July 9th, 2011 by admin in Opinion
Tags: Big Pharma, Commentary, ePocrates, Ethics, Free Medical Apps, Influence, Medscape, Pharma, Pharma Marketing, Pharmaceuticals, Smart Phone Apps, Who Pays?
1 Comment »
The medical app industry is a big business, but the apps are no longer the product – the physicians, nurses, and other healthcare providers who use them are. In the first part of this series, we examined some of the financial forces driving the medical app industry. Our focus then was Epocrates, the veritable founder of the industry. As is clearly stated in their recent SEC statement, Epocrates primary revenue stream has become the pharmaceutical industry and as such a key goal has become to further grow their user base by enhancing their free offerings.
Now, one might be tempted to say that this is just one company or even that it is just limited to free apps. An expected counter-example would be Skyscape, which probably has the largest cache of apps of any developer and nearly all for fee. As a private company, there isn’t much financial data available nor is the website particularly forthcoming, but it does appear that the company has been enjoying some success. A deeper look however suggests they in fact have more in common with Epocrates than you may think. Read more »
*This blog post was originally published at iMedicalApps*
July 9th, 2011 by Edwin Leap, M.D. in Opinion, True Stories
Tags: Culture, Emergency Medicine, Family, Fun, Marriage
No Comments »
This is my column in July’s EM News. Have a restful day!
We travel to Hilton Head, SC, every spring for an ‘end of school-year’ vacation. It is a tradition that started several years ago; one which our family treasures. We plan months ahead, when we arrange lodging. Then, as the date draws closer we have to restrain ourselves from jumping up and down at odd, inappropriate times. The beach calls to us in an inexplicable way.
We live in a beautiful county, surrounded by mountains and lakes. It is, in itself, a worthy destination, perfect for biking, hiking, fishing and/or kayaking. But when May rolls around, our eyes turn to the east, and we long for the sand and sea. It is one of the special gifts of South Carolina, that highland forests and crashing surf are half a day’s car ride apart.
The morning we leave, the car is packed, the snacks tucked away, and we drive through the local Chick-fil-A for drinks. Then my dear wife immerses herself in a novel, her i-Pod turned to her music collection (eclectic as when we first met, running the gamut from Prince to Loreena McKinnet, from Aaron Copeland to Veggie-Tales). The children slip off their shoes and drift into games, or their own books and music before boredom takes them to sleep.
I am left enjoying the singular pleasure of driving across the state of South Carolina, Read more »
*This blog post was originally published at edwinleap.com*
July 8th, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: Advice, Being A Doctor, Doctors, Intern, July, Medicine, New Doctor, Physicians, Residents
No Comments »
It’s the cusp of a new medical year and there’s no shortage of advice on how to succeed as a house officer. The White Coat Underground and Wes Fisher will put you in the right direction. And I love Mary Brandt’s Advice for New Interns.
But just a couple of more points to keep in mind:
Keep your options open. Medicine is changing quickly. You’ll start your career training as a 20th century doctor and retire in a place none of us can imagine. Your ultimate success will be determined by your ability to adapt to a shifting foundation. Keep an open mind.
Quiet your fingers. You are the first generation to have publication tools that make it dangerously easy to breach your patient’s trust. Keep their business off the public forums. Better yet, find a way to apply all this wonderful technology to really move the chains forward. Read more »
*This blog post was originally published at 33 Charts*
July 8th, 2011 by DrWes in Health Policy, Opinion
Tags: Chantix, Clinical Research, CMJ, FDA, Government Grants, Lazy Research, Meta-analyses, Pfizer, Statistical Power
No Comments »
It was another headline busting study this week: Pfizer Drug Tied to Heart Risks – a provocative title no doubt fed to the media from the publisher: the Canadian Medical Association Journal. The study was yet another meta-analysis that culled the world’s literature in an attempt to determine if a trend could be found that might implicate Chantix as a causative agent for and increased incidence of heart disease in smokers.
On its surface, the study sounds authoratative, analyzing “14-double-blind randomized controlled trials involving 8216 participants” ranging in duration from “7 to 52 weeks.”
Never mind that 57% (25) of adverse events were weighted from one study and that none of the 14 studies had odds ratios that did not cross the unity line.
Despite this, the lead author concluded:
Despite the limitations of our analysis, our findings have potential regulatory and clinical implications.
Sorry, this is not correct. There are no clinical implications of this trial. Like all metanalyses, meta-anaylses simply cannot determine cause and effect. (Note to main stream media: are you folks listening?!?)
That being said, there’s another concern I have Read more »
*This blog post was originally published at Dr. Wes*
July 8th, 2011 by AnneHansonMD in Opinion
Tags: Damages, Ethics, Expert Witness, Forensic Expert, Lawsuit, Legal Case, Psychiatrist, Psychiatry
No Comments »
In Dinah’s post “The Chapter I Wish We Had Written” an anonymous commenter wrote about his problems finding an expert witness for his or her employment discrimination case (since I don’t know if Anonymous is male or female I’m going to use a standard male pronoun in this post—apologies if I got this wrong). Anonymous asked his doctor to help with the case, but he refused. He explained to Anonymous that he would be a biased witness and Anonymous also understood that the doctor’s involvement might affect the therapeutic relationship. Anonymous’s doctor gave her a number of referrals to forensic psychiatrists, but since he was not working with an attorney no expert would take the case. Anonymous was understandably frustrated by this situation.
I wanted to write about this because this situation comes up fairly often and I get calls from friends, colleagues and former students asking how to handle it. I’ve already written about what to do when you get served with a subpoena in my post “When Lawyers Call.”
First of all, I think Anonymous’s doctor was particularly astute to recognize the dilemma that arises when trying to help patients in situations like this. Read more »
*This blog post was originally published at Shrink Rap*
The medical app industry is a big business, but the apps are no longer the product – the physicians, nurses, and other healthcare providers who use them are. In the first part of this series, we examined some of the financial forces driving the medical app industry. Our focus then was Epocrates, the veritable founder of the industry. As is clearly stated in their recent SEC statement, Epocrates primary revenue stream has become the pharmaceutical industry and as such a key goal has become to further grow their user base by enhancing their free offerings.
