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After eight weeks of treatment, response rates were 50 percent in the medication group, 43 percent in the cognitive therapy group and 25 percent in the placebo group. After 16 weeks of treatment, response rates were 58 percent for patients receiving either medication or cognitive therapy. Remission rates were 46 percent for patients receiving medication and 40 percent for those in the cognitive therapy groups.
Originally posted by WyrdeOne
I really was honest about taking suggestions, I take criticism at face value, and if I think it will help, I'll use whatever suggestions people want to throw my way.
Originally posted by WyrdeOne
The universal human condition ties us all together, it drag us down or lift us up.
Originally posted by GradyPhilpott
Contrary to what has been stated here, anti-depressants are not designed for long term use for most patients. Studies going back as far as the fifties have shown that most episodes of depression will abate without any intervention whatsoever.
This study is not going to affect the use of the appropriate anti-depressants significantly, in my opinion, nor should it. What it should do is to limit the practice of General Practitioners prescribing anti-depressants to patient who complain of sadness without first ordering a psychological work-up to determine if psychotropics are indeed indicated and the idiotic idea that children with behavioral problems can be "fixed" with the right medication.
..general practitioners who feel that many patients who will refuse psychiatric treatment will readily take an anti-depressant prescribed by the "family doctor."
It is bad news if insurance companies get on the bandwagon and start making it difficult for MDs to practice without undue intrusion by the bean counters.
MDs have already been spooked by the DEA over pain medications and too many people are suffering from chronic pain without proper medication because of it.
Originally posted by WyrdeOne
Do you mean the insurance companies won't cover therapy, or will urge doctors to presribe therapy instead of medication even in cases where medication could prove useful? Could you clarify?
Long ago, before the days of managed care, there were two opposing forces at work in the field of health care. One was the insurance company which depended upon profits for its survival. Since profits meant taking in more money in premiums than were paid out in claims, medical insurers did there best to limit the amount of money they had to spend on their clients. Strategies included having large deductibles, excluding elective or routine care, denying coverage for certain types of procedures and excluding coverage for preexisting conditions.
On the other side were physicians who were paid a fee for their services. They made money by practicing medicine and so they had every incentive to see as many people as often as possible and, if their specialty was a surgical one, perform as many operations as possible.
This system of checks and balances had its problems, but at least patients knew that their doctor was their advocate. If their insurance company decided to deny a surgery which their physician said was necessary, the doctor could get on the phone and argue with the insurance company, secure in the knowledge that the worst that they could do to him was refuse to pay. His contract was with his client, not his client's insurance company, and as long as the client was happy, the doctor-patient relationship was safe.
Then managed care came along. It gave up the right to apply large deductibles and to exclude preexistent conditions and routine health care in exchange for the right to control the way that doctors practice medicine.
How do HMOs control physicians? Lots of ways. Some contracts have "gag clauses" which prevent a doctor from discussing treatment alternatives which the HMO does not cover with a patient or from criticizing the HMO or its decisions. For instance, if a young woman has aggressive breast cancer with four affected lymph nodes, her physician may not be allowed to suggest the experimental treatment option of bone marrow transplantation since her HMO does not cover experimental treatments.
HMOs also gain power through sheer size. If one HMO dominates a certain market, it can drive an uncooperative physician out of business simply by dropping him from its plan. Since the contract between the patient and the HMO specifies that the HMO will cover only those services which are provided by its own physicians, the patient will have to see a new doctor or pay for his visits with his preferred doctor out of his own pocket.
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