Tuesday, January 13, 2009

Series on U-Wisc. Docs on the Take: Milwaukee Journal-Sentinel Series

Check out:


This two-part series (plus several sidebar stories) by John Fauber of the Milwaukee Journal-Sentinel contains no surprises for us hardened old-timers, but it is a generally good survey of the shenanighans of academic physicians taking company bribes as "key opinion leaders." The notable feature is the background indication of the changing times-- there are more physicians willing to speak out against these practices, and the deans of both Wisconsin med schools are quoted as saying they favor stricter policies to outlaw such practices as company speakers' bureaus. (This may or may not have to do with the Wisconsin Medical Society's notably terse and forthright stance on just-say-no to drug company money:


I feel the need to point out one flaw in this otherwise well-done series of articles. The writer mentions in several places that the drugs these docs are shilling for have dangerous side effects. For instance, the danger of tendon rupture with fluoroquinalone antibiotics is mentioned. Now, the possibility that company over-promotion will cause harm to patients via incrased adverse reactions is a legitimate point. But the hint in the articles seems to be that a physician should never advocate the use of a drug that has any dangerous side effects, which of course is nonsense, as many of these drugs have legitimate uses for which the benefits clearly outweigh the risks. For that matter, as the writer did not know the content of any of these talks, how could he be sure that the speakers did not in fact spend all their time warning the audience about dangerous side effects of the drugs? (Since the company paid for the talks and approved the speakers' slides, we can hazard a shrewd guess that side effects were not emphasized; but I take it that journalists ought to deal with facts and not shrewd guesses.)

The unprofessional behavior of academic docs acting as shills for drug company marketers is sufficiently blantant as it is--there is no need for undue piling on.

1 comment:

Anonymous said...

"The unprofessional behavior of academic docs acting as shills for drug company marketers is sufficiently blantant as it is--there is no need for undue piling on."

You have an uninformed and narrow minded view of this topic and show how little you know.

Lets talk about the Infectious disease MD from UW mentioned in the article who has done multiple talks, one of those you say "shills" for the drug company.

Because of overuse of antibiotics, various forms of resistance occur. It then becomes necessary to develop new ones as older generic versions become ineffective.
Primary Care docs have the impossible job of determining the correct sequence to use these medications so as to not use the big guns too early, or not at all based on the bug they are trying to treat. They often make mistakes, using highly potent drugs too early, potentially making them innefective as resistance to them can happen.

Dr. Cox from UW should be doing exactly what he is doing. Community physicians have an idea as to the prevalance of various bugs in their institution. Educational talks on new agents usually involve how to correctly integrate new agents into treatment regimens so as to not over utilize them.

The reason he is the correct person to do this is these primary care physicians are the very physicians calling him with a resistant patient because they screwed up when they initially treated the patient and now HE has to manage it.

The bigger issue , though, is you, you moron. By calling a highly respected physician a name shows how little you really do know. You show that you do not understand the complexity of care. Have you ever been treated in an ICU? Why don't you strap on a set and put in your advance directives that you only want cheap generic drugs if you ever have a complex disease? It is people like you that take pot shots, but cry to mama.

You're a moron!