What I'm Reading (May 12)

The media is constantly reporting on conflicts of interest in medical research. As a result, the only time we hear from academicians involved in this work is when they are “back on the heels,” defending their behavior. MedPage Today offers the voice of someone who has actually performed important pivotal trials.

“I want to be clear: Nothing in this essay should be construed as implying industry is evil. The positive role industry plays in improving and extending human health is enormous. We need industry to develop new drugs, and we need the sponsor's funding to test the efficacy and safety of these products. Furthermore, we cannot ask or expect industry to abandon its pursuit of self-interest. In fact, for a publicly traded company, vigorous pursuit of self-interest is a legally binding fiduciary responsibility. Yet, depending on the company, the promotion of self-interest may not be subtle.”

Milton Packer writes on, Are Academic Collaborators Just Useful Pawns to Industry?

There is no doubt that keeping an exposed patient warm in a cold operating room is beneficial to the patient’s outcome. In the tradeoff between the comfort of those at the operating table and the individual lying on the table, we have for many years draped the patient in a special blanket, a Bair Hugger, which flows warm air across their body and helps maintain core temperature. And now this,

“A friend and long-time patient recently told me that my ability to use this invaluable device is being threatened by a lawsuit suit brought by none other than the inventor of the Bair Hugger, who now claims his invention causes infections.

Why would the inventor turn around and claim his invention endangers patients? It turns out that Dr. Scott Augustine, who invented the blanket, pled guilty to Medicare Fraud and had to give up his rights to the Bair Hugger. He then invented a competing device, only to find that the healthcare industry was perfectly satisfied with his original invention and had no plans to switch.”

Dr. David Higgins, the author of Trial Lawyers Inc. vs. Patient Care, asks the right question. How do the Courts and trial lawyers get to practice medicine?

There is no doubt in my mind, or in the medical literature, that having a consistent, established relationship with a doctor yields better health outcomes for you as a patient. When I was clinically active, it was far easier to find or recommend a physician. As a retired clinician and a civilian in the healthcare ecosystem, I have to rely on word of mouth from friends. (Of course, many of my friends are still in the ecosystem and able to help) But how do you identify your physician BFF? Dr. Peter Attia offers his council, How to find a good doctor. I would disagree with several of the questions he poses because I do not think they are germane and because I do not believe the answer will be especially informative to the typical person seeking a long-term relationship with a physician. But it is a start.

“Look, I get it. Some ads are just icky, especially for supplements for everything from memory to testosterone. (Yes, I’m looking at you, Mayim Bialik, “actual neuroscientist.”) Their claims, as the makers are always quick to tell you, “have not been evaluated by the Food and Drug Administration” and “are not intended to diagnose, treat, cure, or prevent any disease.” I see all the worst ads because I’m a night owl and occasional insomniac. I fully understand that at 3 a.m., there will be ads for prostate cures, or for drug and alcohol rehab, or—duh—over-the-counter sleep medications. Why else would you be watching Mannix in the wee hours unless you had to pee, were on a bender, or were suffering from a sleep disorder?”

 

Medical ads are a plague upon us. Tom Nichols, promising to go full Andy Rooney, shares his views in this column from The Atlantic, Pharmaceutical Ads Give Me Hives Hilarious and true at the same time.