I am surprised here that a more expensive, less effective solution to scabies isn't used on Americans...:)
PATIENT: Can I take Invermectin for these scabies?
DOCTOR: We don't generally give that to Americans. We only give that to people in some third world country where they don't know any better and it is the only thing offered.
PATIENT: Does it work?
DOCTOR: Sure. But we have better things to prescribe. We use those instead.
PATIENT: Oh. Do they work as well as Invermectin?
DOCTOR: Hmm...about the same.
PATIENT: Are they safer then?
DOCTOR: Well...they have different potential drawbacks. Invermectin can cause neurological things like muscle tremors or fluctuations in cardiac rhythms if the patient takes too much, but they are generally transient.
PATIENT: Oh! Does the drug you prescribe have bad side effects like that?
DOCTOR: Well...it has different ones. This drug can cause liver damage.
PATIENT: Ah! So, if I take too much, it could damage my liver?
DOCTOR: Um, sure, but...your liver might get damaged regardless. It happens to some people regardless.
PATIENT: Oh no! Why don't we use Invermectin instead of your drug?
DOCTOR: Well, ours costs more, and...it's got electrolytes! It's what people need!
I have a real life complaint about this - my FILs memory care had an outbreak of scabies from a new resident. In addition to treating all the bedding, mattress,clothes, they had to apply a treatment cream, head to toe for every patient (some of which are not compliant) twice and soothing cream every other day between treatments. It was a month total of daily applying cream to every patient (20).
Ivermectin would have been so much easier. Plus my FIL who is a very private man, was humiliated by the whole ordeal.