While it saddens me that doctors remain skeptical about generics this is not unexpected, nor is it necessarily a global conspiracy of Big Pharma bribes and kick backs. Conservatism in medicine is normal, and on the whole protects patients for embarking on new treatments before they have been reasonably proven. Fear of making a mistake and being sued for it is also an ever present concern – their are probably no doctors who are not at least aware of colleagues being sued by patients (rightly or wrongly). At the last medical dinner I went to fully 50% of the doctors there, all highly respected, had a current medicolegal complaint they were dealing with…..

Ok, so that’s enough background the current reality is that only a tiny minority of doctors will willingly participate in generic treatment. A larger minority will monitor patients on the basis of duty of care, and not being the prescriber the risk of not monitoring is higher than monitoring.

So here is an approach that was successfully by a number of patients last year, when generics were very fresh and out on the bleeding edge.

It plays to simple psychology, and while it might be viewed by some as deceptive conduct, and indeed I am not suggesting you do anything like this, it did conclude with useful outcomes.

A perfectly reasonable story is that you want to get treated and can get the money (borrow, mortgage, inherited whatever) for treatment. Do not mention generics.

On this basis ask for the baseline tests (bloods, genotype, viral load, fibrosis) to see if you need to treat now. Then you are set. Maybe your doc will even write the script. Of course have a crack at free insurance treatment if it’s available.

Now go and source the generics using a service like FixHepC and doctors from GP2U or Monkmed to script it. You have your baseline so this is easy.

Then next visit, when you have the generics and have taken for a month revisit the original doctor and spin a tale about a friend who told you about generics because they are SVR12. Even if you don’t have such a friend it will only take a day on the forum here to find one.

Then say you’ve been taking this generic medicine (show box) for a month and feel fantastic. You will probably be asked for the box so make sure it’s empty.

Then ask for tests to monitor your progress.

Most doctors are curious, and even if totally anti-generic will almost certainly test (to prove they don’t work) and then when the results come in they will go I see it but I don’t believe it and probably call you in for a retest.

The key thing at this point is that you are like somebody who say arrives at ER/DEM with a heroin overdose. While I would not prescribe morphine to them in clinic, I would attend to the problem at hand because I have a duty of care to do so irrespective of causation.

This is not actually fiction. I know dozens of patients who did exactly this last year and the first person evidence they provided slowly changed the status quo.

As each (not unreasonably) skeptical doctor saw the results of medicine they knew existed but could not access each generic rebel patient tilted the balance….. In the bigger clinics the volume of patients turning up undetected and clearly not unwell made a compelling case for generics in a way that no scientific paper can.

In medicine we are taught “Primum non nocere” which is Latin for “first do no harm”. You the patient, can personally prove the no harm, opening the door to this part of the Hippocratic Oath

I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing