Thyroid Meds are NOT Interchangeable

[DebE13]

Does the pharmacy really not know or don't they care? I went to pick up my RX this morning and was cheerfully told that my bottle had meds from two different manufacturers but not to worry because they are the same and separated by a cotton ball.

I was taken back at first and then promptly refused the RX. REALLY? She was snippy with me and told me I'd have to wait and wouldn't get the full bottle.

Lesson learned: don't use the automatic refill service. Leave a message with specific instructions. AND Call before wasting a trip to the pharmacy to check the manufacturer. In my case, they will always have to special order it because it is not the regular contracted supplier who provides it to them cheaper than Mylan, who I use.

Fillers are a killer and I'm not chancing playing Russian roulette with my pill bottle.

[tex]

IMO, they should be required to call before making such a change, but the regulations allow them to make such changes without any patient input, so they do what they want. This is all part of the obsolete "patients don't know anything about medical issues, so they shouldn't be allowed to have any say-so in the matter" policy established and maintained by the medical community.

This also appears to be the basis of the FDA ruling in the 23andme case. The FDA claim is based on the position that the company has no right to make medical recommendations. But I have no doubt that the driving force behind this attitude is the position long held by the doctors of this country that they are entitled to a monopoly on patient health recommendations (essentially, that's the guarantee behind their license to practice, and it's why they originally campaigned so hard to persuade the legislature to adopt the licensing law — to eliminate unlicensed competition), and most importantly, "patients should have no rights that allow them to determine their own health care (independent of a doctor's care)". IOW, the medical profession doesn't like being cut out of the equation. That's their squawk against EnteroLab, but unfortunately, EnteroLab is run by a doctor, so they can't do anything about it. This country's medical organizations have zero tolerance for labs that offer to deal direct with patients, thus cutting doctors out of zillions of dollars of extra profits.

I have a hunch that the bigger issue is that doctors are afraid that more and more people will realize that they don't always need doctors for all of their health needs, and that is bound to greatly trouble the American Medical Association. And even worse, they fear that many patients will eventually realize that much of the advice handed out by the medical profession is counterproductive for good health. So it's a battle for power, and above all, money (as always). And as always, even though the FDA has no authority over doctors, when push comes to shove, they virtually always come down on the side of the "industry", (ignoring the needs of consumers), so consumers are unlikely to come out the winner in this issue. 23andme will probably be forced to make concessions.

Sorry, I tend to get carried away sometimes.

Tex

[DebE13]

I whole-heartedly agree! I often find myself on my soap box at work. It's a good thing they put up with me. It's too bad that I am now accustomed to such disappointment and poor service that I'm actually pleasantly surprised when a pill pick up or doc visit goes well. It's like finding a penny on the ground to wish on!

[JFR]

I whole-heartedly agree! I often find myself on my soap box at work. It's a good thing they put up with me. It's too bad that I am now accustomed to such disappointment and poor service that I'm actually pleasantly surprised when a pill pick up or doc visit goes well. It's like finding a penny on the ground to wish on!

Deb,

Some years back I decided that the best way to approach doctor's appointments was to expect nothing. That way I could be pleasantly surprised if the appointment turned out to be useful but not particularly disappointed or surprised if nothing useful was accomplished.

Jean

[DebE13]

That is a great approach. I still get riled up but am learning it has no effect on the outcome and only drains me even further. Although, so sit se a good rant just feels good!

[DJ]

This also appears to be the basis of the FDA ruling in the 23andme case. The FDA claim is based on the position that the company has no right to make medical recommendations. But I have no doubt that the driving force behind this attitude is the position long held by the doctors of this country that they are entitled to a monopoly on patient health recommendations (essentially, that's the guarantee behind their license to practice, and it's why they originally campaigned so hard to persuade the legislature to adopt the licensing law — to eliminate unlicensed competition), and most importantly, "patients should have no rights that allow them to determine their own health care (independent of a doctor's care)". IOW, the medical profession doesn't like being cut out of the equation. That's their squawk against EnteroLab, but unfortunately, EnteroLab is run by a doctor, so they can't do anything about it.


Tex

Tex, I've been wondering why consumers can deal directly with Enterolabs. How have they dodged requiring a prescription? Is a lab run by a doctor exempt? Are there other circumstances where consumers can order directly from a lab?

[tex]

No prescription is required to order any lab tests. Prescriptions are only required for the purchase and use of controlled substances. Labs don't prescribe any medications — they only provide test results.

There are at least a couple of states (New York and Maryland come to mind) where residents are prohibited by state law from ordering tests directly from labs, but this is strictly a result of the state medical associations lobbying the state legislature in order to acquire a monopoly on the right to order lab tests. The doctors' argument is that most patients are not qualified to interpret the test results, which could lead to adverse outcomes.

Sure, they're not qualified initially, but as we prove on this board every day, anyone who wants to take charge of their health can certainly learn whatever they need to know, in order to make much better informed decisions than their doctors. After all, most doctors only devote a few seconds to making decisions about test results, treatments, etc., whereas the patients themselves are willing to spend as much time as is necessary to properly consider all the options, since they have so much more at stake (their own health) than their doctors.

Tex

[DJ]

I agree that an actual prescription is not required but I meant to say that a consumer can not make a request and get results, at least in NY. On the other hand, when tests become over-the-counter, we are automatically qualified to interpret them and cope with the results without a physician. The pregnancy test is a perfect example.
Is Enterolab available to us because of the state they are in or is it because the are not defined in the same way as other labs?

[tex]

There are only 2 or 3 states that prohibit their residents from ordering lab tests directly. As I mentioned, NY and MD are 2 of them. I'm not sure if there is another state with that restriction or not, but everyone else in the country is free to order lab tests from wherever they please. They probably could even legally order tests from NY and MD, but I'm pretty sure that labs in those 2 states don't offer any direct-to-patient testing, and if they don't offer the tests, then obviously citizens can't order them.

Note that not all labs offer tests to the public. IOW, the reason why we can order tests from EnteroLab (and certain other labs) is because they are willing to sell tests direct to the patient. In fact, only a few labs offer tests direct to the public. The reason for that is because of the fact that mainstream doctors tend to blacklist and boycott labs that cut doctors out of the equation, so most labs choose not to alienate the medical establishment, because most medical associations have a memory like an elephant, when it comes to issues involving spite or contempt. LOL.

They got ticked off at Dr. Fine, because of his lab, (and probably because of his long hair, and his music writing and performing hobby) roughly 15 years ago, and they still refuse to publish any of his research. They also probably didn't like the way that his research work demonstrated that the "gold standard" celiac blood tests they all doctors were/are using, are pathetically insensitive (several orders of magnitude less sensitive), when compared with EnteroLab's stool tests. So they simply refuse to publish his research work, and as long as it isn't published, they can safely continue to ignore it. Is that childish, or what?

Whatever it is, it's definitely effective, and it preserves the current obsolete celiac diagnostic criteria by fiat. Before that fateful day when they decided to lock him out, his research articles were published, just like articles written by any other researcher.

Tex