The Trump administration has made a big deal about the idea that doctors are getting paid to prescribe drugs — specifically, antidepressants. Robert Kennedy Jr. makes it sound like the doctors have only been paid set drugs before, but now – shock, gasp – they will be prescribed to describe them too! If doctors were only paid per prescription, that would be big news indeed. However, as with most of the vile garbage pouring out of the White House right now, this is nothing but a lie. Doctors have always been paid to prescribe and prescribe medicine — it’s called treating patients.
Doctors are not paid to prescribe
Back in the bad old days of decades past, there were times when doctors could be financially incentivized to write certain prescriptions. This was usually done through generous perks such as all-expenses-paid trips and huge “consulting fees” (because direct payment was illegal, as it is now). Some unethical doctors may have had the opportunity to line their pockets with pharmaceutical company dollars this way in the 80’s and 90’s.
However, in this day and age, there are more rules and transparency. No pharmaceutical company can ever bribe a doctor like him. Now, are drug companies still trying to influence doctors’ prescribing habits? Yes, of course they do. It’s a business like any other, but paying doctors per prescription is not a method available to them. (If you want to know if your doctor is being paid by the industry for speaking fees etc. see here. Yes, some doctors will always be unethical.)
Not only are doctors not paid to prescribe specific drugs, they are not paid at all to prescribe drugs. Whether you talk to your doctor about your depression and it results in a prescription or shows a picture of your cat, your doctor gets paid either way. What the doctor is paid for is to treat you for depression. This does not require a prescription in all cases. (Showing a picture of your cat is talking therapy, at least for cat lovers.)
Doctors describe all the time
I have been on many psychiatric medications, including anti-depressants, and the vast majority of them I no longer take. In other words, all these drugs have been described. And believe me, the doctors who did the prescribing were paid way back — both in Canada and the US. “Prescribing” is simply the act of withdrawing a drug, something doctors do every day.
Again, what a doctor gets paid for is treating a disease like depression, not writing illegibly on a prescription pad. I have left many over the counter doctors appointments for all sorts of reasons. This is normal and nothing new.
Why RFK Jr. does it make the description sound like a new thing?
Just as the Trump administration has tried to make antidepressants sound dangerous and scary, they are also making it sound like doctors are being slyly bribed to shove them down the throat. They are trying to make political hay out of the idea that they are the ones who can get the US off the bad anti-depressants.
This, of course, is hogwash on its face.
Doctors today do exactly what they did a month ago, what they did two years ago: they treat people for medical conditions like mental illness. Sometimes, these conditions require the prescription of medications such as antidepressants. And sometimes these conditions require the withdrawal of medications such as antidepressants. It’s always been that way.
Doctors are also paid just to talk to you and find out how the treatment is going, in case you forgot. Prescribing is just one of the things these highly trained professionals do.
What really happens when the wrong emphasis is placed on the description?
Unfortunately, what is likely to happen is that, instead of prescribing antidepressants appropriately at the appropriate times, what this will all lead to is more stigma around medication and treatment for mental illness, not to mention people willfully stopping their medication (which you should never do). People will further ingrain in their brains that something is wrong with antidepressants, something is wrong with doctors who prescribe antidepressants, and therefore something is wrong with people who take antidepressants. This is the opposite of auxiliary. This is harmful to the millions of people who have many illnesses that are helped by antidepressants and other psychiatric drugs.
Is there a time to stop antidepressants? For many people yes, of course, but for some people no, there isn’t. Some people will need these drugs forever, and it’s not them or their “bad” doctor who are doing it. Some people just have brains that need a little extra help on a daily basis. That’s fine. Some of us have pancreases or other organs that need help as well. That’s okay, too.
But don’t think that the description is right for everyone or that it’s something new just because a man’s glove said it. Is not. It is an arrow in the quiver that has always been a part of treating diseases.
