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Old 09-13-2014, 01:33 AM   #21
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Physicians make decisions and recommendations based on information available at the time. I would like to know what evidence was available at the time your DW started taking the drug, and when the opposing evidence came to light. You may wish to do a literature search.

If my doctor recommended an expensive drug (or anything unusual) my first step would be to find out as much as possible about the risks, benefits and costs, so I could make an informed decision.
But from reading your posts, I suspect you are in a better position than most of us to make that decision based on the results of your research? Don't some of us have to trust professionals (as long as they aren't "financial advisors")?
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Old 09-13-2014, 07:03 AM   #22
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But from reading your posts, I suspect you are in a better position than most of us to make that decision based on the results of your research? Don't some of us have to trust professionals (as long as they aren't "financial advisors")?
There's a lot on the internet now. Medicine isn't an exact science and no two bodies are alike. My Dad has been on statins for decades with no side effects. After 6 months I had tendonitis. In addition to the commercial stuff put out by the manufacturers and the materials put out by the scientific community that may be harder to follow, there are plenty of other resources. I like HealthBoards for experiences from real people on just about anything. There are also chat boards for people with specific conditions. DH has learned a lot (and shared a lot of info) on one for a condition he has that's so rare that most docs see only a few cases in their careers. Thanks to the internet, he was able to track down a doc who was an expert in these cases and was able to fly to Maryland to meet with him at Johns Hopkins. It helped a lot when we were at a major decision point on medications.

As I said earlier- in the end, it's your body and your money. The doctor is only an expert consultant.
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Old 09-13-2014, 10:15 AM   #23
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But from reading your posts, I suspect you are in a better position than most of us to make that decision based on the results of your research? Don't some of us have to trust professionals (as long as they aren't "financial advisors")?
I am a physician, but I don't trust physicians.
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Old 09-13-2014, 10:53 AM   #24
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I am a physician, but I don't trust physicians.
It sounds as if you don't much trust physicians as a group. But, how about your own physicians--how much do you trust them?
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Old 09-13-2014, 10:56 AM   #25
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It sounds as if you don't much trust physicians as a group. But, how about your own physicians--how much do you trust them?
I don't.
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Old 09-13-2014, 11:00 AM   #26
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I am a physician, but I don't trust physicians.

I have many family and friends who are physicians and they routinely say that other doctors have no idea what they are doing. I thought at first it was just bravado. However, my wife worked in an academic orthopedic surgery department. She had an MRI on her knee and the radiologist said she had arthritis. The doctors she talked in her department said she didn't have arthritis and that they just ignore the radiologist report because they are usually wrong.


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Old 09-13-2014, 11:11 AM   #27
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I don't blindly trust doctors either. I never did, but it got more pronounced when DW worked at a hospital. Think back to the people you knew in college who went to med school. Smart, driven, but usually just as screwed up as everybody else. Nothing happens in med school or residency to turn them into infallible icons. Most of them just do the best they can. I consider my doctor the same way I consider my car mechanic. A highly trained consultant who's opinion I should pay attention to. But any decision making is mine, and I don't like to make decisions without researching the situation myself.
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Old 09-13-2014, 11:15 AM   #28
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Do you have any idea how illegal this is? Really? I can't give a doctor a pen - and I'm talking a plain Bic ballpoint - without breaking a law. This kind of behavior did take place at one time, but the federal government has been cracking down on it severely, and I don't know any salesperson that winks at it. They take it very seriously.
Well, that's good, and no, I didn't know the gov't crackdown had actually changed things. My experience with a pharma sales woman and DWs hospital was from 30 years ago, and it was very similar to the relationship with the music industry and DJs. Lots of baksheesh, wink wink nudge nudge. Glad to hear that things are improving.
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Old 09-13-2014, 11:17 AM   #29
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I don't blindly trust doctors either. I never did, but it got more pronounced when DW worked at a hospital. Think back to the people you knew in college who went to med school. Smart, driven, but usually just as screwed up as everybody else. Nothing happens in med school or residency to turn them into infallible icons. Most of them just do the best they can. I consider my doctor the same way I consider my car mechanic. A highly trained consultant who's opinion I should pay attention to. But any decision making is mine, and I don't like to make decisions without researching the situation myself.
+1
Well put, harley.
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Old 09-13-2014, 04:18 PM   #30
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Do you have any idea how illegal this is? Really? I can't give a doctor a pen - and I'm talking a plain Bic ballpoint - without breaking a law. This kind of behavior did take place at one time, but the federal government has been cracking down on it severely, and I don't know any salesperson that winks at it. They take it very seriously.
In the US, pharmaceutical companies make billions of dollars of payments to physicians. This may be for giving promotional talks or research grants, etc.

ProPublica has done some very good reporting on this. They have a database where you can search for payments by state and doctor name:

Dollars for Docs - ProPublica

Some categories of expenses include: consulting, meals, travel, research, speaking, etc. The payments can be quite substantial.

The pharmaceutical companies can also track how much of their drug (and their competitors drugs) each doctor is prescribing (i.e. they know who to target for marketing).

More stories on their dollars-for-docs series can be found here:

Dollars for Doctors - ProPublica

I haven't looked at this in some time so there may have been some rule changes as to what's legal but it still seems like a common practice.

Here are some more specific examples of doctor payments from Dollars for Docs Mints a Millionaire - ProPublica

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During the last four years, the 47-year-old Draud has earned more than $1 million for delivering promotional talks and consulting for seven drug companies.
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Draud is not the only high earner: 21 other doctors have made more than $500,000 since 2009 giving talks and consulting for drugmakers, the database shows. And half of the top earners are from a single specialty: psychiatry.
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Maletic said he uses company-prepared presentations because they are required to ensure compliance with federal rules.
Note: the dollars for docs database only has a subset of payments and is not complete.
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Old 09-15-2014, 10:24 AM   #31
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In the US, pharmaceutical companies make billions of dollars of payments to physicians. This may be for giving promotional talks or research grants, etc.

ProPublica has done some very good reporting on this. They have a database where you can search for payments by state and doctor name:

Dollars for Docs - ProPublica

Some categories of expenses include: consulting, meals, travel, research, speaking, etc. The payments can be quite substantial.

The pharmaceutical companies can also track how much of their drug (and their competitors drugs) each doctor is prescribing (i.e. they know who to target for marketing).

More stories on their dollars-for-docs series can be found here:

Dollars for Doctors - ProPublica

I haven't looked at this in some time so there may have been some rule changes as to what's legal but it still seems like a common practice.

Here are some more specific examples of doctor payments from Dollars for Docs Mints a Millionaire - ProPublica







Note: the dollars for docs database only has a subset of payments and is not complete.
So handing the doc a Bic pen is illegal, but handing the doc a pharma produced Powerpoint, flying the doc to Hawaii, paying expenses, and all the doc needs to do is click the mouse and read the slides...THAT is legal?
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Old 09-15-2014, 01:42 PM   #32
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As far as I know the payments are completely legal as long as it doesn't cross the line into an explicit kickback (however US DOJ has gone after companies for this). In fact they appear to be standard operating procedure.

I don't know about an unsolicited bic pen -- perhaps this is not okay since it is a straightforward gift and doesn't fall under the umbrella of consulting/employment.

This is somewhat mind boggling to me that any professional group would tolerate this level of conflict of interest.
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Old 09-16-2014, 08:01 AM   #33
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This is somewhat mind boggling to me that any professional group would tolerate this level of conflict of interest.
Yeah, this kind of unethical behavior should be limited to unprofessional groups like politicians.

I think they should add a category to the "Best Places to Live" articles that measures how many state and local politicians have been convicted in the past, say, 25 years. It would leave anywhere in IL, NY, or LA out, and VA would be rapidly dropping down the ranks. DC never makes it on the lists anyway.
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Old 09-16-2014, 10:32 AM   #34
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.............I think they should add a category to the "Best Places to Live" articles that measures how many state and local politicians have been convicted in the past, say, 25 years..............
I agree, best to live somewhere where the politicians are corrupt, but never even indicted.
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Old 09-17-2014, 09:38 AM   #35
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I agree, best to live somewhere where the politicians are corrupt, but never even indicted.
Yep, stick with the smart ones.
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