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Doctors, Voicing Concerns, And Fear Of Retaliation

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Shouldn’t it be possible to voice a concern about a medical treatment, procedure, or claim without the fear of retaliation? If the claims are backed by science, then simply addressing my concerns would be enough.

Fear of retaliation silences discussion. Fear of retaliation makes it difficult to do the “right thing” when the public or an individual patient is at risk.

This incidence involves a British plastic surgeon threatened with libel action by the ‘Boob Job’ cream’s manufacturer after she voiced concerns/doubts of its effectiveness. Sense About Science has a great summary of the entire affair: “Plastic surgeon threatened for comment on ‘Boob Job’ cream.” Read more »

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

Is The Young Pharmaceutical Rep Right?

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I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety, generic medicine-only doctor.** Sadly, my status changed today. Dabigatran (brand name Pradaxa) was the culprit.

It was a little nerve racking. I wrote the order, looked at it, thought it out again, talking to myself: “John, are you sure you don’t want to do it the old way? [pause to think] No, I am embracing the new.”  And then, I closed the chart and handed it to the nurse.

“What’s that? Pradaxa?” asked the nurse. “Stop the Lovenox? You sure?” My face must have told the story.

Eight days had passed since dabigatran’s approval. “That’s plenty of time to mourn warfarin’s demise,” I thought. Enough studies, enough blogs — it was time for the rubber to hit the road. Read more »

*This blog post was originally published at Dr John M*

A Two-Biscotti Physician

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[Recently] I ate at one of my favorite Italian restaurants. I had eaten there many times before, but the experience this time was different. After ordering, I received a vacuous bread basket with precisely two pieces of bread. At the end of my meal I was offered two biscotti — and no more. Only the manager could offer an explanation: As a means of containing costs, the decision had been made to capitate bread and biscotti distribution.

I was disappointed. I had been eating here for years. When Colic Solved was released, my publication party was held here. After all those anniversaries, New Year’s celebrations, and birthdays, I’m shortchanged on cookies? It’s remarkable how a great experience can be shadowed by something so small.

Then I got to thinking: Perhaps I’m a two-biscotti physician. Like this restaurant, there are times when I don’t finish well. I may do a phenomenal job with assessment and diagnosis, only to delay a callback on biopsies or X-ray results. Perhaps I get it all right, but fail to get the detail right on the home health orders. Are there small pieces missing in my encounter that represent everything a parent remembers? I know that there are, and I know there are things I have to work on.

There’s a lot we can learn from a restaurant. I don’t want to be a two-biscotti physician.

*This blog post was originally published at 33 Charts*

More Doctors Are Refusing Industry Perks And Gifts

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Christmas present by the Italian voice via FlickrPhysicians and particularly primary care doctors are reporting fewer industry ties than five years ago, according to a survey.

While 94% of doctors reported some type of perk from a drug or device maker in 2004, 83.8% did in 2009, researchers reported in the Nov. 8 Archives of Internal Medicine.

Researchers surveyed a stratified random sample of 2,938 primary care physicians (internal medicine, family practice, and pediatrics) and specialists (cardiology, general surgery, psychiatry and anesthesiology) with a 64.4% response rate. Read more »

*This blog post was originally published at ACP Internist*

Stem Cell Researchers Turn Skin Into Blood: Could Help Cancer Treatment

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From The Australian:

Stem cell researchers have found a way to turn a person’s skin into blood, a process that could be used to treat cancer and other ailments, according to a Canadian study published today.

The method uses cells from a patch of a person’s skin and transforms it into blood that is a genetic match, without using human embryonic stem cells, said the study in the journal Nature.

Wow. Very cool. I wonder if hopefully someday this could be a replacement for random blood donation?

*This blog post was originally published at GruntDoc*

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