OK, something here that has been bugging me for a while (along with other, more recent events that rankle as well). I never noticed it as much as an RN, because I never worked at a clinic for any length of time, but I am beginning to be of the opinion that everyone that darkens our door in the healthcare setting is only out for what they can get, at no cost to them.
Back when I graduated NP school, I was working for a doc who had a sample closet the size of my laundry room. Not big enough to park a yacht in, mind you, but HUGE for what it was for. Floor-to-ceiling shelves just covered in sample meds. The drug reps came by frequently, brought lunch most days, and always tried to keep us stocked. It was unreal. This doc would bag up handfuls of meds for people, usually the entire stock of what had just been delivered, and hand it off. I was amazed at how nice this seemed, but whan I got into the workings of it, I was appalled.
I would say that roughly 90% of her patients would come in and ask for sample refills. AT LEAST that many, and probably more. People would come in for rechecks and ask for more samples. People would get fighting mad when we either did not have what they needed in samples or were out (I am so sorry that Septra is not in a sample, it's on the $4 list!). Add into that that we got into trouble for attempting to ration the samples, so that MORE patients could share the wealth. People would refuse to take anything unless they got samples, saying that they could not afford it, but yet would have an iPhone, iPod, ICarly, nails, hair done to a fare-thee-well, and all the other various accoutrements that you could buy a house with in possession.
Two cases stuck out in my mind:
* A man and his wife who were, shall we say, quite healthy, were frequent flyers here. They each had several major health concerns, mostly due to their respective weights. The male was taking a very new, very expensive medication that we were hard pressed to get samples of, and he knew that we would give him first dig. One day, doc handed me the 2 sample boxes to give to him, all we had, and when I walked in, I get a baleful look and "Just TWO boxes?" Now, what I SHOULD have done is snatch them right back and tell him that since he obviously does not appreciate it, then he does not get it, like you would a child. What I DID do was explain that that was all we had. Neither of these folks worked, they refused to take steps to better their health, and they expected everything to be handed to them.
*A very ill gentleman (and I use the term loosely) brought his mother in with him for his visit. He had an infection for which she prescribed Septra. The mother told me "Well, we'll need samples of that." I explained that it was a very old med, and that there were no samples available, and she replied that he would not be taking anything, then. I never heard how he did.
Again when I went to my family doc to precept, I was shocked. He actually had people call and complain because the samples were not BIG enough! I have seen the same man for 25 years, have never once asked for a sample, have been grateful for what I have been given, and went on my merry way. It never occurred to me to ask or complain. When I ran out of samples, if they worked, I asked for a script. I though that was how it went. Silly me.
This blows my mind. We go all out to prescribe whatever the cheapest, most effective med is for what ails them, and if it is not free, they don't want it.
I know it can't just be here. Is it this bad where everyone else works?
This is ever so slightly off topic but, I'm gonna throw it out there, anyway:
I have always felt that there should be a component to American education addressing something this thread touches upon: work ethic.
The entitlement that posters have discussed here is often a glaring symptom of the fact that people do not want to work-- in fact, they have an expectation that their needs and wants will be somehow magically addressed without their own hard work.
Frankly, parents often pass this attitude on to their children. If parents who do not work themselves cannot be relied upon to teach work ethic, perhaps it's time that educational institutions took this subject up in a serious way.
Again, this may seem off-base, but it has implications for the delivery of, and personal responsibility for, healthcare as a whole.
A couple of days ago I was prescribed a medication that I found out at the pharmacy I can not afford. Because I can not afford it, I did not have the prescription filled. I would feel thrilled if the doctor would give me samples so that I could receive the treatment. I do not believe that the doctor signs any kind of agreement with the drug rep as to who gets samples and who does not. I also do not like the implication that I want something for nothing. Since I can't afford the medication, I don't get the medication. End of story.
Actual increased ill health particulary chronic ill health is of course linked with deprivation, however what seems more apparent from UK census is those who are more deprived percieved their health to be poorer, why that is so i'm not as sure.
Sometimes those living with chornic conditons feel that the system doesn't see the impact on their lives and find a soluntion.
No free samples in the UK but no prescritpion item is more than £7.20 in usa$14.00(at today exchange rate). There are winners and losers with this under 19 students, over 65's unemployed and a the working poor are exempt.
some drugs perscibed cost the system much less than the charge genric abx etc. however some cost much much more and people dont know the price there is something to be said if your pocket doesn't see the imediate impact of the cost you dont know the value.
Specializes in med-surg, psych, ER, school nurse-CRNP.
Cali,
I'm sorry if you were offended. I never implied anything. You say you can not afford the meds, so you won't have them. You aren't expecting a handout. Therefore, this post was in no way directed at you. You clearly are NOT expecting something for nothing.
Could you ask the doc for a cheaper alternative? If the med is new, does he have coupons (the reps do this sometimes)?
Had the same thing happen to me. Doc gave me samples of Zegerid (for heartburn), and they worked great. But even with my job and insurance, I could not afford them. So I took nothing. Now I have Barrett's esophagus. Did me not taking anything cause this? Maybe. But, it's done, I have a script for Nexium now, and I go without my milkshake fix to ensure I can have my meds, which now are thankfully reasonably priced.
I am in no way against samples. I'm just against using the doc's sample closet as a free pharmacy for meds that are really quite affordable if one would jsut make an attempt to work. I assume you work, Cali, so no part of this was directed at you. Feel better soon!
I *heart* my NP. She gives out samples just like the lollypops I would get at the end of a doctor visit as a kid. I've never asked for a sample of anything, but between the samples, the pharm coupons she gives me, and my health insurance, I often leave the pharmacy owing nothing.
I can certainly see how people of a certain mindset can develop an entitlement mentality. Me, I maintain a mindset of gratitude and respect, and appreciate being given otherwise "expensive" freebies.
Prescription meds are expensive, can only be (legally) obtained via the largess of those with prescriptive authority, and can range anywhere from beneficial to downright life-saving and life-sustaining. The prescription pad is in many ways foundational to the power and prestige of the medical profession, and is an vital component in those who want a bite of that pie. Witness the passion with which that power is sought (NPs, PAs, psychologists, etc), and the passion with which those seeking that power are resisted by those who have it.
Given that environment, is it surprising that people want to get all they can?
Wow this type of behavior and gimmee gimmee gimmee attitude sheds is unbelievable. I too am the type of person who would not even think to ask for free samples let alone abuse them and or call and complain about them being too small. Just another case of kindness being abused.
On the other hand I have thrown many hundreds of $ worth of expensive meds away because a. They did not work, b. the side effects were too bad to take the drug, or c. I was allergic.
I think the day of customer satisfaction is here, and docs (as well as most suppliers of commodities) don't want to lose their piece of the market. Most HCP don't chat with their patients to even know who needs a hand up. It usually is not the person with the hand out. imo
Pharmaceuticals are a huge reason that we have such a health care crisis. It seems the more you really need the med, the more expensive it is. Insurance companies and pharmaceutical companies seem to charge different amounts depending on what they think the market will put up with. Why are seizure meds so expensive and many antibiotics and pain pills so cheap? Only when you need the "big guns" of either of these meds are they costing an arm and a leg.
I am a great believer in karma. The free ride people don't upset me that much anymore. I would not like to have to walk in their shoes forever. What goes around, comes around.
As a former drug rep, I can say with certainty that it is a vicious cycle. Drug reps want the physicians to use the samples so that we can leave more so that we can get signatures so that we can show our boss we've actually done something so that our bosses can show THEIR bosses that their reps have been "working..."
I agree that patients can be greedy. But on that same vein, you can't really blame them, because the drug companies have basically been "courting" them for years with free samples. It does become a little ridiculous, the sense of entitlement that people become accustomed to, but in a sense it is "operant conditioning," wherein behavior is strengthened if followed by a reinforcer. If you offer patients samples or they receive samples each time they come, they start to expect it every time. It's sad the way samples can be used and abused, especially when there are people that truly cannot afford prescriptions and thus rely on the supply of samples, but it is an unfortunate reality. If you don't offer samples in the first place, patients probably would not expect them.
Like the old Field of Dreams adage, "If you build it, they will come."
This is ever so slightly off topic but, I'm gonna throw it out there, anyway:
I have always felt that there should be a component to American education addressing something this thread touches upon: work ethic.
The entitlement that posters have discussed here is often a glaring symptom of the fact that people do not want to work-- in fact, they have an expectation that their needs and wants will be somehow magically addressed without their own hard work.
I wonder why people think we in general don't have a great work ethic. We get less vacation time, sick leave, maternity leave than the rest of the world. We come in to work even when we are sick. We generally reject unions. Our stores are open 7 days a week. We don't take midday siestas. There is a small percentage amongst us that do lack the work ethic, but...unfortunately our liberal entitlements have encouraged that...& slightly off-topic, but why do we pay more for medications when many drug companies have hired from scientists who benefitted from NIH (US-taxpayer)-funded research. Just recently the British NICE refused Avastin for colorectal cancer, guess what! Roche reduced the price in the UK! And this has happened several times. Not to excuse the freeloaders, but as many posts here show, sometimes honest, hard-working people are depending upon free samples b/c there is no other way.
Haha.... I bet you all those samples that the drug companies pass off to doctors may contribute to the fact that these drugs are so expensive when we go to buy them.
Gosh OP it sounds like you work at my office! I HATE when patients get angry with me because I don't have samples for them- they just expect us to SAVE them for them month after month. I had a patient once tell me we were just being greedy with our samples. I don't think patients realize I pay for all my own meds too. Just because I work there doesn't mean I get free samples.
Just another case of kindness being abused.
GoalsInTransition
96 Posts
This is ever so slightly off topic but, I'm gonna throw it out there, anyway:
I have always felt that there should be a component to American education addressing something this thread touches upon: work ethic.
The entitlement that posters have discussed here is often a glaring symptom of the fact that people do not want to work-- in fact, they have an expectation that their needs and wants will be somehow magically addressed without their own hard work.
Frankly, parents often pass this attitude on to their children. If parents who do not work themselves cannot be relied upon to teach work ethic, perhaps it's time that educational institutions took this subject up in a serious way.
Again, this may seem off-base, but it has implications for the delivery of, and personal responsibility for, healthcare as a whole.
Sorry if I am getting too soap-boxy here!