Thoughts on why doctors often prescribe meds for T2 diabetes

[donnellysdogs]

Phoenix is correct ref all the targets that GPs have to hit to get payments.

The initial QOF payments started in 2004 and are updated each year. http://www.nhsemployers.org/your-wo...y-and-outcomes-framework/introducing-qof-2004

This also gives a link to prescription payments. "Contractors" are basically the GPs
https://www.gov.uk/government/publications/nhs-primary-medical-services-directions-2013 (again updated most years).

And then there is MPIG too. http://www.england.nhs.uk/wp-content/uploads/2014/02/gp-gms-practices.pdf

The CCGs though do hold the purse funds for the prescribing of drugs that GPs or hospitals can do.

There is not just one simple payment of £xx to a GP Practice. It is incredibly complicated.

If you need a hip op. It isn't a case of a consultant just saying yes and giving you a date. He has to write to GP confirming this. The GP then has to request the CCG to pay for that op.... And then confirm to consultant.

The red tape and bureaucracy is really incredible....

Then it will all depend whether your Practice is on a GMS contract or a PMS one.....

 

[Totto]

Could you please lighten up? Seriously, there is no reason for you to be so persistent with me about this issue. Plenty of other people on this site have said their doctor encouraged them to monitor their BG. People have different experiences, that is life.

I can see no reason to, as you call it, lighten up on as serious a question as this. Your thread and your topic is why Dr's will prescribe meds. My view on this is that testing and diet comes first. If you disagree with this then say so.

The advice given to most diabetics is harmful. I am glad the advice you were given was better than mine.

I don't say medication is useless, of course not, it's very useful when needed. Question is when it's actually needed.

 

[ButtterflyLady]

I can see no reason to, as you call it, lighten up on as serious a question as this. Your thread and your topic is why Dr's will prescribe meds. My view on this is that testing and diet comes first. If you disagree with this then say so.

The advice given to most diabetics is harmful. I am glad the advice you were given was better than mine.

I don't say medication is useless, of course not, it's very useful when needed. Question is when it's actually needed.

The reason I suggested lightening up was because you said this:

No, I haven't and they are few and far between.

Could you please make list a of those you have met who do encourage their patients to monitor BG?

You asked me to make a list that would be completely irrelevant to the issue at hand. Of course health care is a serious issue, but that's not what we were discussing. You have misunderstood my view and I don't think there's any point in you and me continuing to discuss it.

As for your earlier post where you gave a link to a thread about people being told not to test their blood sugars, I think we're all aware that happens, and again you misunderstood my post. I said there are doctors who encourage home BG testing. It is illogical to then say there are other doctors who discourage it. That fact is obvious, and is not anything I disagreed with.

Let's leave it at that, shall we? The mods don't seem to like it when people go on and on about an issue in a thread, instead of just agreeing to disagree or taking it to PMs.

 

[Bebo321]

I see this "buffer/insurance as a problem, not a solution. Many Type 2's newly diagnosed are sent away to lose some weight and take these tablets, come back in 3 months. They are not told how Metformin works. They assume it is a miracle drug that will allow them to continue eating carbs/sugar. For them, it is a way to carry on much as normal. Some of these people arrive on this forum to ask why the Metformin isn't helping them, why they see spikes after eating. They honestly believe the tablets should be stopping this happening.

If only they were told by the GP that Metformin doesn't work that way, that it is mainly an appetite suppressant and also works on the liver to help reduce liver dumps, to a limited extent, and that carbs are the problem.

I believe prescribing Metformin to newly diagnosed should be accompanied by a full description of how it works, to what extent, and more importantly, what it doesn't do. Otherwise, I see it as the start of a slippery path for many.

Absolutely right @Bluetit1802 - Arm people with the information so that they can make informed decisions. Perhaps it is not done because it would seem like 'information overload' - after all, it's only after a bit of learning that we get to know exactly how the body/diabetes works. Nevertheless a leaflet to take away (written in plain english) to support any of the D prescriptions would I feel be invaluable.

 

[Bebo321]

This seems to be a pretty contentious topic, so GBdoc have chosen to discuss it at next week's tweet chat on Wednesday night at 9pm. Join in and share your views, or just 'listen in' to what's being said. www.gbdoc.co.uk

 

[Celeriac]

A GP gets ten minutes to greet a person, diagnose and give the patient something of a solution be it a prescription or a referral or some advice and reassurance. That sounds incredibly stressful. GPs have their hands tied, because they cannot give advice to patients which conflicts with NHS policy. Dr Charles Clark and Dr John Briffa are both in private practice. They can advocate low carb, Dr Average Joe can't.

Big Pharma isn't interested in creating a drug which combats insulin resistance because that kills the golden goose. So the majority of drugs focus on upping insulin production. Burn out the beta cells and then hey ho, put the victim on insulin so making them more money.

When the rich get richer and the poor get poorer, calories per dollar/pound/euro etc is more important than food quality. In the USA 94% of soya, 95% of sugar beet, 88% of corn and 90% of rapeseed are genetically modified with 80% of processed food in American supermarkets being GM. In the UK, ASDA, Morrisons, Tesco, Sainsbury's and Waitrose allow GM feed for livestock/products in some ranges - Marks & Spencer allows it for everything non-organic.

With the GM experiment following on from the low fat disaster, we just don't know if that makes us sicker and even if you're eating clean and additive free you could be ingesting GMOs if your food isn't organic.

I'm not surprised that in the face of inadequate inaccurate dietary advice and the all pervasive carb culture we live in, that some people carry on with the standard carby diet. Because trying to negotiate your way through the mnefield is time-consuming and scary. Not everyone finds their way here and even then, healthcare providers can be really disparaging.

 

[Nyxks]

Depends on the doc, my Endo starts all T2s on a diet deal (as in sets an appointment with the hospital dietitian and goes from there - They work as a team to try and get the t2 stable only resorting to medication if the first line of defence fails to work or if things get worst n meds are the only option.