SSRIs and the PDR; doctor's smarts and training

We don’t have pAs but we do have NPs. Most of our NPs work rural and remote although there are still plenty in the city. NPs work well under Strict narrow focus in the city but Rural is where they have a much much broader scope and are invaluable. I know one guy who is up to his tenth masters degree and just loves working remote and when I say remote I mean 200k to the nearest town!! Even then they have a limited scope of practice and have to be guided by things like the the Primary Clinical Care Manual and/or linking via Telehealth to medical practitioners

Bottom line - many remote facilities would not have ANY expertise were it not for nurses

 

I agree!! I live and work in an UHC. It is not perfect - not by a long stretch but in every country that has a UHC it is political death to try to dismantle it.

 

Yes, it makes sense in rural areas.
In my large and sophisticated metropolitan area, though, there are thousands of PAs and NPs.

 

I agree with your first part and that is the "advice" you would give, the "advice" I would be paying for

which is why people have to doctor shop... because like my doctor, he did not think I needed a drug I did need until he actually saw me in that condition, my words were not enough, as he did not believe me, even though my previous doctor prescribed it before I moved and got the new doctor - doctors sometimes think they know things and they don't too

the drug I took at that time was Atarax\hydroxyzine, it was before the non-drowsy versions came out, which was the greatest thing ever, then they went OTC and that was perfect

 

I don't have huge objections to hydroxyzine being OTC, except for the drug-drug interactions with other agents that can prolong the QTc. As long as you're not on one of those, it is fairly safe to take hydroxyzine for your allergies (or even as a mild sleep aide).

The fact that some doctors are more accommodating or trusting than others shouldn't alter national prescription policies. As I said, the job of an individual doctor is different from the job of a health policy regulator. The goals and scopes are different.

 

You misrepresent the dispute, your own contentions being: A) ALL doctors possess both a high degree of competence, diligently keep up with all new medications which they might prescribe, and
B) they ALL give their patients a fulsome explanation of any risks associated with their recommendations, because of the profession's uniformly-strict adherence to ethical standards.

Here is a partial reply, because I could easily double, if not triple, the length of this thread, with examples disproving your two main contention, above.

https://nicholaswade.medium.com/origin-of-covid-following-the-clues-6f03564c038

<SNIP>
Science is supposedly a self-correcting community of experts who constantly check each other’s work. So why didn’t other virologists point out that the Andersen group’s argument was full of absurdly large holes? Perhaps because in today’s universities speech can be very costly. Careers can be destroyed for stepping out of line. Any virologist who challenges the community’s declared view risks having his next grant application turned down by the panel of fellow virologists that advises the government grant distribution agency.

 

NO!
Those Antidepressant / anti schizophrenia medicines
cause massive weight gain as to create Diabetes type 2
patients! Then on to cardiac, etc.


Try psychedelics.
Try life on the "farm".


Modern psychiatric medicines are about profits.
Like this week's vaccine

 

The above snip (in post #56) is describing medical community politics (not an elevation & pursuing of truth, above all else), and belies claims of the status quo, in the medical establishment, being open to independent thought & questioning by individual members-- much less from outside its own walls. This mentality of hostility toward alternative views (see article SNIP, above) and attempts at enforced group-think, have led to egregiously erroneous assumptions, being mindlessly adopted & held by physicians for far longer than necessary. One indicting example of this is the long-held assumption that there was no difference between the sexes, in the way they would be affected by drugs; so, until fairly recently, DRUG TRIALS were typically done (& FDA approved) using only male subjects, to avoid the complicating factor of women's cyclical varying levels of hormones. Now we know that drugs that have nothing to do with gender-related issues (e.g., sleeping pills) can have distinctly different effects on the two sexes.

Another example of how unquestioningly trusting one's physician can lead to tragic consequences, is the fact that lobotomies were used to treat a wide range of mental, "illness," including depression, for decades, not beginning to subside until the mid 1950s.

https://www.livescience.com/42199-lobotomy-definition.html

 

One of the plagues of the information age is the Holiday Inn Expert phenomenon.

There are few people who believe less in the value of a legitimate education, and actual expertise, than those who don't have any.

 

Well said.