doctor

  1. Your doctor may be a liar

    Ever wonder what's in that manila folder with your name on it?

    Your doctor has one on every patient... and if your doc is like most, he'll never leave you alone in the exam room with yours.

    Turns out that folder might have a lot more than test results, insurance information, and the names of your spouse and children. It might even have a few secrets about your health -- so secret not even you know about them.

    A recent survey of doctors finds they're not always forthcoming with their patients, even if a surprisingly large number are weirdly honest about how often they lie.

    More than half -- 55 percent to be exact -- admit to telling what generously could be called a "white lie." They say they give their patients a more optimistic prognosis than actually warranted.

    I get that. No one likes to be the bearer of bad news, and maybe some of them believe positive thinking will help.

    If it ended there, maybe I could live with it. But it gets worse.

    Much worse.

    Nearly a fifth say there's no need to be honest in all situations, and 11 percent say they've lied in the past year to a patient or a patient's parents.

    In addition, just over a third say there's no need to always tell a patient about a medical mistake (y'know, just in case the patient doesn't actually notice). And 20 percent say they've made a mistake they didn't tell the patient about in the past year alone.

    They say they're too afraid of being sued to be honest. I say they're in the wrong line of work.

    Believe it or not, the bad news doesn't end there, either. Nearly 40 percent say there's no need to tell a patient of any financial relationships they have with drug companies or the makers of medical devices.

    In other words, if your doc is prescribing you a new med, don't expect him to come right out and admit that he's being paid to promote it.

    That means it's up to you to ask -- even if it makes you uncomfortable -- and hope he tells you the truth.

    And while you're at it, maybe you should ask for a peek inside that folder, too.

  2. Who's paying your doctor?

    Everyone likes free stuff, and your doctor is no exception.

    But when those gifts come from a big drug company, they come with strings attached: prescribe our drugs... prescribe them more often... and prescribe them for more people.

    Soon, it's going to be easier than ever to figure out if your doc is on the wrong end of one of these arrangements -- because every drug company with even a single product covered by Medicare will have to report every last penny they give to doctors.

    Doesn't matter if it's a $50,000 speaking fee for being a "thought leader" or a $50 lunch for his office staff -- it has to be reported to the feds, who will then place it online for the world to see.

    This has been a long time coming, but your doctor probably can't figure out why. He thinks he can't be influenced -- that he might get a gift or cash from Big Pharma, but he can still think for himself.

    The track record says otherwise: Docs who get cash and prizes from drug companies are more likely to use that company's drugs and are even more likely to use them off-label for unapproved conditions.

    One Big Pharma rep told NPR in 2010 that he could pay a doctor $1,500 to deliver a short presentation prepared by the company -- and the following week that doctor will write up to $200,000 in new prescriptions for his company's drugs.

    That's one heck of a return on investment.

    So, starting later this month, you'll be able to search a federal database and see who's giving your doc what -- from those mutually lucrative speaking fees to a cheap lunch.

    Companies that fail to report payments and other gifts will be on the hook for fines of $10,000 per violation -- but with a cap of $1 million a year, that alone is probably not enough to get the industry's attention.

    After all, drug companies routinely pay hundreds of millions and even billions of dollars in fines. Next to that, a million bucks is a bargain -- the kind of spare change they might find in the CEO's sofa cushions.

    But the new law has some other penalties that could turn out to be a lot harsher than any dollar amount: A senior official -- the CEO, CFO or the chief compliance officer -- is going to be held responsible for the accuracy of each report.

    And if it's got a few missing pieces, he could face some consequences.

    Fines might not get their attention -- but that sure will.

  3. Question authority -- question your doctor

    For years, the doctor-patient relationship went a little something like this: Patient visits the doctor... doctor tells the patient what to do. That's the way it still is in many practices, and that might even describe your relationship with your own doctor. But you're perfectly capable of making decisions about your health -- and two new campaigns are urging you to do just that.

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