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?
Specializes in RN Education, OB, ED, Administration.
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.
What an excellent posting! Americans, in general, work hard and play hard. We pay more for medications in our country because it has been an accepted practice by the populace and the rank and file lawmakers. We will see change in our country only when the consumers demand it. Kudos to the UK for advocating for affordable medications for their citizens.
Specializes in RN Education, OB, ED, Administration.
I can definitely see the value in referring patients back to their primary care doctors; however, I am reminded of a time when this would have been an impossible option for me. When I was in nursing school, I had no health insurance to speak of. I once had an extraordinarily painful abscess in my mouth. I went to the ED for antibiotics and analgesia. I paid my bill in payments and I am GRATEFUL that the ED was able to help me when I needed it. If I had been referred to the dentist, who would have been the appropriate provider since my wisdom teeth were the problem, then I would have never been able to afford the care I desperately needed. Litbitblack, many patients have no other option than to go to the ED to receive treatment for minor medical conditions. A visit to a PCP or dentist can set you back at least $100 and many folks simply can't fork over that kind of money if they are to put food on the table and a roof over their head. This is why I am adamant about the need for a government-funded public medical insurance option for all U.S. citizens. I am so thankful that my children always had coverage during my time of need; however, for me--there was nothing. At the point in time where there is coverage for all U.S. citizens, your idea would seem to support responsible use of healthcare-related services. Kudos!
What are your thoughts?
Best!
Tabitha
A hospital system in south texas has a doc that triages in the er, (or a nurse don't remember) and they actually turn people away if its not an emergency. Thats how the system should work. Have a doc triage, say no its not an emergency see your primary care doc. then maybe people would quit abusing
Specializes in RN Education, OB, ED, Administration.
Yes, Yes, Yes! There is a noticeable difference in the upcoming generation! I am a nursing instructor and I am saddened by what seems to be a desire for instant gratification. I can be very humorous at times, and the younger generation is quite difficult to impress. It isn't all that surprising. Here are a few things that make me chuckle. How many of you remember actually walking up to the television and turning the knob to change the channel and adjust the volume? Many of the new generation have never known what it is like to have less than 300 channels to choose from! How about using the oven and stove to heat up all of your food? How many of you remember when you did your research for term papers in the public library? Never even have to leave your home computer to conduct scholarly research these days.
I have noticed that the younger generation has a markedly different level of respect for authority as well. It has seemed to me that some of these students are waiting for the information to be handed to them and blame others when they don't "get it." I have worked diligently to instill a sense of responsibility in my students to get the information for themselves. After all, who will "give" them the information once they graduate? A nurse who is incapable of thinking for himself or herself scares me more than anything.
Best!
Tabitha
This is not something that is unique to the healthcare field. I feel, that it appears to be a sign of a much broader problem.
My husband owns a business and it is not in the healthcare field, I have also worked in other industries, and people will do whatever they can to get something for free. Most of the time, it is an expectation. For instance, in my husbands business, people feel that they are entitled to call up and get extensive technical support for a product that was not purchased from him nor serviced by him for nothing. They expect that he will talk them through the issue over the phone, no matter how long, then hang up, the end.
They also expect to be treated first. We see people come in needing something serviced or repaired when they enquire when and we advise that there are 6 people ahead then we get abuse.
People will come into the shop and ask for advice, then go and purchase a system from somewhere else, then expect us to talk them through the setup over the phone.
People in general, not just health care recipients, not just low socioeconomic (in fact sometimes it appears to be those who are in the higher wage bracket that are more prevalent) want something for nothing.
Not everyone, obviously, but the portion is increasing.
A lot of my friends have teen children, and are experiencing a lot of difficulties, which I know isn't abnormal, but one thing I will hear repeated over and over is "We made sure that they had every opportunity, all the things that we didn't have" etc.
And it makes me wonder. By taking away peoples opportunity to earn/work for something are we in fact enabling the entitlement that they feel?
It is an interesting sociological issue, and I have only been on this planet for 30 yrs. I see what is happening in my generation and below, but what about those of you with more experience?
Specializes in RN Education, OB, ED, Administration.
To err is human ...
Well, Diane, if all patients were as grateful and appreciative for the samples, I would not have posted what I did. I wish it were that way. I, too, have seen undying appreciation and gratitude from patients over free samples. But, sadly, they were in the minority.
It's a sad fact that this is not isolated to the healthcare field, as has been mentioned. My own DH stunned me a couple days back when we were eating out and he made the comment that he could get his meal for free anytime he so desired, all he had to do was raise a ruckus. Well, y'all know me (most of you) and y'all know my mouth. After I got finished with him, and after a few choice expletives pertaining to his character (namely one that started with "jack"), he made one last feeble attempt to explain by saying "It's a SERVICE industry".
I then told him that what I do for a living is also considered a service industry, but that neither I nor those poor waiters and waitresses were his servants. I asked him how he would feel if one of my patients were to raise sand over nothing just so they would not have to pay me. Well, he got mad. No one's going to abuse his baby! LOL
He never thought about the fact that those "servants" were somebody's "baby" as well. At least I KNOW how he came to be this way. His whole male family is like this.
Case in point:
A few years back, we went to eat with his family in their neck of the woods at some little hole-in-the-wall. As the little waitress brought out drinks, we had an oopsie, and long story short, I got baptized with a WHOLE TRAY of iced tea. Well, I was soaked (there were about 20 of us eating), the waitress was hysterical, the whole dining room was rolling, and every male at that table had blood in their eye. My SIL took me to change clothes, and we came back to find the rest of the party demanding free food. I was the one who nearly got drowned, and they thought that meant they could go ape. The poor waitress ( who was probably all of 16) was in the corner sobbing her eyes out as a manager went to town on her, so I walked over and gave her a hug and told her it was all right. We did get free appetizers, but that was all I would let the restaurant do. Like I explained to the table at large, this happened to ME. I am the one who should be mad, and I am not mad, so neither should you be.
That was 5 years ago, and we still talk about it every Christmas.
Maybe I'm in the minority here, but I was taught that I had to EARN my way and that my success or demise in life depended largely on what I was or was not willing to do. I can not tell you what those values have done for me. I am where I never thought I would be in my life, at the point in my life that I am. I have the very real possibility of owning my own beach house in Florida, I have a great hubby, 3 furbabies, and a great family. All of this is by my own doing, (well, except the family and the hubby...I lucked out there). Yes, I had help. My parents pushed me into NP school, they paid my tuition. That was their gift to me. In return, they are getting free healthcare for the rest of their life, at least from me.
I just have to say something here- you say you've worked for everything you have is your own doing except for family support and tuition (which you do acknowledge is luck), but that luck (family support and tuition) is a HUGE leg up. You happened to be born in to a family that wanted and had the ability to help you. Not everyone has that to start out with, and while some people are able to successfully overcome disadvantages of birth and poor public schools and poor role models, those people are actually pretty exceptional.
I don't want to suggest that you wouldn't have made it to the same place you are without the help of your family (you have obviously still had to work hard), but just that there's a bit of a disconnect between recognizing your luck and saying that you're where you are solely based on your actions.
As far as the original topic, my only experience with assistance with medications was volunteering at an HIV clinic. We didn't give out samples but there was a social worker there to help patients not only with medication costs, but additional social services such as meals on wheels. No one was demanding and the patients I met were grateful (or just stunned by their new diagnosis) for the help. I know that's a small sample and I don't deny that there are people out there that expect to be taken care of without any energy on their part. But I think that greater availability of affordable preventative care AND education about its availability would at the very least reduce reliance on the ER for non-emergent cases.
I just wanted to add that I had no intention of demeaning people who sincerely try to support themselves asking for and/or receiving help when needed.
My comments regarding work ethic, in particular, were intended for a specific subset of people who CHOOSE not to work and expect to be supported by family, charity, government, etc..
I just wanted to add that I had no intention of demeaning people who sincerely try to support themselves asking for and/or receiving help when needed.
My comments regarding work ethic, in particular, were intended for a specific subset of people who CHOOSE not to work and expect to be supported by family, charity, government, etc..
I hear you. I was a recipient of public assistance during my adult life. I used the resources offered me to better myself and become self-reliant. That's what those resources are there for, and I have no issue with that. I'm glad to see my tax dollars helping people in this way.
Maybe that's my own personal bias; that because I have worked so hard to overcome the odds, that I have little patience for those who don't even try.
I would get samples of my BCP from my FP doc due to working at a catholic institution that would not cover these and we were hard up for money-if there were no samples we would have scraped it together somehow-not something I expected but very much appreciated at the time.
Yes, Yes, Yes! There is a noticeable difference in the upcoming generation! I am a nursing instructor and I am saddened by what seems to be a desire for instant gratification. I can be very humorous at times, and the younger generation is quite difficult to impress. It isn't all that surprising. Here are a few things that make me chuckle. How many of you remember actually walking up to the television and turning the knob to change the channel and adjust the volume? Many of the new generation have never known what it is like to have less than 300 channels to choose from! How about using the oven and stove to heat up all of your food? How many of you remember when you did your research for term papers in the public library? Never even have to leave your home computer to conduct scholarly research these days.
I have noticed that the younger generation has a markedly different level of respect for authority as well. It has seemed to me that some of these students are waiting for the information to be handed to them and blame others when they don't "get it." I have worked diligently to instill a sense of responsibility in my students to get the information for themselves. After all, who will "give" them the information once they graduate? A nurse who is incapable of thinking for himself or herself scares me more than anything.
Best!
Tabitha
I earned my BA in 1979, so yes, I remember going to the library for term paper research, and also typing papers with a typewriter. I also remember computer punch cards, and waiting 90 minutes average for the mainframe to run my programs.
Walter Williams wrote a commentary: Academic dishonesty discounting worth of a degree. He said that due to grade inflation, an Ivy League education is not what it once was. While I respect Walter Williams, and do not have an Ivy League education, my experience with the college system is quite different.
I took a few classes after graduating, and then started back part time in 1993. Because most of my classes are undergraduate, I can directly compare recent classes to past classes. It's true that average GPA is higher, but much of this is due to more liberal drop policies.
We learned far more in recent computer classes than we ever did in the mainframe punch card era. I have written far more research papers with the computer and internet than I ever did with the library and typewriter. We cover far more in class with PowerPoint handouts and downloads than we ever did taking notes by hand.
I greatly prefer today's world of personal computers and the internet. However, these advances in technology have resulted in an increase in student knowledge, not a reduction in student time.
I think the issue here is that the OP acknowledges that there are people who are in need, and then there are people who take advantage of the system.
We aren't talking about people in need, we are just looking at the issue of the abuse of the systems and the sociological implications.
There are honest, hard working, genuine people out there, and we can recognise that too.
But there is a big difference between genuine need, and abuse.
And there is also a wide range of issue that lead to the difference in those two areas.
From a sociological, technological, behavioural, economic and educational perspective.
And I remember having only two TV channels, one TV in the house, and my parents were the ones who dictated what we watched and when....
I just spent a morning with a mother of a 14yr old who her and her husband have worked their butts off to send him to a good school, he will go on an excursion overseas next year, and they just spent $1750 on a mac book.
As a discipline tool, his macbook privilidges were removed, he responded with "You are stealing my property, you can't take that from me, it is mine!"
She is devestated. They have worked so hard to give him these things, and he shows no respect or appreciation for it.
Perhaps this is what is at the heart of the discussion. Perhaps it isn't to do with need, but if I walked in and showed a great amount of appreciation for recieving a free handout, would you be more inclined to give it to me?
Well, Diane, if all patients were as grateful and appreciative for the samples, I would not have posted what I did. I wish it were that way. I, too, have seen undying appreciation and gratitude from patients over free samples. But, sadly, they were in the minority. .
I totally get it Angel. This is a me me me society, and it's gets old real fast. I just wanted to share my own personal 'rare' exception to the rule.
One I my favorite sayings "I see rude people.. they're EVERYWHERE. Pushing, shoving, yelling into cellphones, weaving in and out of traffic...."
You know....maybe we should just have some of these folks work off the bill??? Go to the ER and don't have any$$$ How about coming in next week (when you are feeling better of course) and give a hand. Fetch the pop and ham sandwhich for bed B. Clean out the bedpan for bed A. Clean bed C for the next pt. You work it off we have a clean slate. Free ambulance ride?? Wash the truck on Sat. afternoon. No excuses here for not having money/ins. All this requires is time and it is free.
SheaTab
129 Posts
What an excellent posting! Americans, in general, work hard and play hard. We pay more for medications in our country because it has been an accepted practice by the populace and the rank and file lawmakers. We will see change in our country only when the consumers demand it. Kudos to the UK for advocating for affordable medications for their citizens.
Capitalism at its finest!
Tabitha