Articles Posted in Conflicts of Interest

Doctors who sexually abuse their patients too often get away with it because of weak oversight, sympathetic regulators, and their capacity to move around to elude punishment, a new investigation has found.

The Atlanta Journal Constitution says it spent months, scrutinized more than 100,000 medical board disciplinary orders from across the nation, and found too many disturbing instances where perverse physicians harmed patients but escaped punishment or received only a slap on the wrist.

Stacks_of_moneyBig Pharma is not just  whistling Dixie, as Southern, for-profit hospitals lead the nation in rolling out the welcome mat so doctors can take meals, consulting, and promotional payments from drug and medical device companies, an investigation shows.

Pro Publica, the Pulitzer Prize-winning investigative site, has put up its latest findings from its multi-year tracking of which doctors at which hospitals across the country report, as they are legally required to, to federal authorities that they have taken the blandishments of Big Pharma or medical device-makers.

Docs scooped in the most green from these providers in the Garden State: Pro Publica found almost 8 in 10 MDs in New Jersey−where many in Big Pharma have their headquarters−took such pay in 2014. Almost 8 in 10 physicians in Louisiana, Mississippi, Florida, South Carolina and Alabama took the money.

$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.

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.

NFL-vector-logosWhat’s $30 million among friends? When the National Football League offered in 2012 to provide that sum to support concussion research by the National Institutes of Health, the conventional wisdom held that the sports powerhouse was finally coming around. The league basked in public praise for taking a more progressive approach to its challenges with deadly, debilitating head injuries.

But a congressional panel has found the NFL’s magnanimity was a sham. Instead, pro football sought to strip $16 million of its funding from the NIH when the agency wanted to bring in Dr. Robert Stern, a Boston University researcher who has been a major critic of the league.

The NFL, instead, tried to lateral its gift to members of its own committee on brain injuries.  As for these “experts,” the New York Times reports:

nihclincenterFederal officials have decided to sweep out the executive ranks at the flagship hospital of the National Institutes of Health in Bethesda, this after a blue-chip investigating committee rebuked the institution and declared that research concerns there had wrongly taken precedence over patient safety.

Initial reports about the NIH Clinical Center, as I wrote recently, had suggested that systemic changes were required at the venerated and sprawling facility, particularly after disturbing reports surfaced about neglect and unsanitary conditions in its pharmacy operations. Officials first spoke just of creating a new, external oversight body, and an office to monitor quality and safety concerns.

But, as the Washington Post since has reported, the NIH’s chief has decided to “replace the hospital’s longtime leadership with a new management team with experience in oversight and patient safety, similar to the top structure of most hospitals. He is recruiting for three new positions: a chief executive, a chief operating officer and a chief medical officer. … [He] wants all three to be physicians, and he wants them in place by the end of the year.”

oxycontinOxyContin in two decades not only has become a highly profitable, exceedingly popular prescription, it also has become one of the nation’s most abused painkillers─for a crucial reason, the Los Angeles Times says. The paper investigated and found that the drug’s maker wrongly has promoted the medication as having a 12-hour effectiveness─twice that of generic medications.

That isn’t so. It wears off for many much sooner, leaving them with intense cravings and excruciating withdrawal symptoms. This leads to addictive abuse of the drug, the paper says.  The Times reports:

More than half of long-term OxyContin users are on doses that public health officials consider dangerously high. … Over the last 20 years, more than 7 million Americans have abused OxyContin, [which] is widely blamed for setting off the nation’s prescription opioid epidemic, which has claimed more than 190,000 lives from overdoses involving OxyContin and other painkillers since 1999.

eisenCaulfieldpaltrowHype and health misinformation is a metastasizing aspect of our age, in which technology both increases the public’s access to varying points of view─and, to put it kindly, the great gullibility of all too many. Which is why it’s also heartening to see skeptics also are out there to question the widespread humbug.

Look, for example, at what may be one of the most-read health information websites around, WebMD. Yes, it provides some good information. It also seems to be one of the high temples for cyber practitioners of clickbait-ing, offering headlines in recent days such as: Could you be allergic to kissing? 6 ways to fix eggs. Does getting older have to a drag? And Is it OK to drink your pee?

There’s a good reason for the site, of course, to provide provocative teases, upping its online traffic and boosting its appeal to advertisers. Like who? Try Big Pharma for millions of dollars in ads. As the website Vox reports, WebMD also has raised eyebrows by the way it places Big Pharma pitches with content that (hypochondriacal) readers see when they seek information about certain health conditions. Caveat emptor, use caution and common sense when consuming health related information, as I have written before.

ny-med-premiereHospital patients who are dying or in extreme duress should not have their privacy exploited by reality television camera shows, federal health care regulators now have made clear. They have just settled with a noted New York hospital on $2.2 million in penalties and fines for its role in cooperating with a celebrity doctor whose crews recorded for broadcast the last throes of a an elderly Manhattan resident fatally injured when hit by a garbage truck.

The dead patient’s family complained that neither he nor they gave the hospital permission to film during his unsuccessful emergency treatment. Further, they said repeated broadcasts of the reality TV show “New York Med,” headlined by Mehmet Oz (the heart surgeon-cum-TV show celebrity known as “Dr. Oz”), caused them great pain and distress, as well as invading their and their loved one’s privacy.

Federal authorities, who oversee patient privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), finally agreed with the family years after they filed complaints, posting online this stance about patients’ protected health information (PHI):

zapSome recent health headlines have made stories sound so enticing they’re hard to resist:  Are there genetic superheroes walking among us who can provide invaluable clues to preventing deadly diseases? What’s the secret of a big, long lost research study and could it have changed contemporary views on the risks of dietary fat? Should many older Americans who take statins, one of the most commonly prescribed medications, give them up in favor of a more costly therapy? And is there really a dazzling new way to test the blood for health markers?

Skeptics to the front, please. Somehow some very good, very savvy folks, again, are pushing health-related information that needs careful scrutiny or outright howls of complaint. I’ve written about the problems with health care information, and it gives me no pleasure to detail this quartet:

Superhero hype

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