quote:

Originally posted by captain127:
I have been a practicing PA for over 35 years now, and medicine has changed immensely in that time. The reality is the focus of internal medicine doctors is to prescribe medications. But I will also say that a lot of this was driven by patient demand- every time someone got a sniffle they would demand antibiotics even when not appropriate and if you didn’t cave you were a “ bad doctor”
Insurance and billing is another can of worms. Spend time giving a patient what they need - “tough love” counseling on lifestyle changes, diet and exercise and you don’t get paid more than if you just write an RX and leave the room in 5 minutes.
Many guidelines for medication usage are taken by more recently trained providers as etched in stone, without regard for the unique concerns comorbidities or other factors that may not make them a good choice for everyone.

Finding a provider with whom you get along and can for lack of a better term, negotiate with to develop a treatment plan best for you is difficult!

Some years back even I had a provider suggest I go on a statin for cholesterol - I had to point out my low triglycerides high HDL and low LDL when taken together made it not appropriate.