Free Drug Samples, Anybody?

To the best of my knowledge, drug samples are meant to be given to patients for trials. To see which medication works best for you. Samples were given regardless if you’re insured or uninsured, rich or poor. Let’s say I’m coming in for allergy. Instead of prescribing something right away -for example Allegra- which may not work, given samples -let’s say Zyrtec- to try is really helpful.     

But some people like to take advantage of free samples. Patients and also sadly, clinic’s employee, love to ask for samples even though they’re not being seen by a physician. When I first started working here, I voiced my concern about this, and the reply from a co-worker was, “Don’t worry about it. Everybody’s doing it.” I don’t mean to be all hollier than thou but it really bugs me. I understand medicines are costly, that’s why we have medical/health insurance, but taking drug samples on monthly basis? C’mon…

I noticed there are three different types of drug sample requestors. The first one is what I call ‘In Betweens’. Patients who are out of meds refills but couldn’t get in to see physicians soon enough. They’ll be out of meds until appointment date, but don’t want to pay for short-period refills. Typically, they’d call and say, “I couldn’t get in to see Dr. X until 3 weeks from yesterday but I’m going to be out of meds. Do you guys have any samples to get me through my appointment date?”

The second type is the ‘Flip Floppers’. Those who think a medicine should be able to cure the sickness in 24 hour. ”The sample given yesterday by Dr. A isn’t working; I still feel bad. Can I get a different sample?” Or patients who don’t like the way some medicines ‘work’. “The sample given by Dr. B a week ago is working for my depression, but it’s making me gained a few pounds. Could I get a different sample?” For one, medicines do need some time to ‘kick in’, even antibiotics. A lot of things need to be considered when you’re trying on samples; like if you’re diabetic or have blood pressure problems. And especially if you’re on so many different meds. There’s no such thing as ‘the magic pill’.

The worst one is the ‘Freeloaders’. I understand why the uninsured ones are doing this, but the ones with insurance? Unbelievable. Some scenarios:  

• “Hey, can I speak to Jane (Dr. X’s nurse)? This is John. I need my monthly samples for Lipitor 20 mg. I’ll swing by tomorrow around noon to pick it up.”
• “Hello, this is Mrs. so and so. Mary (Dr. Y’s nurse) told me that anytime I need more Nexium, I could call you guys and she’ll give me a bag of it.”
• “Is Dr Z’s nurse available? I need my monthly samples.”

And a hundred more different ways of them requesting free samples. The very frustrating part is, some of them have insurances. And how do I know this? It’s there in the patient’s database. So when I couldn’t resist the frustration, I just asked, “Oh? You need samples again? Do you not have health insurance? What’s that? Oh, you do. Any problem with the insurance or something?”

Sad thing is, our clinic’s employee are doing it too; for themselves and/or family members. Almost everybody. They are as bad as those naughty patients. 

When I had my pap smear appointment, I was offered by the midwife to take home some samples of birth control pills. I was ‘in between’. I told her I feel bad taking free samples from people who need it more than me. She said it’s OK and that I as an employee have ‘the right’. Still doesn’t feel right; so I said ‘no’. I don’t feel it’s right for me that just because I work for the clinic, I’m entitled to gorged myself with samples. I do take Advil or Tylenol samples from time to time when I have a tension headache at work from time to time. But not on a regular basis and for more ’serious’ medicine. 

This source shows that patients with the highest incomes were the most likely to get free samples, according to a survey of nearly 33,000 Americans in the February issue of the American Journal of Public Health. Only 28% of those who got samples were poor, whether insured or not, with incomes less than twice the federal poverty level — $18,400 for a family of four in 2003, when the survey was taken. The study doesn’t suggest doctors deliberately discriminate against the poor. Study author Sarah Cutrona, a hospital doctor with Cambridge Health Alliance in the Boston area and an instructor at Harvard Medical School Cutrona says many poor and uninsured people never get to see a doctor and more often visit public health clinics or emergency rooms, where samples may not be available, or go without care.

And here I am, just got done talking to a patient who requested her monthly free samples of Cymbalta. Tsk… tsk…

If Two-Faces Baby Were Your Child

Why do parents put their kids on braces? Why do they want to spend a lot of money and time to make sure their kids’ smiles are perfect? When their teenagers are starting to have acnes, why don’t parents mind spending cash on dermatology products and consultation? Why are parents okaying their youngsters’ wish to switch the glasses to contact lenses? Giving the health-related answers would be very common, but let’s be frank: it’s to make them look good.

I’ll be honest. I had my mole on my face removed 7 years ago because not only it was noticeable, but it started to itch and growing in size. Again, health reason and look-awareness. Why did I agree to suffer multiple tooth extraction and braces tightening for 28 for months? Sure my dentist was concerned about my mouth being over crowded (I used to have 32!) and it was hard to keep them clean and decay-free. He also mentioned something about crossbite. But to be honest, I hated my crooked teeth. I tried to switch from eyeglasses to contact lenses, especially to go out socializing, but I hate poking my cornea. So then, back to eyeglasses to complete my dorky look.

When my 5 year old son was diagnosed with chronic hyperopia or farsightedness (difficulty seeing up close), I felt so bad. My boy has to wear glasses in such a young age?  I groaned. What if his friends make fun of him? I worried. Spending extra on ’hip’ glasses was our choice. Yes, I still want him to look good besides to able to see.

We all very cautious about how we look. Consciously or not. To ourselves, to our children, to people we care about. Sometimes we care about it too much, we judge people by it. When the Indian baby girl was born with two faces in mid March (read here), I deeply symphatized with the parents. Like the rest of the world, my first reaction was ‘Omg!’. Then as I followed the news, I learned that the father of Lali -the baby’s name, meaning ‘red’ because of her cheeks- had refused the doctors suggestion to have a CT scan to determine whether her internal organs were normal. He felt that his daughter is acting normally, therefor no need for the test.

Lali has an extremely rare condition known as craniofacial duplication, where a single head has two faces. Except for her ears, all of Lali’s facial features are duplicated -two noses, two pairs of lips, and two pairs of eyes. Regardless, her parents who are poor farm workers, think she is fine just like any other child. Even though Lali’s rare condition often linked to serious health complications, the doctors of Saifi Hospital in New Delhi saw no need for surgery. Reason being, she has no breathing difficulties. ‘Nuf said.

As I did more online research on Lali, I found out that some people’s reaction toward the treatment refusal is somewhat concerning. “Why would you as a parent do that [refusing]?!” a coworker exclaimed.

Others worried about the child’s psychological development when she’s growing up. If peers should giving her a hard time. If she’d be making fun of. But since they live on a rural India which is very superstitious and the fact that Lali is already hailed as a return of the Hindu goddess, maybe she’ll be okay. Some says she’s the reincarnation of Durga or Shakti. Living among people who think you have a god-like status is not so bad after all. The village chief wanting to built a temple on your behalf. Hundreds of people want to see you, touch your feet out of respect, and even offer money to receive blessings. Not a bad life, huh?  

I don’t know what would happen should this take place in United States, to an American. Would the parents undergo a surgery to ‘fix’ the baby? Look at Abigail and Brittany Hensel. Born 18 years ago, the conjoined twins are still inseparable and live happily with their mom who is a registered nurse and a carpenter/landscaper dad. The twins have made many media appearances and have a younger brother and sister. I think they have an amazing parents who don’t judge a book by its cover and love them unconditionally.

First Time In History, Catholic Is Not At The Top; Muslim Is

As I was reading the newspaper during my lunch break few days ago, the World News section mentioned: World has greater number of Muslims than Catholics: ”For the first time in history, we’re no longer at the top. The Muslims have surpassed us,” said Msgr. Formenti.

“Hm.” I thought.

And that’s it, no more no less. Although I was born and raised as a Moslem, I didn’t go ‘hooray’ after reading that news. Actually I thought, “Yeah, so what?”

Couple of days later, my iGoogle showed a news feed about the same subject. It was from Catholic.org and it appeared that Msgr. Vittorio Formenti, who heads the Vatican’s statistics office, thinks that the shift was because Muslims’ family have more children and are outpacing the average growth rate. He heh. I can’t help but sensing a little sarcasm there.

I personally do not have any vendetta on Catholic versus Muslim thing. My concern is, does the world know anything about Muslims? U.S. News & World Report March 24-31, 2008 edition has an article about ‘Inside the Minds of Muslims’. Dalia Mogahed, the executive director of the Gallup Center for Muslim Studies, did a survey and wrote a book, Who Speaks for Islam? What a Billion Muslims Really Think along with Georgetown University Prof. John Esposito. The book is based on a Gallup Poll, the largest of its kind, which surveyed some 50,000 Muslims in more than 35 countries.

Based on the interview, it seems that we [Americans] are no closer to understanding Muslims. Because Gallup did a survey in 2002, asking what Americans knew about the beliefs and opinions of Muslims around the world. Fifty-four percent said they knew nothing or not much. Same questions were asked in 2007, after two wars and more media coverage on Muslims, and this time 57 percent said they knew nothing or not much. When asked what they admired about the Muslim world, the most frequent response was “nothing”.

I’m curious about what do they think about us [Americans]. Mogahed answered that Muslims admire the West’s technology the most, followed by freedom of speech, the rule of law, and the transparency of government. They resented our democracy, perceived moral laxity and libertinism. Only a very small percentage of people in places like Iran and Saudi Arabia, said they admired nothing about the West.

The way I look at it, while answering ‘we admire nothing about the Muslim world’ is one’s choice and right, it does show ignorance. Do we not like it because: a) we know something but against it, or b) we don’t know shit anything at all…

No S-Word, Please!

Today is April 1. Also known as April Fool’s Day. When I woke up this morning around 6:15 am, I saw snow on the ground. Argh! Is this a joke? Ha ha, very funny… *dry laugh*

As I was driving to drop my son off to daycare then to work, I heard the radio announced some more snow showers for the rest of the day. No! Don’t they know they can’t mention the S-word anymore? By that, I mean ’snow’. Everybody here had grown weary of this prolonging snow. By this time last year, I’ve seen flowers blooming… tree leaves changing colors… so gorgeous. This time? Grass is still brown, trees are still ‘bald’, no colorful flowers in sight.

*Sigh*