Do you bargain with your doctor?

Back in the old days, patients used to pay their physicians with crops, knitted blankets, and animal meat. Of course, we now have supermarkets and Walmart, so physicians are expecting cash for their services. Some patients still bring gifts (like fruit and vegetables from their gardens) to their physicians, but I don't think that most patients are bargaining for their healthcare services (unless they lack health insurance and they're paying with cash).

What if that evolved? As we prepare for healthcare reform, maybe bargaining skills will be one of the main components of reforming healthcare costs. What if more patients start bargaining with their physicians? Some are doing that right now because people would rather get paid something (even if it's less) over nothing. What if physicians start offering sales and specials for certain services? (get two physical exams for the price of one!)

Physicians can only control so much when it comes to price. The prices for labs and other diagnostic tests are generally not controlled by physicians. Maybe we'll start seeing some special deals (20% off your CT scan this month!) in the hospitals.

Generic drugs for BPH from Walmart

I was having a discussion with someone about generic drugs used to treat BPH or Benign Prostatic Hyperplasia. Since you can get $4 drugs Walmart, I decided to write a blog post evaluating generic drugs that are currently available at Walmart. I don't know how much the Walmart generic drug formulary varies from state to state, so this may not be entirely accurate. Plus, I imagine that these formularies are constantly changing.

Alpha-1-adrenergic antagonists

Here are the generic drugs on the Walmart $4 list:

• terazosin (on the $4 Walmart generic drug list) - generic form of Hytrin (made by Abbott)
  
• doxazosin (also on the $4 Walmart generic drug list) - generic form of Carduara (made by Pfizer)
  

Not currently available as generic drugs:

• tamsulosin or Flomax (marketed by Boehringer Ingelheim and Astellas)
  
• alfuzosin or Uroxatral (made by sanofi-aventis)
• silodosin or Rapaflo (made by Watson)
  

5-Alpha-reductase inhibitors


Here is a generic drug, but it is not on the $4 Walmart list:

• finasteride (not on the $4 Walmart list) - generic form of Proscar (made by Merck)
  

Not available as generic drugs:

• dutasteride or Avodart (made by GSK)
  

So, you can't get a 5-alpha-reductase inhibitors for $4 at Walmart, but you can find the alpha-1-adrenergic antagonists (and they are listed under "Heart Health & Blood Pressure").

Fraudulent 2009 H1N1 Influenza Products

The FDA is warning consumers about fraudulent swine flu (H1N1) products that are mainly being sold on the Internet. You probably won't find these products at Walmart, Rite Aid, or CVS, but if you open your computer, then you may see advertisements and other links that promote such products.

Not sure if a product is fraudulent? Make sure to consult the FDA H1N1 product list here.

eClinicalWorks, Dell, and Walmart

The eClinicalWorks package at Walmart will include Dell computers. Which Dell tablet PC will be included in the package? That's right, the expensive Dell XT2 Tablet running Microsoft Windows. No Apple tablet running OS X for those who are Mac lovers. I wonder if we'll actually get the chance to play around with an XV2 in the Walmart stores. People don't recognize the value of a tablet PC and most will probably use this convertible tablet as a notebook/laptop. However, for those who take advantage of the pen-based input system, they will quickly learn how efficient they can be by using the digital stylus. What about the ultra-mobile PC platform? Sometimes I wonder about these tiny devices and netbooks. Will they gain momentum in the healthcare field?

Walmart and eClinicalWorks: An Odd Couple?

I stumbled on an article that talks about Walmart and eClinicalWorks. It's an interesting perspective about how Walmart/Sam's Club and eClinicalWorks (eCW) are an odd couple with good intentions. Hence, it's approriately titled, "Wal-Mart + eClinicalWorks Electronic Medical Records | An Odd Couple with Good Intentions."

The author makes some interesting and probably accurate predictions about how physicians may get exposed to eCW by visiting Walmart or Sam's Club, but they probably won't buy the EHR solution on that first visit. If they do some price comparision and shopping around, are they likely to find a better deal (or better product) somewhere else? Physicians may purchase Quicken or TurboTax at Walmart, but what's the likelihood that they'll purchase an EHR from the shelves of a local retailer? Maybe the bigger question is: what's the return policy on eCW if you purchase it from Walmart?