Think About This
Topic: insurance companies whose preauthorization (or "prior authorization) process for approving medications requires a "trial" of one or more "equally effective alternatives" before the drug in question will be approved.
Example: I have a patient whose depression has been successfully controlled with name brand Prozac for several years now. (Yes, back when I was young and stupid -- about two years ago -- I offered her a trial of the generic; didn't work.) Now her insurance is again looking for a trial of cheaper meds.
Never mind that this patient is being asked to potentially suffer a relapse of debillitating depression symptomatology (or, as the esteemed Dr. Dork puts it: hosting the black dog.) What they are asking is for me to prove that their formulary medication choices are inferior to my selections based on clinical experience and the patient's proven response.
Not only are they practicing medicine; they are doing it badly.