Otherwise I'd go it alone if possible.

None of the neurologists I saw recognized my problem as being Tolerance Withdrawal or Cold Turkey from Valium.  Yet it was right there in my history and medication list for them to find.  The neurologists I saw were condescending and I don't feel they would want to dedicate the time to figuring out any kind of taper.  They seem vastly more interested in the "bigger" neurological problems.  I can tell you the ones I saw were certainly not interested in neuropathy.  They were from teaching hospitals, so I don't know if that makes a difference.

Once I finally got Benzo-wise I have figured out the taper with the assistance of the Ashton manual and this group and my doctor finds it reasonable to reduce my prescription and give me liquid to taper with.

[[Buddie]]

Another story on YT video called "Opiods Inc." by Frontline about tactics used to market a spray of more powerful fentanyl. The idea is that it was rapid drug for end stage cancer pain.  The chemist who created the drug was VERY ambitious and did all kinds of things to make profits. At 10:16 sales manager talks about the only way to get the kind of returns they wanted was "to bribe doctors". How did he know? "This is how it's done in the industry." At 14:00 lady nurse practitioner talks flatly about how she had 5 kids and worthless spouse so she needed the cash. When asked about her duty as a healthcare person, she said,"Something was going to get prescribed one way or another. Why not get the income?"


            “Opioids, Inc.” tells the inside story of how Insys profited from Subsys, a fast-acting fentanyl-based spray that's been linked to hundreds of deaths. Tactics included targeting high-prescribing doctors and nurse practitioners known as “whales,” misleading insurers, and holding contests for the sales team: the higher the prescription doses they got doctors to write, the larger the cash prize — despite the dangers to patients. But as the documentary traces in unprecedented detail, the scheme fell apart: With federal prosecutors using anti-racketeering laws designed to fight organized crime, Insys became the first pharmaceutical company to have its CEO sentenced to prison time in federal court in connection with the opioid crisis.

https://www.youtube.com/watch?v=WvCld2vKug8

[[Buddie]]

Hi so I just started seeing a new doctor. I told him that my psychologist was tapering me off ativan and I wanted to make sure that nothing was medically wrong with me (I experienced a sudden rapid heartbeat and was nervous about it). He seemed stunned that I had been taking it as long as I have (4 years) and said I should get off as quickly as possible. He also seemed to think it was crazy that I was splitting up my dose and taking it three times a day. I tried to explain but he knew noting about benzo tapering and it made me fee like I am doing this wrong. Has anyone else experienced this? He said I was young fit and healthy so stopping the medication should be no problem (this just isn’t the case)

How common is your story! Many doctors and psychiatrists told me the same thing eventually I found a doctor who completely agreed with me and my husband firstly about what can sometimes happen if you withdraw to quickly and that you should taper slowly .
Tapering slowly allows your body to adapt to the change you are going through . You have been using an aide to calm your system you should not just pull that assistance away suddenly it is to much of a shock to your system . You would not suddenly take a walking stick off someone and expect them to walk perfectly immediately it would take time to rehabilitate, common sense tells one that .
Keep strong your doing the right thing by tapering, the slower the better.
If you find you need some professional advice from people who know what they are talking about and have had decades of experience and are in contact with many health professionals they are The Bristol Tranquilliser Project I am closely connected to them and have done Voluntary work for them .
You can find their website on your computer they are also known as the BTP project .
Best of luck