Seeing that poor woman with the Implanon yesterday, reallly brought this dilemma into focus for me. As you may or may not know, Implanon requires training and "certification" for its use. This requires an investment of the physician's time.
Those who implanted the device in this woman, may not have effectively educated her of the hormonal side effects. Someone probably gave her the information, handouts, etc. Every day Medicos sees patients carrying 10 pages of printed information following their ER or clinic visit. These papers document that patient education materials were distributed, but the reality is that the patients know little of the contents. A month later, they know even less.
In the case of the Implanon woman we saw this week, she was unaware that someone with surgical skills would be required to remove the device when its 3 year life was over. She was unwilling to leave it in as she viewed it as a foreign object. Even simple surgical extractions seem to be beyond the abilities of the generic primary care provider. This patient could not remember the name of the "provider" who inserted her device almost 3 years ago.
Later that night I witnessed the Mirena campaign on television.[See below] When I see these glossy million dollar advertisements on network TV, I think about the Cialis dual bath tub spots. I remember the Avandia and Vioxx and Neurontin and Zyprexa misrepresentations. Mirena prosecuted physicians who imported low cost equally effective generic IUD's on behalf of uninsured women.
Medicos deeply admires the mission and passion of the One Step Ahead Foundation in providing family planning for uninsured women.. On the other hand, my experience with the Mirena and Implanon marketing campaigns suggests that Medicos will continue to refer those women with special needs for these products. Comments are appreciated.
With best wishes for professional success,
WMR
While I agree that we can often do a better job with patient education, especially in providing patient-centered contraceptive counseling, I have to correct one of your points, at least as it applies to my locale...The many docs in Rhode Island (all OBs, to my knowledge) who were inserting cheaper IUDs acquired abroad were billing insurers AND self-pay patients the full price for Mirena. The Dept of health, not Mirena manufacturer, came after them for fraud. The insurers and the patients weren't too happy either.
-Melissa
Someone sent me this last Spring...
God knows there's a lot of competition for that category, but selling drugs to vulnerable people at bankrupting prices who've put their faith in you to help them has to rank at or at least near the top.
Here's an ex-pharmaceutical rep explaining how the business works and what its true goals are.
Hint: The goal is not to make you better.
Video: http://www.brasschecktv.com/page/1065.html
Index--Contraception, IUD, Family Planning
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