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Why Industry Largess Is A Necessary Part Of Good Healthcare

Largesse: (Form thefreedictionary.com):

1. a. Liberality in bestowing gifts, especially in a lofty or condescending manner.
b. Money or gifts bestowed.

2. Generosity of spirit or attitude.

Two days into last week’s Heart Rhythm Society meeting, Propublica, an independent online investigative journalism-in-the-public-interest endeavor published a series of high profile articles as part of their Dollars for Docs series. Their marquee piece, published prominently in the USA Today, chronicled the strong financial ties (the ‘largesse’) that bind medical societies to industry. Reporters Charlie Ornstein and Tracy Weber highlighted the meeting’s ‘mansion’-sized exhibits, intense advertising, and the fact that most of the opinion leaders, officers of medical societies and guideline writers, the experts, have financial ties with medical device companies. More than half of HRS’ revenues came from industry.

Well.

I’ll offer four simple thoughts about all this conflict:

1. Nothing about industry influence at medical meetings is new news. I have been attending medical meetings for nearly twenty years, and industry has always been there. And here’s something you don’t read much about: it was far worse then. That’s all I will say about that. I won’t tell you how cool it was seeing the Charlie Daniels Band play at a medical meeting for free.

You can quibble with the extent of these current-day “cozy” relationships, or the glitz of exhibits at our gatherings, but you should also know that there is progress. The show is now out in the open. There is infinitely more disclosure. Smart people are now watching, tweeting, and reporting. Any doctor who’s been around more than a few years will agree that things have grown increasing more transparent. Which I believe is an improvement. Read more »

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

Should Pharmaceutical Companies Get Involved In Social Media?

Imagine you’re a pharmaceutical company product manager and your specific product helps people with a chronic illness, or a cancer that can be managed by taking a pill or an injectable medicine over many years. You want to be part of the dialogue patients have with each other. You want to be part of the community. Facebook users, and other social media participants, are increasingly forming groups around health conditions, big and small. You want to be there, because, after all, your company has invested hundreds of millions of dollars developing the approved drug and hopes this medicine, and perhaps a successor, will be on the market for a long time.

This is an exciting time on the Internet and pharmaceutical product managers want to be part of health discussions. But it is fraught with legal pitfalls and penalties that can range into the millions of dollars if the product manager, or associated marketing agencies, make even an innocent mistake. Read more »

*This blog post was originally published at Andrew's Blog*

Twitter Transparency: 6 Rules

They say transparency is king — the more you share the better you look. But I’ve got rules. Here are a few things you won’t find in my Twitter stream:

Beer. I was recently speaking at a meeting out of town and caught up with some friends at the end of the day to visit and have a beer. I was in a different time zone and noted on Twitter the specific microbrew I was enjoying. The following week in my clinic a parent commented on my social activity. While I’m no stranger to transparency, the realization of my visibility was eye-opening. It reminded me that everyone’s watching and 140 characters doesn’t offer enough space to explain the why, or the time zone, of what I’m doing. So I’ve sworn to keep activities like beer consumption out of my twitter stream.

My kids. I try to keep my children out of my social footprint as much as possible. But as most of you who follow me know, they sneak their cute little selves in on occasion. It’s unfortunate because everybody loves hearing about my kids. This is at the request of my wife who’s a booger about privacy. I do mention the occasional date night with my daughter but, by and large, you won’t hear much. Kids are great jumping-off points for personal digression, but we have to be careful about using them to our own advantage. Read more »

*This blog post was originally published at 33 Charts*

Connecting With Patients: A Forgotten Piece Of Medicine

I [recently] visited a small town in west Texas to address a local medical society on the emerging role of social media in healthcare.

My presentation involves social media and the evolving relationship that patients share with doctors. I discuss challenges and opportunities -– especially as it relates to transparency, personal boundaries, and even the ethical obligation to participate in the online conversation. I target the disconnected physician and offer education as well as a compelling argument for involvement.

When I arrived at the venue I found that the meeting was attended predominantly by physicians much older than myself.  While waiting to speak, I was concerned that my message of connection and changing relationships would elicit pushback. After all, isn’t it this era of physicians we hold accountable for paternalism and control in dealing with patients? That’s what I’d been lead to believe. Read more »

*This blog post was originally published at 33 Charts*

Physicians’ Anemic Response To Healthcare Reform: Passivity Or Denial

With the turn of the calendar to the new decade, the reality of health care reform has set in for doctors and patients. Already cuts to physician salaries and patient access to care are becoming starkly apparent to those of us on the front lines of health care.

I wonder why doctors have been so ineffectual relative to the other special interests “at the table,” in the health care debate? One would think that those with the knowledge base and skill to manage their patients would be the ultimate power brokers in the efforts of health care reform. Yet here we are, watching the commoditization of our profession at the hands of lawyers and politicians in Washington, eager to avoid being perceived as the spoiler. Read more »

*This blog post was originally published at Dr. Wes*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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