Are Pharmacies and Insurance Companies Practicing Medicine Without a License?

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Do Insurance Companies and Pharmacies have a Hidden Medical Agenda?

In order to practice medicine legally, one must acquire an education which is specified and regulated by state law. These requirements are very precise and complex, they require an education that is also specified by law to include various courses and practices. Once you have obtained such a license then you can be a doctor. One of the benefits of being a doctor is the ability for you to prescribe medicines. These medicines are also regulated and controlled by the federal and state governments. The ability to prescribe them is only given to those individuals who have followed the regulations laid out in the law to acquire the license of a Doctor of Medicine.

Insurance companies do not have such a license. Pharmacies do not have such a license. They do have licenses to do other things and their licenses are also specific and detailed in focus. These laws also require specific educational elements and are closely regulated by law.

Sometimes there is confusion about where the line is drawn regarding the practice of medicine. Insurance companies do not play a role in this decision making, they merely determine whether or not they will pay for services provided by physicians, and these decisions are determined by their interpretation of the specific clauses in the policy the individual or group have bought. If there are disputes, they are determined by the legalities of the wording of the contract and are disputed in court. Pharmacies cannot practice medicine either, they facilitate the practice of medicine by making and providing the prescriptions as ordered by the doctor. Pharmacies can advise people about over the counter (non- prescription medicines), they can explain what they know about side effects and operation of drugs and prescriptions, but they cannot determine what medicine you should have or how you should take it. Those determinations are made by physicians who are licensed to make these decisions.

This week, Dr. Maupin and Brett are discussing some of the areas of confusion that happen around these topics. They will explain and discuss several examples of behaviors by insurance companies and pharmacies acting in concert with each other under the guise of patient education that are a reflection of their marketing practices and beliefs. As you will hear, there are occasions when these agencies get very close to the line of practicing medicine without a license! We are opposed to their behaviors and will talk with you about why we are.

We are particularly concerned about the impact of these behaviors of the insurance and pharmacies on elderly people who receive these phone calls. We are worried that it will lead to confusion and anxiety and misunderstanding. We discuss those concerns and possibilities.

It is our hope that by listening to our conversation, you will become more aware and more involved in pushing back on these attempts to increase market share under the guise of “medical concern”. And that being aware, you will help your elderly friends and relatives to deal with these situations when they arise.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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