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Conflicts Of Interest Within Clinical Trials Can Jeopardize The Participants

Follow the money.

Earlier this week, I blogged about the growing economic relationships and even mutual dependency between medical device manufactures and physicians, citing a pre-emptive strike against an Institute of Medicine report that recommended closer regulation of medical devices before and after they enter the market. Such ties, though, are only one part of a broader medical-industrial complex that has enormous impact on public policy in the United States.

A 2009 White Paper by the Seton Hall’s Center for Health & Pharmaceutical Law & Policy reported that “ drug and medical device companies fund up to 80% to 90% of all clinical trials; in 2005, and that by 2004, three-quarters of all of the clinical trials paid for by industry were in private physician practices or for-profit research centers.” The paper’s authors argue that such trials “create potential conflicts of interest that possibly jeopardize the rights and well-being of research participants as well as the integrity of research results” and that “the goal for public policy should be to structure physician-investigator payment to achieve financial neutrality between treatment and research.”

A recent web posting by a medical billing company unabashedly crows about the extra income doctors can make from clinical trials. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Patient Stories About Hair Loss

The New York Times has a series called “Patient Voices” which gives insights from the patients with the disease, physical and emotional changes in their lives, and accommodations made. The most recent series is on patients with alopecia (hair loss).

“The Voices of Alopecia” by Tara Parker-Pope (July 6, 2010):

This week, Patient Voices explores alopecia, an autoimmune disease that leads to a few bald patches to the loss of every hair on a person’s body.

To hear what it’s like to live with alopecia, listen to the Patient Voices audio slideshow that features adults, children and their parents who are coping with the condition.

Listen to these seven people tell what it’s like to live with alopecia:

- Matt Kelly, 43, lost his hair at age 38 over a 6 week time span.

- Jennifer DeFreece, 29, developed alopecia totalis as a child.

- Margaret Staib, 42, an artist with three daughters.

- Rafi Wasselman, 16, says his best medicine is his collection of caps.

- Maureen McGettigan, 47, began losing her hair at age 16.

- Annie Kazmi, 33, tells her daughter Noori’s story. Then Noori tells her own. Read more »

*This blog post was originally published at Suture for a Living*

Medical Schools: Why Do Some Do Primary Care Better?

A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities.

- “Public schools graduate higher proportions of primary care physicians” than private schools.

- “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent of the American College of Physicians.)

- “The level of NIH support that medical schools received was inversely associated with their output of primary care physicians and physicians practicing in underserved areas.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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