The Trump administration has created a major uproar about the concept that doctors are being paid to prescribe medication – especially antidepressants. Robert F. Kennedy Jr. is making it sound like doctors are only paid Write First medications, but now – shock, gasp – they would even be prescribed to describe! If doctors only got paid per prescription, that would be big news indeed. However, like most of the dystopian fluid coming out of the White House at the moment, this is nothing but a lie. Doctors have always been paid to prescribe and prescribe medications – it’s called treating patients.
Doctors do not get paid for prescribing medicines
In the bad old days of past decades, there were times when doctors could be financially incentivized to write specific prescriptions. This was usually done through generous perks such as all-expenses-paid trips and hefty “consulting fees” (since direct payment was illegal, as it is now). Some unethical doctors in the 80’s and 90’s may have taken the opportunity to line their pockets with drug company dollars in this manner.
However, in today’s era, there are more regulations and transparency. No pharmaceutical company can bribe any doctor like this. Now, do drug companies still try to influence doctors’ prescribing habits? Yes, of course they do. They are a business just like any other business, but paying doctors per prescription is not a method available to them. (If you want to know if industry money is being paid to your doctor in the form of speaking fees, etc., see here. Yes, some doctors will always be unethical.)
Not only do doctors not get paid for prescribing drugs Specific Medications, they don’t get paid at all for prescribing medications. Whether you talk to your doctor about your depression and it results in you getting a prescription or seeing a picture of your cat, your doctor gets paid either way. The doctor is being paid to treat your depression. It does not require a prescription in all cases. (Showing a picture of your cat is talk therapy, at least for cat lovers.)
doctors keep writing all the time
I was taking several psychiatric medications, including antidepressants, and most of them I no longer take. In other words, all those drugs have been described. And trust me, the doctors I described are underpaid in both Canada and the US. “Deprescribing” is simply the act of withdrawing a drug, something doctors do every day.
Then again, a doctor is paid to treat a disease like depression, not to write vaguely on a prescription pad. I have missed many doctors’ appointments without a prescription for all kinds of reasons. This is normal and nothing new.
Why is RFK Jr. making narrative seem like a new thing?
Just as the Trump administration tried to make antidepressants seem dangerous and scary, they’re also making it seem like doctors are being horribly bribed to shove drugs down your throat. They are trying to take political advantage of the idea that they are the ones who can rid America of evil antidepressants.
Of course, this is a show on its face.
Doctors today are doing what they did a month ago, what they did two years ago: They’re treating people with medical conditions like mental illnesses. Sometimes, those conditions require prescription medications such as antidepressants. And sometimes those situations require withdrawal of medications like antidepressants. Was it ever like this?
Doctors also get paid to talk to you and find out how treatment is going, in case you’ve forgotten. Prescribing is just one of the things these highly trained professionals do.
What really happens when the wrong emphasis is placed on description?
Unfortunately, what is likely to happen is that, rather than antidepressants being prescribed appropriately at the appropriate time, the result of all this will be that there will be more stigma surrounding mental illness medication and treatment, not to mention that people will go off their medications without thinking (which you should never do). It will further ingrain in people’s minds that there is something wrong with antidepressants, that there is something wrong with doctors prescribing antidepressants, and thus, that there is something wrong with people taking antidepressants. This is the opposite of helpful. This is harmful to the millions of people who have multiple illnesses that are helped by antidepressants and other psychiatric medications.
Is there a time to get off antidepressants? For many people, yes, absolutely, but for some, no, it is not. Some people will always need those drugs, and it’s not them or their “evil” doctors who do that. Some people just have enough brains that they need a little more help on a daily basis. That is okay. Some of us have pancreases or other organs that also need help. This is also fine.
But don’t think that describing is right for everyone or that it is a new thing just because someone said so. it. This is one arrow in the quiver that has always been part of the treatment of disease.
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