Health and Medical News and Resources

General interest items edited by Janice Flahiff

4 reasons why doctors should be outraged

From the 7 December 2012 article at KevinMD.com

4 reasons why doctors should be outraged

Outrage #1: Wasting time of skilled caregivers. Everyday skilled nurses and physicians’ assistants waste hours of time on the telephone either getting approval for medications that we prescribe for our patients or trying to fight a rejection for a medication we requested.

Outrage #2: Choosing a medication for cost, not effectiveness. A child cannot breathe because the acid and other nasty stomach contents come up from the stomach and inflame the airways without the right treatment. Although many of them might respond to one “preferred” drug, not all of them do. And, guess what? There is another “non-preferred” drug to which more of them will respond, but it is not allowed as a first line treatment, even in this critical airway situation. When there is an airway problem and the infant is choking, coughing, turning blue and not sleeping, or the airway is becoming progressively narrower, wouldn’t you want your child to have the medication that works more often? I know I would. The insurance companies call their approach “best practices” because most, but not more, might respond.

Outrage #3: Pretending we are giving care when we are not. So the one “preferred” (i.e. less expensive) medication also tastes really nasty. Many kids won’t take it at all no matter what flavor is used. So then families are told to mix it with their formula or juice or some other food and this dilutes its effects because it won’t work in that preparation.

Outrage #4: Pretending that patient diversity doesn’t exist. Different people respond to medication differently (? pharmaco-genetics). You know that’s true just from the way some of us fall asleep after one dose of Benadryl and others of us don’t get knocked out even with a whopping dose of morphine. We are in a real quandary when we have to fight (sometimes for weeks or months) to try another medication because the one we are allowed (first tier) doesn’t work. And then on the second or third tier, the family cannot afford it, doesn’t get the medication, and the child might go untreated. We have wasted money, time and have put the child in harm’s way….

….

Yes, I am angry about this. Very angry and very frustrated. I am tired of being told what medications to use, what tests I can order and even what surgeries to perform. I am “appealing” to one insurance company to be paid for an operation they said was not proven effective in children. Were they faced with the anatomy that I encountered and knew was the cause of the problem and required a different operation than planned? Another has denied payment for an assistant surgeon which I needed because we performed a difficult airway case!….

December 15, 2012 Posted by | health care | , , | Leave a comment

Fewer U.S. Docs Accepting Perks from Industry

HealthDay news imageBut nearly 84% still report some relationship with companies, results show

From a November 8, 2010 Health Day news item By Robert Preidt

MONDAY, Nov. 8 (HealthDay News) — U.S. physicians‘ links with drug makers, medical device manufacturers and other health-related companies have decreased since 2004, but many doctors still have ties to these businesses, new research shows.

A 2004 survey found that about four out of five doctors accepted gifts of food and beverages from industry in their workplaces and more than 75 percent were given drug samples. In addition, more than one-third accepted reimbursement from companies for professional meetings or continued medical education, and more than one-quarter accepted payment for consulting, speaking or clinical trials.

The new 2009 survey of 1,891 primary care physicians and specialists found that nearly 84 percent reported some type of relationship with industry in the previous year. Nearly two-thirds (63.8 percent) accepted drug samples, about 70 percent received food and beverages, 18 percent received reimbursements, and 14 percent were paid for professional services.

The findings are published in the Nov. 8 issue of the journal Archives of Internal Medicine [free full text article].

Certain types of specialists were more likely to have industry ties. For example, these connections were more common among cardiologists (92.8 percent) than psychiatrists (79.8 percent). The type of practice also made a difference.

“Physicians in solo or two-person practices and group practices were significantly more likely than those in hospital and medical school settings to receive samples, reimbursements and gifts. However, physicians in medical schools were most likely to receive payments from industry,” the researchers wrote.

“These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the study authors concluded. “However, given that 83.8 percent of physicians have physician-industry relationships, it is clear that industry still has substantial financial links with the nation’s physicians. These findings support the ongoing need for a national system of disclosure of physician-industry relationships.”

SOURCE: JAMA/Archives journals, news release, Nov. 8, 2010

 

 

November 10, 2010 Posted by | Uncategorized | , , , , | Leave a comment

   

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