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Motherhood

Is Your Pediatrician Working For Your Child or For Big Pharma?

I try to be a good mom. I swear; I really do.

There isn’t much I could choose about my kids. I didn’t choose the date of their conception. I couldn’t choose whose features they’d more strongly favor between Marshall and I. I could never have imagined what day and time they’d spring up from a half crawl to an enthusiastic, self-pleased toddle. There was no way I could ever have control over these things… which is why I am so particular about the things I CAN control.

Where they go to school.

How much television they watch.

Their bed time.

Where they receive their medical care.

Many months before Nadjah was born, I scoured the internet and talked to other parents for pediatric referrals. Finally, I settled on a pediatrician in Sandy Springs. I visited with Dr. Leonard – who was new to the practice – when I was in my 6th month so that I could discuss what kind of doctor I was looking for for my child and compare personalities. It was a good thing too. I gave birth a month later.

Dr. Leonard and I got along famously. She was dry and no-nonsense. I was a clown and a no-fuss patient. She was an excellent medical provider for all of my kids and was at the hospital to tend to them after every delivery. When I had Liya, she came to see me one final time.

“I’m moving out of state,” she said, giving me a sideways glance.

“But you can’t,” I said simply. “Who’s going to look after my children? And furthermore, how long have you known this??”

What a silly question.

“Well, I told your husband a few weeks ago when he brought Stone in for his one year exam. I told him he could tell you if he liked, but I was not going to be responsible for your duress.”

Marshall had never breathed a word or given a hint. So these two were in league with one another, eh? No matter. I’d fix them. I asked Dr. Leonard when she would be leaving.

“Next week.”

I stared at her blankly. Finally, I struggled to sit up and extended my arms for a hug. She told me that I was one of her favorite parents.

“You’re just so easy,” she confided. “And I wouldn’t say it if I didn’t mean it!”

And then she was gone.

Suddenly, I was left with the daunting task of finding another pediatrician. I didn’t like anyone else in her practice, really. They were all either creepy or self-absorbed or dictatorial. For a year, I had to endure less than stellar care and was seriously considering changing practices. For some reason, I felt I had to remain loyal to the memory of Dr. Leonard, despite the fact that she wasn’t there and was never coming back. A part of me hoped she would.

Eventually my pediatric group hired a new doctor: a fresh faced blond whom we will simply refer to as Dr. Might (because we might not make it together after this most recent incident).

Dr. Might is a sweet girl, but graduated from medical school about fifteen minutes ago. The tell-tale signs of this being her first gig are evident. Her goofy grin, her eagerness to please, her dainty diamond jewelry that she wears to each exam and that pretentious monogramed quilt Brighton bag she insists on carrying. Please don’t mistake this description for dislike for the woman. I like her well enough. She’s just no Dr. Leonard, you understand.

Anyway, over the course of the last year and a half that she became my kids’ de facto doctor, I thought I might be able to work with her. Perhaps I could mold her into the image I wanted her to be. It was not to be so. She obstinately refused to take direction or engage in discourse outside of what she had read in a book. For instance, Dr. Leonard knows that Stone has always tipped the scales in weight and height since he was a newborn.

“Don’t concern yourself with his weight,” she always said. “He’s perfectly square, and this has been his consistent growth pattern.”

Dr. Might on the other hand is adamant that we cut down portion sizes because his “BMI is telling us he’s obese.”

One only has to look at my son to tell he’s not obese. He’s built like a midget wrestler.

fat fileThen there’s this bloody chart that hangs in every exam room that has obviously been provided by some government weight Nazi. Oftentimes, I will catch Nadjah furtively glancing at the diagram until I (angrily) command her to “Look away!” because “That chart has nothing to do with you!”

It has become the bane of my bloody existence.

“Where do I fall on this chart, Mommy? Am I green or red?”

“You’re neither. You need to worry about your health, not just some random government ‘approved’ weight.”

Dr. Might never does anything to assuage my girls’ body weight issues, or even point out the fact that being too skinny is just as unhealthy as being overweight. Fortunately, they have an intelligent mother to fill in the gap.

Which is why today’s event pissed me off so much.

Last week I took the youngest kids for their annual check-up. Stone insisted on bringing his football, which he of course left behind. We dashed into the office this afternoon to go and get it, not intending to stay at all. One of the nurses points to Aya’s eyes, the whites of which are flaming red.

“Mom, I think she has pink eye,” she says gravely.

“She might,” I admitted. “We just got back from the sprinkler park last night, so I don’t know if the chlorine affected her eyes.”

The nurse was adamant that we see the doctor. There were no home remedies she could recommend for pink-eye. My kids have never had it, and it’s been years since I’d had “Apollo” (as we call it in Ghana) myself, so I was happy to have the doctor take a look at it.

“Who’s your regular doctor?”

“Might.”

“Good! She has a 2:15 slot open that you can take.”

Excellent. It was 1:58, which meant it would be a short wait. There is nothing more irritating than waiting at the doctor’s with 4 hungry kids.

When Dr. Might walked into the room, we exchanged pleasantries. She washed her hands and examined Aya’s ears, eyes and throat.

“She definitely has pink eye,” she said with her perfect Valley girl smile. “I’m going to prescribe Vigamox. It’s an eye drop that you apply twice a day, which is nice because other drops have to be applied 4-6 times daily. And who has time for that, right?”

Good parents have time for that if that’s what the healing process requires, lady!

“Yeah…”, I said quietly.

“I do have to warn you. It’s VERY expensive, but you can get a coupon online if you Google ‘Vigamox coupon’. It knocks it down to 20 or 30 bucks and you don’t have to register online or anything to get it.”

Heh? How much does this medicine cost if it’s $30 at discount?

I thanked her and herded my children back to the car. Aya proclaimed that her “eyes were hurting” as soon as we were seated and launched into a coughing fit. I told her to quit it.

We pulled up to the drive-thru at CVS shortly afterward, where the pharmacist informed me that the coupon I was using was generic. He advised me to go to the company’s website and pull the coupon down from there. That’s where things got interesting. After going through several searches, I discovered that Vigamox is manufactured by Alcon, a subsidiary of Novartis. They had no coupons on their website – just a link directing users to a ‘Coupon Complaint’ page. I was getting frustrated, so I did something I rarely do: I called customer service. I was then informed that there were no coupons available online, and that I could get a rebate. I hate rebate programs. It always takes so long to get your money back. Nevertheless I gave the rep my contact info and she said someone would follow up with me later.

My irritation led me to perform a search for ‘natural remedies for pink eye’, during which I made a startling discovery. Vigamox, it turns out, it highly overprescribed in this country, particularly in pediatric circles. The course of treatment has been likened to “killing an ant with a rocket launcher”… which I guess is effective if you’re into bio-warfare and carnage. It was also cost prohibitive, at $117 if you do not have insurance. Fortunately, I do, but I’d seen enough.

I called the pediatrician’s office and told them the medicine was just too expensive. Could the nurse get the doctor to prescribe something else? A few minutes later she took me off hold and told me they had called another scrip in. She prepared to say goodbye without even telling me what it was. I stopped her so that I could inquire as to what I was supposed to be dispatching into by baby’s face.

“It’s Ciprofloxacin,” she said dryly before hanging up.

Was that disdain I heard in her voice? And more importantly, how much was this going to cost me?

$1.11, if you care to know. A solution that cost $1.11 to be administered every 4-6 hours… or 2 to three times a day. Not much different from Vigamox

Why couldn’t Dr. Might just prescribe this in the first place? Why try to sell me the more expensive brand. Did she not care that I have four kids to look after, whose daily cost of feeding and entertaining over the summer can sometimes run into the hundreds? My guess is no… she just wanted that kickback from the Big Pharma rep who visits the Sandy Springs office quarterly in her pencil skirt and rolling drug case, flashing her pearly white grin.

I don’t like how this makes me feel. I feel wretched, filthy, like my children’s health is on an auction block. There’s something very Orwellian about it. I don’t like it at all…

 

So parents! Have you ever felt fisted by your pediatrician? How did you deal with it? Have you felt fisted by your own general practitioner, perhaps? Is this an inescapable plague? Are we all at the merch of Big Pharma, no matter what? Discuss. Discuss!

 

 

 

This article has 4 comments

  1. guestar

    I don’t think that Dr. Might gets any sort of kick back from Big Pharma for prescribing Vigamox. Free samples and expensive dinners to try and convince her of Vigamox superiority, maybe, but nothing else beyond that. Cipro and Vigamox belong to the same class of drugs, but Vigamox is newest generation. Most drugs, antibiotics especially, require constant revamping, especially as bacterial resistance develops. With Cipro being a first generation drug, there’s likely to be more bacterial resistance that has developed over the years. Vigamox is probably the solution to that problem. For Dr. Might, especially seeing as she is relatively fresh out of residency, probably learned about and used Vigamox more in her training, and hence this extends to her daily practice.

  2. Arhyel

    I thought the pharma-doctor drug promoting relationship only existed in Nigeria, apparently i’m wrong.

  3. Joy Soto

    I agree , many of the young doctors and veterinarians(no kids….dog owner) are inexperienced, by the book “nazi’s” who try to get you to spend the most money possible. They don’t give you options and they give you those condescending looks when you don’t agree with their treatment plan.
    On another note, I have been in the health and fitness business for 20+ years and have tons of credentials to boot. Although I’m no longer in the business and actually have a job in the real world, I have just about had it with this stupid BMI Index crap! Besides your doctors ( although my older doctor agrees its crap, too) pushing this agenda, you now have the HR Nazi’s joining in. Now some young HR person with no health or fitness background is telling me how to work out…. And get this, I have to log it each month for insurance purposes!
    Joy

  4. guestar

    I disagree that most young doctors want you to spend the most money possible. Most young doctors don’t get any kind of special cut from getting you to use one medicine over another. In defence of Dr. Might, Vigamox is probably the best drug out there in that drug class with the least potential for bacterial resistance and hence the one most likely to result in complete cure compared to Cipro. This is not to say Cipro wouldn’t work, but to say that your best bet would be to use Vigamox. People fresh out of residency are more likely to be up to date on the latest research and drugs and thus will tend to use those more.

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