Saturday, March 29, 2008

National survey of hospital patients

From the New York Times article:
Many hospital patients are dissatisfied with some aspects of their care and might not recommend their hospitals to friends and relatives, the federal government said Friday as it issued ratings for most of the nation’s hospitals, based on the first uniform national survey of patients.
The new data, part of a survey of patient experiences and perceptions of hospital care, is posted at a government Web site,

Richard J. Umbdenstock, president of the American Hospital Association, which helped develop the measures, said they allowed “an apples-to-apples comparison” of hospitals at the state, local and national levels.

Click here to access the NYT article.

Friday, March 28, 2008

Culture and health care delivery

Just read a fascinating article that was published Monday in the Boston Globe entitled "Culture Gap"; an excerpt:

Hinton, speaking in You's native Khmer language, told her to taper off her antipsychotic medications, according to his records, and handed her prescriptions for two other drugs - one to help her sleep, another to control her anxiety attacks. He urged her to continue her traditional Cambodian practices to help "wind" flow.

After regular therapy sessions with Hinton, You's emotions stabilized. And she trusted these words from him: You're not going to die from your neck vessels bursting.

Click here to read the article.

A lot more than shrimp on the barbie?

From the Sydney Morning Herald article:

Australian drug companies forked out more than $30 million in six months hosting doctors at controversial "educational" events, a report has revealed.

Pharmaceutical industry body Medicines Australia has been forced to detail spending on doctors' seminars of up to $2,500 a head, often hosted at expensive hotels and in exotic locations.

A report prepared for Medicines Australia by international consulting firm Deloitte shows that 42 companies spent $31 million, including $16.4 million on direct hospitality costs like meals, flights and hotels, in the second half of last year.

Click here to access the article.

Wednesday, March 26, 2008

Self assessment

The newest issue of the Journal of Continuing Education in the Health Professions has been published and it has a wealth of articles on self assessment:
Self-monitoring in clinical practice: A challenge for medical educators
Ronald M. Epstein, Daniel J. Siegel, Jordan Silberman

ldquoI'll never play professional footballrdquo and other fallacies of self-assessment
Kevin W. Eva, Glenn Regehr

Making self-assessment more effective
Robert M. Galbraith, Richard E. Hawkins, Eric S. Holmboe

Self-assessment and continuing professional development: The Canadian perspective
Ivan Silver, Craig Campbell, Bernard Marlow, Joan Sargeant

Self-assessment in CPD: Lessons from the UK undergraduate and postgraduate education domains
Tim Dornan

Self-assessment of practice performance: Development of the ABIM Practice Improvement Module (PIMSM)
F. Daniel Duffy, Lorna A. Lynn, Halyna Didura, Brian Hess, Kelly Caverzagie, Louis Grosso, Rebecca A. Lipner, Eric S. Holmboe

ldquoDirectedrdquo self-assessment: Practice and feedback within a social context
Joan Sargeant, Karen Mann, Cees van der Vleuten, Job Metsemakers
A subscription to JCEHP (and online access) comes with membership in the Alliance for CME.

Ruling on access to JAMA peer review files

From the Wall Street Journal article:
In a court case pitting Pfizer Inc.'s corporate interests against a medical journal's confidential article-review process, a federal magistrate rejected Pfizer's attempt to gain access to documents of the Journal of the American Medical Association.
Click here to access (sub. req.).

Monday, March 24, 2008

Feds focusing on physicians

From the New York Times article:
A long-running federal investigation into the orthopedic device industry’s suspected kickback payments to hip and knee surgeons now has the doctors in the spotlight.

Having reached settlements with the five leading makers of artificial joints last year over the payments, the government has been focusing on the many doctors who receive money as the companies’ paid consultants.
Click here to access the NYT article.

Sunday, March 23, 2008

An excerpt from the New York Times article on this website:
But PatientsLikeMe seeks to go a mile deeper than health- information sites like WebMD or online support groups like Daily Strength. The members of PatientsLikeMe don’t just share their experiences anecdotally; they quantify them, breaking down their symptoms and treatments into hard data. They note what hurts, where and for how long. They list their drugs and dosages and score how well they alleviate their symptoms. All this gets compiled over time, aggregated and crunched into tidy bar graphs and progress curves by the software behind the site. And it’s all open for comparison and analysis. By telling so much, the members of PatientsLikeMe are creating a rich database of disease treatment and patient experience.
Click here to access the NYT article.

Friday, March 21, 2008

IOM committee looks into conflicts of interest

From the Medical Marketing & Media article:
Last week's meeting of an Institute of Medicine (IOM) committee gave some hope for a thaw in attitudes toward commercially supported CME, but supporters and providers remain anxious about the group's inquiry into conflicts of interest in medical research and medical education.
Click here to access the article.

NIH establishes new research center

From the New York Times article:
The Center for Genomics and Health Disparities will be led by Charles N. Rotimi, former director of the National Human Genome Center at Howard University.
“By understanding the nature of human genetic variation,” Dr. Rotimi said in an interview, “we can see how that overlaps with group identity and individual identity.
Click here to access the article.

Tuesday, March 18, 2008

Stark introduces new bill on gifts to physicians

From the Kaiser Daily Health Policy Report article:
Reps. Peter DeFazio (D-Ore.) and Pete Stark (D-Calif.) have introduced a bill (HR 5605) that would require pharmaceutical medical device companies to disclose to the public any gifts or payments to physicians valued at $25 or more, CQ HealthBeat reports.

The legislation is a companion to a bill (S 2029) sponsored by Sens. Chuck Grassley (R-Iowa) and Herb Kohl (D-Wis.) (CQ HealthBeat, 3/14). Under the bill, companies with at least $100 million in annual revenue would be required each quarter to disclose gifts or payments exceeding $25 in value, and the information would then be posted on a Web site.
Click here to read the article.

Monday, March 17, 2008

Senate Special Committee on Aging requests documents from Schering-Plough

Click here to access the press release. Click here to read the letter sent to Schering-Plough.

New book on pharma by former reporter

"Our Daily Meds" was recently reviewed by the New York Times -- an excerpt of that review:

“Our Daily Meds” begins by illustrating the established drug-company practices that have led to this sorry juncture. There is the rigging of studies, so that to be deemed “effective” a drug need only perform better than a sugar pill. There are the promotional strategies that evade the need for F.D.A. warnings by, say, planting logos for the sexual enhancement drug Viagra and the antidepressant Wellbutrin on Nascar vehicles. There is the co-option of doctors and university researchers by aggressive, payola-dispensing drug company representatives.

Ms. Petersen, who has done much of her digging with the help of obscure but gratifying corporate documents, even finds feedback from doctors about the bribe-style amenities offered by drug company junkets. (“Hotel too cold inside,” one said, in an evaluation of a June 1998 drug company program, adding, “Resort places preferred.” From a different doctor, miffed at the lack of a chauffeur at another event: “Hired car would have been much preferable.”

Click here to read the entire review.

Friday, March 14, 2008

A red face for the AAD?

From the MedPageToday article:
The American Academy of Dermatology is locked in a furor with a subset of its membership over whether to sell its name, prestige, and a special seal for endorsement of commercial sunscreens.

The imbroglio has an eerie similarity to the infamous Sunbeam logo-for-sale scandal that rocked the AMA a decade ago.

Click here to access the article.

Wednesday, March 12, 2008

What can CME providers do to promote safe medication practices?

Well, for one thing they can provide guidance to their CME faculty and give them the Institute for Safe Medication Practices' List of Error-Prone Abbreviations, Symbols, and Dose Designations! Click here to access this list.


Methinks Dr. Brewer over at the Wall Street Journal makes several important points today:
Patients present their doctors with undifferentiated problems, such as fever or trouble sleeping. Sometimes a common disease like a sore throat will present in a striking way. Or worse, a serious problem like lung cancer will present with a common symptom like a stubborn cough.

There's a steep penalty for being mistaken, however. An uncertain diagnosis often leads to expensive defensive medicine in the form of extra X-rays and lab tests. Tests like those can be a crutch. In my experience, they don't always help with diagnosis as much as a thorough medical history or physical exam.
Click here to access (sub. req.).

Tuesday, March 11, 2008

FDA may go further on anemia drugs

From the article:

The Food and Drug Administration has toughened warning labels on the anemia drugs -- Aranesp, Epogen and Procrit -- three times since last March, but now it is considering more drastic action. Amgen manufactures all three drugs, which treat the blood-disorder anemia in kidney-failure or chemotherapy patients, though New Brunswick, N.J.-based Johnson & Johnson sells Procrit.

In documents posted online Tuesday, regulators laid out several options for addressing safety risks, including withdrawing their use for chemotherapy patients.

Click here to access the article.

CT sues Lilly over Zyprexa

From the article:
Attorney General Richard Blumenthal, who announced the suit, is seeking to recover "millions of taxpayer and consumer dollars improperly spent on Zyprexa as a result of its illegal marketing, and millions more spent for treatment of serious side effects from Zyprexa," according to a press statement from his office.
In the lawsuit filed Tuesday, Lilly is accused of promoting Zyprexa for unapproved uses, including the treatment of children, and of hiding dangerous side effects, such as increased risk of diabetes, weight gain and heart problems.
Click here to access.

Senate hearing on academic detailing set

From the article:

“The drug industry’s educational outreach is essentially a marketing program, and evidence shows that doctors’ prescribing patterns can be heavily influenced by pharmaceutical sales representatives,” says the news release from the Senate Special Committee on Aging that announced the hearing...The hearing – Under the Influence: Can We Provide Doctors an Alternative to Biased Drug Reviews? – will be at 10:30 a.m., March 12, in Room 562 of the Dirksen Senate Office Building...The hearing will be Webcast and the link can be found at the committee webpage:

Click here to access the article.

Oregon Academy of FPs just says no to pharma

From the Register-Guard article:

The Oregon Academy of Family Physicians, representing 1,300 doctors around the state, announced last week that it would no longer accept financial support from the pharmaceutical industry, swearing off unrestricted grants for continuing education seminars, sponsorship of events or advertisements in its publications. But individual members can still see pharmaceutical reps at their discretion.

“This is about taking the institutional view that as a professional medical society, we are committed to decision-making that is based on scientific evidence,” said Kerry Gonzales, the group’s executive director. “We want to avoid even the perception of influence or impropriety.”

Click here to access the article.

One in four female teenagers have an STD!

From the New York Times article:

The first national study of common sexually transmitted diseases among teenage women has found that one in four are infected with at least one of the diseases, federal health officials reported on Tuesday.

Nearly half of African-American teenage women were infected with at least one of the diseases monitored in the study — human papillomavirus (H.P.V.), chlamydia, herpes simplex type 2 and trichomoniasis, a common parasite.

That figure compared with 20 percent of white teenage women.

Click here to access the NYT article.

Sunday, March 09, 2008

It's a small, small, small world?

From the article:
At least one pharmaceutical was detected in tests of treated drinking water supplies for 24 major metropolitan areas, according to an Associated Press survey of 62 major water providers and data obtained from independent researchers.
Click here to access the article.

Check out Dr. Carlat's blog posting on the two recent journal articles on industry-supported CME

Click here.

Expert witness testifies on Lilly drug

From the New York Times article:
Eli Lilly, the drug maker, could and should have warned physicians as early as 1998 about the link between Zyprexa, its best-selling schiophrenia medicine, and diabetes, an expert witness told jurors Friday in a lawsuit that claims that Zyprexa has caused many mentally ill people to develop diabetes.

Instead, Lilly hid Zyprexa’s risks from doctors to protect the drug’s sales, according to the witness, Dr. John Gueriguian. Lilly waited until 2007 to add strong warnings to Zyprexa’s label to reflect the drug’s tendency to cause severe weight gain and blood sugar changes.


A lawyer for Lilly said after Dr. Gueriguian’s testimony that the company had shared all it knew with the F.D.A. and that the question of the link between Zyprexa and diabetes was still a subject of scientific debate.

Click here to access the NYT article.

Wednesday, March 05, 2008

Prescription drug costs rise for seniors

From the Washington Post article:

Drugmakers increased prices by an average of 7.4 percent last year for the brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP.

The increase far exceeded inflation, continuing a longtime trend.


The trade group representing drugmakers, the Pharmaceutical Research and Manufacturers of America, said AARP's numbers reflect neither the true amounts consumers pay for medicine nor a slowing in the growth of drug prices when taking into account generics.

Click here to access.

Hospitals and drug errors

From the Wall Street Journal article:
Hospitals are taking steps to prevent errors in the use of so-called high-alert medications -- those that, when given in the wrong dose or used incorrectly, have the highest risk of seriously harming or even killing a patient.
While there are 19 categories of high-alert medications, according to the Institute for Safe Medication Practices, studies show that about eight medications, including heparin, account for 31% of all medication errors that harm patients.
Click here to access (sub. req.).

Monday, March 03, 2008

Will MA ban industry gifts to physicians?

Maybe -- from the Boston Globe article:

Senate President Therese Murray proposed today a broad measure to control healthcare costs by in part banning all gifts and freebies to doctors from drug companies, saying the perks have helped drive up costs for consumers.

If adopted, the legislation would make Massachusetts the first state in the country to place an outright ban on drug-industry gifts. Prohibited gifts would include any payments, entertainment, meals, travel, honoraria, subscriptions -- and even a pen bearing a drug company logo. Companies would be forbidden from offering the gifts and doctors, their families and employees would be forbidden from accepting them.

Under the proposal, anyone who violates the ban could be fined $5,000, face two years imprisonment or both.
Click here to access the BG article.

"the Jarvik episode"

Check out the New York Times article "Drug Pitchman: Actor, Doctor or Pfizer's Option" by Doctor Zuger; an excerpt:
Years ago, a large poster featuring an appealingly sweaty and smiling young man climbing a mountain appeared in my subway station, directly across from my usual waiting spot. Purportedly he had been invigorated by one of the first AIDS drugs marketed directly to the public. He looked magnificent on top of his mountain, a lot better than my AIDS patients — a lot better than me.
Click here to access.

Sunday, March 02, 2008

The heart of a champion

From the New York Times article:

The high school wrestling career of Dustin Carter ended Friday in defeat but with an ovation from the crowd at the Schottenstein Center in Columbus, Ohio.

Carter, who had an acute bacterial infection in his bloodstream at age 5 and had parts of all of his limbs amputated, battled his way into Ohio’s Division II wrestling tournament as a 103-pound senior for Hillsboro High School.


“I told him, ‘Dusty, you went way beyond your expectations,’ ” Russ Carter said by telephone. “ ‘With everything you did, you inspired people out there.’ ”

I've categorized this as "Off topic," but is it really? Click here to access the article.

Saturday, March 01, 2008

Rise in nursery product injuries

From the Wall Street Journal article:

Nursery products were involved in 66,400 injuries that sent children to emergency rooms in 2006, an 11% increase from the year earlier, according to the Consumer Product Safety Commission.

The agency said in a report yesterday that the number of injuries to infants and children under age five involving cribs, high chairs, walkers and other items rose by 6,600 from 59,800 in 2005.

Click here to access the article (sub. req.).

The China syndrome?

From the Wall Street Journal article:

The Food and Drug Administration needs more inspectors and a comprehensive computer database to better track products entering the U.S. from foreign sources, a top drug-safety official told lawmakers.

Click here to access (sub. req.).

FDA Public Health Update

Recall of Heparin Sodium Injection and Heparin Lock Flush Solution (Baxter)