Dr. Thompson's Blog

Is your "Doctor" an M.D. or Something Else?

I am always surprised when even well education friends don't know the difference between a board-certified medical doctor and a "doctor" who is not an M.D. Now many states are allowing even nurse practitioners to write prescriptions. Then there are the so-called doctors of naturopathic medicine, doctors of chiropractic medicine, and doctors, who are not medically trained, but have a Ph.D. or dental degree and nurse practitioners who get a doctor of nursing degree.  Sadly, many M.Ds today are all about making money, so some become hospitalists, which means they have fewer hours, work in hospitals, and are not on call or have regular office hours, as do pediatricians, family doctors, internists, and other specialties. When you look at the number of hours it takes to become a board-certified physician and compare  it with the hours it takes for the other "Doctors", there is no comparison. To become an anesthesiologist or a neurosurgeon, for example, you need four years of college, four years of medical school, a year of  internship, and three or four years of residency. Doctors of naturopathic medicine do not do an internship or residency and special provisions are made if they have had just two years of college. Some nursing schools, I am told are taking students right after high school without a college degree.

Now with the Internet you can look at a "Doctor's"  training. It is always important to see where a doctor went to school, what training he or she has had and if the doctor is an M.D. or something else. You could even save your life or that of a child or  family member. 

The greed of Drug Companies

There was a good article in today's New York Times about the high cost of drugs and how much more Americans pay for drugs than in other countries. The author, Austin Frakt, hopes that President Biden can make a change. I certainly agree. Mr. Frakt notes that U.S. drug prices are" the highest in the world."  Of course, when CEOs of some drug companies are making millions of dollars a year in salary, that is understandable. The drug companies argue that the high costs are due to research and development. I laugh when I realize that a medicine I have taken for many years formerly cost one cent for each pill and now costs six dollars for each one. No research and development is needed for this drug. Countries such as  Germany have a law where " a central body evaluates the benefits of new drugs" and then negotiates with the drug companies to work out the price. Even if you have Medicare or some kind of insurance it usually does not help unless you pay extra, as for Medicare Advantage. An independent review board could be helpful, but the drug companies are so powerful that it would take Congress to pass laws that would give an agency the power to force the drug companies to charge reasonable prices. However, with their many lobbyists I wonder if anything can really be done. With some many things in the U.S. money and lobbyists make a very great difference. What makes me especially angry is that for terrible disorders such as spinal muscular atrophy, the price of the new drug that can greatly help Type one and two children is so expensive that many parents cannot afford the drug. These babies can die or be severely disabled. 

Becoming Informed about Medical Issues

Unless you have medical training, it can be hard to get true facts about medical issues or problems. There is a great dal of misinformation on the Internet and even in medical books. Sites such as the Mayo Clinic are usually good, but occasionally I find erroneous statements about subjects I know well. One day I found some wrong information on NORD, which is usually excellent, but when I told them about it they were good about letting me give them the correct information, so they could make changes. 

I was amazed to find out that some X-rays are sent to far away countries for reading. My own daughter had an X-ray of her head at UC Medical Center in San Francisco that was reported as showing a tumor.  I took the X-ray to an   excellent radiologist I knew in another hospital and he said "there is nothing wrong with your daughter's head." She could have had surgery on her head had I not done that. A second opinion is always wise in a case like this. 

I would always ask about any side effects from a medicine a doctor prescribes. If a non-M.D. prescribes a medication, I would not fill it until you check with an M.D. If you are taking multiple medications, you want to be sure there is no bad interaction between any of the medicines. You want to check also if an Rx should be taken with food or on an empty stomach. 

There are substances being purchased at health food stores that are not checked by the FDA or Food and Drug administration. Protein powders and similar substances may contain ingredients that can cause harm.