Physicians holding patients hostage to medication?

This is a medical issue, but it's also a bit of a rant.

Currently my friend is taking two simple medications, a water pill and an ACE inhibitor. They are effective safe and not controversial methods of controlling mildly high blood pressure.

Their BP is about 120/90 and stable. Ideally, it should be about 118/80-ish.

The MD gives them a four-month supply of refills, but then requires an office visit to refill those.

This seems to be tantamount to holding the patient hostage - they will not refill essential medications if the patient doesn't feel the need to go into the office to get a brief physical.

The problem with going into the Dr's office include:

1. Sick people go there. If you sit in the waiting room you will be coughed on by sick kids and adults; Want to catch a cold? Go to a daycare center, a physician's office or a school. ; In fact Hospitals are a leading cause of death (due to nosocomial infections and Surgical blunders)

2. Door handles and knobs and chairs and paperwork are contaminated. Being in infection control, I know that those items are frequently contaminated with Staph, Strep and other bacteria and with viruses. In the old days they used 'brass doorknobs' in hospitals because bacteria doesn't live on them.

3. They try to push other drugs, specifically Cholesterol drugs. My friend went in and got an erroneously high (lab error?) Cholesterol test and on the basis of one test they INSISTED the friend go on these potentially dangerous drugs (Statins), and the MD looked at them as said 'YOU are going to DIE unless you take these'. Being that the test was erroneous, the MD created HARM by saying this, causing a elevated BP and depression.

4. In the event of a catastrophe, such as a flood, power outage, or meltdown of society, having ONLY a four month supply of medication puts people at an incredible risk. (This is a system problem, including Medicare payments and insurance payments as well - if you have a prescription you can only get one month supply of a medication.

In fact the Physician could help out with this. They could put you on a double dose of a relatively benign medication (say a water pill) and write the prescription for three doses per day when really that would be fine, but you could also get by on one. This is not really cheating anyone, and with many medications is within standard practice. This would cut visits and pharmacy costs by 1/3 to poorer patients.

For example instead of getting 30 tablets of a water pill, the patient could get a 6 month refill of 3x/that dose (still safe) and only take 1 per day, allowing a prescription to be filled for 90 tablets (these are VERY inexpensive and if a problem was felt with cheating Insurance the patient could pay out of pocket). That would mean the patient could stockpile a supply for the purposes of emergency, and they would be ok for about 18-24 months before a revisit would be needed. (obviously you would NOT do this for drugs with abuse potential, strong pain killers, etc)

In fact the Physician DOES do this with a pain killer drug (a mild NSAID like Advil), and has the prescription written for 3x per day when 1x per every other day suits the patient just fine. IOW, they are abridging the system, but selectively.

I'd think that if the patient is responsible and the medications are mild that the Physician should be willing to give one-year's worth of medication, by either slightly over prescribing or writing refills for every 12 months not every 4 months.

I would argue that most healthy people don't need to visit the Doctor more than once every two years. Going in more often just turns people off for reasons I posted above (risk of infection, over-medication, and negative psychological issues).

The medical profession seems to want to give us the impression that 'you are sick in some way, we just need to find it'. It's unlike the Oriental or Chinese system where the emphasis is on wellness and the MD pays you a modest amount (credit?) if you get sick under his care.

So what do Members think? Is this a valid rant? Is my friend over-reacting? Couldn't diet and exercise solve these minor problems just as easily? Is the current cut-off for 'mild hypertension' too low? (it was lowered recently)? Are physicians just trying to 'stay in business' by making you visit them more often?

I think it's bordering on negligence, malpractice and subverting their Hippocratic Oath ("First, do no Harm").