A physician colleague's insurance will not cover her anti-nausea medicine (Zofran/ondansetron) for her CHEMO. It is $280.40 cash for 30 pills at Walgreen's. I logged into a physician/hospital medical supply company and can buy 30 pills for $3.30. That's an 8500% markup. 1/

It is easy to be angry at the insurance company bc Zofran is a well-known therapy for chemo-induced nausea and it should absolutely be covered. However, I'm sure Walgreen's buys in bulk and gets it for even less than $3.30. Add in labor, plastic bottle and charge $25. 2/
Retail pharmacies make an absolute killing, especially on cash-pay patients. Some pharmacies will offer a cash discount. However, in some states, pharmacists are not allowed to tell patients if the cash price is lower than their insurance co-pay. This is absolutely criminal. 3/
Medicaid negotiates with drug companies. For example, if you had asthma prior to 2016, Medicaid would cover brand-name Xopenex inhalers but not generic albuterol. So, we would have to write prescriptions for an expensive drug the patient didn't need so it would be free. 4/
How are emergency room physicians supposed to remember what drugs are on Medicaid's formulary, let alone all of private insurance? But how frustrating to be a patient and take in a prescription your doctor thinks you need only to find out it isn't affordable. 5/
Emergency physicians are shift workers. Then the pharmacy calls and asks for the doc who wrote the Rx to see if they can substitute something else. But that doc is home sleeping to return in 12 hr and the new doc is busy seeing her own pts, plus she doesn't want the liability. 6/
The patient is angry, the doctor is frustrated, and the pharmacist is busy because there's a line out the door and the doctor is in on a code blue so he's on hold. All of this could be avoided if prescription drugs were covered equally by all insurance. 7/
So, realize when you see an ER physician "on the phone," we jump through a ton of unnecessary hoops trying to do the right thing. There is much wasted time on red tape that cannot be done by the clerk. And we worry you won't ever get your prescription filled at all. 8/
Because if you don't, and your infection gets worse, we know you'll be back and then we've just doubled our work. You'll probably be sick enough for admission but there aren't any beds. 9/
So you'll wait in the ER and we'll avoid eye contact the 9 hrs you're there feeling like we've failed you. But you belong to the upstairs team now. And we did everything we could. How could we have known? A $20,000 hospital stay bc your $10 antibiotic was priced at $300. /End
Also realize that we are not supposed to know what kind of insurance you have or if you even have insurance. And it feels kinda unethical to ask because we treat everyone in the ER. It's not easily accessible in your chart. However, the most worthless Rx is the one never filled.

More from Health

Now you know I love to sh-t in Harvard. But I also like accuracy. So I decided to go look at Harvard’s catalog to see its lack of military history that this article describes (they only teach history of pets it claims) and what I found shocked me! Shocked me! A thread: 1/


First off, Harvard students literally have multiple sections of military history that they can take listed. (It appears these ones are taught at MIT, so they might have to walk down the street for these) but... 2/


Say they want to stay on campus...they can only take numerous classes on war and diplomacy...3/


They have an entire class on Yalta. That’s right. An entire class on Yalta. 4/


But wait! There is more! They can take the British Empire, The Fall of the Roman Empire for those wanting traditional topics... 5/

You May Also Like

Department List of UCAS-China PROFESSORs for ANSO, CSC and UCAS (fully or partial) Scholarship Acceptance
1) UCAS School of physical sciences Professor
https://t.co/9X8OheIvRw
2) UCAS School of mathematical sciences Professor

3) UCAS School of nuclear sciences and technology
https://t.co/nQH8JnewcJ
4) UCAS School of astronomy and space sciences
https://t.co/7Ikc6CuKHZ
5) UCAS School of engineering

6) Geotechnical Engineering Teaching and Research Office
https://t.co/jBCJW7UKlQ
7) Multi-scale Mechanics Teaching and Research Section
https://t.co/eqfQnX1LEQ
😎 Microgravity Science Teaching and Research

9) High temperature gas dynamics teaching and research section
https://t.co/tVIdKgTPl3
10) Department of Biomechanics and Medical Engineering
https://t.co/ubW4xhZY2R
11) Ocean Engineering Teaching and Research

12) Department of Dynamics and Advanced Manufacturing
https://t.co/42BKXEugGv
13) Refrigeration and Cryogenic Engineering Teaching and Research Office
https://t.co/pZdUXFTvw3
14) Power Machinery and Engineering Teaching and Research
“We don’t negotiate salaries” is a negotiation tactic.

Always. No, your company is not an exception.

A tactic I don’t appreciate at all because of how unfairly it penalizes low-leverage, junior employees, and those loyal enough not to question it, but that’s negotiation for you after all. Weaponized information asymmetry.

Listen to Aditya


And by the way, you should never be worried that an offer would be withdrawn if you politely negotiate.

I have seen this happen *extremely* rarely, mostly to women, and anyway is a giant red flag. It suggests you probably didn’t want to work there.

You wish there was no negotiating so it would all be more fair? I feel you, but it’s not happening.

Instead, negotiate hard, use your privilege, and then go and share numbers with your underrepresented and underpaid colleagues. […]