$20 billA primary care physician in the United States receives an average, total, annual compensation of roughly $195,000, and likely will take in more than $6.5 million over a lifetime of practice. Ask most Americans and that’s a respectable, and deserved, income.

Which makes it all the more eyebrow-raising that a leading journal,  JAMA Internal Medicine, published a study that finds that Big Pharma can sway doctors’ drug prescribing practices for about the cost of a large pizza and a few sodas, roughly $20.

Just to be clear, this scrutiny involved more than 275,000 MDs, and more than 65,000 payments over four medications. The research doesn’t purport to demonstrate cause-and-effect but shows a troubling correlation.

British experts predict the exit from the EU will be bad for Britons’ health.

Brexit advocates, in fact, celebrated their win by immediately conceding a giant campaign falsehood: They suddenly denied claiming that almost a half-billion dollars wrongly was going to the EU, and that these sums would, post Brexit, help to support the embattled British National Health Service. That claim, analysts said, had been crucial in persuading many voters to back Brexit. But a leader of the exit movement said in a televised interview that the assertion “was a mistake,” adding, “No, I can’t, and I would never, make that claim. And it was one of the mistakes I believe that the Leave campaign made.”

nntModern medicine can get mired in a lot of mumbo jumbo, so much so that it gets daunting for patients and consumers to try to understand something simple but critical: How effective is a therapy that my doctor wants me to have?

Because I’ve written before about the virtue in a clear and decisive figure, the Number Needed to Treat (NNT), I was delighted to see that Stat, the online health news site, has published a piece headlined, “What are the odds your medication will help you get better?”

The article explains that the NNT answers the question:

FDA logoCongressional overseers of the federal agency that regulates drugs and medical devices have gotten red-flag warnings about problems at the Food and Drug Administration, including: two separate calls for improvements from lawmakers’ top watchdog; and an eyebrow-raising corruption case brought against an agency official by U.S. prosecutors and securities enforcement authorities.

As Stat, the health news site, has reported, the Government Accountability Office has criticized the FDA in reports, saying the regulatory agency has failed to plan how it will keep up with rapid advancements in medical science. Stat observes of the studies by GAO, Congress’ watchdog:

One report notes that the FDA lacks goals, targets, and time frames for keeping up with scientific advances—and also fails to track the money it spends on these efforts. The other finds fault with the FDA’s strategic plan, which is supposed to speed approvals of drugs and devices, especially combination medical products, such as heart stents that also deliver blood thinners to prevent clots.

big_sodaThe City of Brotherly Love has passed a tax demonstrating its affection for new revenues and its dislike for unhealthy, sugary soft drinks: It’s unclear, however, whether other governments will follow Philadelphia in imposing soda taxes and whether these levies achieve their public health goal of discouraging harmful sugar consumption, especially by kids.

Big Soda and its allies, grocers and labor unions, fought tooth and nail the city’s 1.5-cent per ounce soda tax, airing $700,000 in opposition commercials and spending an estimated $5 million to persuade officials in a notably poor city to be like 40 other municipal or state governments in rejecting what opponents attacked as a Big Brother levy.

In the end, Philadelphia’s craving for cash for its coffers, as much as any potential health benefits for young folks in town, carried the day. City officials stressed, for example, that the soda tax could fund pre-kindergarten education and other programs. As the New York Times describes it:

As the world mourns the death of Muhammad Ali, this remarkable public and sporting figure left two more key lessons as part of his legacy:

ormc_tower_00a_1024_web300x600wHere’s hoping that the mass shooting in Orlando will focus attention on some health care issues that the event flushed into open view:

bloodGay activists and others have denounced anew these restrictions. They say these rules unnecessarily stigmatize members of their community, who were bitterly reminded of them when donors sought to assist the many wounded in the Orlando gay club.

tarcevaFederal prosecutors have wrung $67 million in a settlement with two pharmaceutical companies accused of deceiving doctors to prescribe a drug that the firms knew would be ineffective in treating lung cancer patients. Genentech and OSI Pharmaceuticals pushed the drug Tarceva for non-small-cell lung cancer, “even though studies had shown that it worked for just those who had never smoked or had a certain gene mutation,” the Los Angeles Times says.

The paper and prosecutors described the sleazy promotion of Tarceva, which was disclosed in a lawsuit filed against Genentech by a former employee. He will receive a $10 million payment under federal whistleblower laws. His lawsuit asserted that the companies wrongly hawked Tarceva by:

Giving doctors illegal kickbacks disguised as fees for making speeches or serving on Genentech’s advisory boards. Sales representatives across the country were ‘instructed to spend lavishly’ on physicians, the case said, and given ‘an unlimited budget to wine and dine.’ Genentech also organized lunches or dinners for lung cancer patients where ‘patient ambassadors’ were paid fees to speak about how Tarceva could be used in ways never approved by regulators.

mergerFew states are monitoring, much less acting to protect, patient-consumers from one of the hot trends in today’s health care: the mergers, acquisitions, consolidations─and yes, closings─that are creating super-sized hospital organizations, chain-institutions that for business reasons seek greater efficiencies but also may be lessening access to care, sometimes as a result of religious reasons.

That’s the contention of a group called mergerwatch.org, which arose from a group of New York state family planning advocates who reacted when two hospitals, one Catholic and the other secular, merged, and reproductive services became a contentious issue in the new institution.

The group since has scrutinized hospital mergers, consolidations, and closings nationally, issuing a new study from its “When Hospitals Merge” project─an initiative that has been foundation supported and has published in peer-reviewed, respected medical journals like the AMA Journal of Ethics.

339-CloseupWeighBeamHuman failings vex doctors, too, and their biases against the overweight, especially women, may be detrimental to quality of  care. White practitioners also may benefit from racial bias, earning significantly more than their colleagues of color.

Stat, the online health news site, delves into the less discussed issue of physicians’ prejudice against patients who are heavy, if not obese, resulting, as one clinician says, in “inadequate health care, and preventative advice, and counseling, and support, and treatment—because the focus is on weight instead of managing risk factors.”

Doctors, like patients themselves, may be perplexed and frustrated that some patients carry lots of pounds and can’t seem to shed them, adding to an array of proven health issues, including heart, lung, liver, and kidney problems, as well as diseases like diabetes and cancer.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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