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Re: OTC BCP's?

From: AMD (anonymous@obgyn.net)
Fri, 30 Jun 2000 18:30:05 -0500 (CDT)


I guess that was my point --

Is it appropriate to basically blackmail patients into regular exams so they can have access to birth control?Maybe we should start dragging the partner in too...make sure he isn't having sex while unhealthy (please read in the intended sarcasm).

It is wonderful that a lot of problems that would have gone undetected are diagnosed and treated because a woman drags her butt in just to get her BCP's. And I appreciate Dr. Shanahan's insight into the reasons to keep BCP's as prescription. And from a public health standpoint, it makes sense to continue this practice. I honestly don't have an opinion on what the outcome of these hearings should be. It would be better for me personally to keep them by Rx since my insurance covers it and I pay $15 for a 3 month supply. It would be entirely out of my pocket if it was OTC.

I just dislike the idea of a government agency basically thumbing their noses at American women, implying that we are too stupid and irresponsible to have access to reliable birth control (read here "having sex") without a doctors permission. If use of the medication itself does not require a doctor's supervision, I want the FDA to take a hard look at whether or not it should be by prescription only.

Again, Dr. Shanahan, thanks for your insights.

Andrea

At Fri, 30 Jun 2000, Kelly Shanahan, MD wrote: >
>At Fri, 30 Jun 2000, AMD wrote:
>>
>>Maybe they can be "sorta" OTC. They are behind the pharmacy counter and
>>you need a photo id. If you're < 15 or > 35, you need a prescription.
>>
>>Of course, how many women would NEVER go for a pap/pelvic if they didn't
>>want BCP's??
>
>Lots and lots
>
>On the other hand, how often does the pelvic or pap give
>>reason to not prescribe BCP's?
>
>it is not uncommon ot find that a woman is pregnant, or has very high
>blood pressuer, both conditions which would preclude use of hte pill.
>Also, a pap, pelvic and breast exam can identify STDs, abnormal cells
>which if untreated could lead ot cervical cancer, breast cancer, ovarian
>cancer, benign but potentailly troublesome fibroid, not to mention all
>hte other medical conditions I diagnose like hypertension, diabetes,
>thyroid disease,high cholesterol -- just because I make you come in for
>a pap once a year if you want your OCPs or hormones
>
> Or can most of the potential problems be
>>assessed on history and a less invasive exam?
>
>Not cervical cancer or precancerous changes
>
> Is there a legitimate
>>medical reason to require a pelvic/breast/pap to prescribe birth control
>>pills?
>
>yup -- see above
>>
>--
>M. Kelly Shanahan, MD, FACOG
>S. LAke Tahoe, CA
>
>This post is for educational purposes only and does not construe a doctor-patient relationship. It does not take the place of a consultation with your own doctor.
>
>***private e-mails will NOT be answered -- or even read. Please do NOT send a private e-mail as it interferes with the very limited time I have with my own family!!***
>






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