Author Topic: "Don't become a victim of medical marketing" article from cnn.com  (Read 2624 times)

ppearl214

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well, I found this on cnn.com. I know there has been recent discussions here about how some dr's play up their facilities (or not) based on the technology and such that their facilities offer.... so, for discussion sake only, I post this here for you all...... should be a lively discussion!

Phyl

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http://www.cnn.com/2008/HEALTH/08/21/ep.conflicts/index.html

Don't become a victim of medical marketing


By Elizabeth Cohen
CNN Medical Correspondent
     
ATLANTA, Georgia (CNN) -- Linda Lewis says that when she had back surgery two years ago, her surgeon didn't do what was best for her health; he did was best for his bank account.


If Linda Lewis had known of her surgeon's financial ties to a device maker, she'd have sought a second opinion.

 Lewis, a graduate student who lives in Sherman Oaks, California, says Dr. John Regan, a surgeon in Beverly Hills, put in an artificial disc to help relieve her lower back pain.

"He said my back would be better than ever," said Lewis, 45. "I'm thinking, 'Wow, disc replacement is the best thing since sliced bread.' "

But after the surgery, Lewis says, she ended up in debilitating pain, could walk only with the assistance of a walker and had to have a second procedure to correct the first one.

"I couldn't take enough drugs for the pain," she said. "Having that surgery was the worst decision of my life."

Lewis said she was "livid" when she later found out that Regan had financial ties to the company that makes the disc, saying she believes that those ties prompted Regan to recommend the disc over other treatment options.

In an e-mail to CNN, Regan's office manager said he "is not available for comment."

How likely is it that your doctor has a tie to a company that makes drugs or devices? Very likely, according to Dr. Robert Steinbrook, who wrote an article on doctor/industry ties this month in the New England Journal of Medicine.

"Most physicians in the United States have financial relationships with industry, ranging from the acceptance of meals to the receipt of large sums of money for consulting, speaking, or conducting research," he wrote.

For example, two physicians made more than $8 million each from Dupuy Orthopaedics Inc., which lists the payments on its Web site.

"Consumers should absolutely know where their doctor is coming from," said Steven Findlay, a health care analyst at Consumers Union. "Doctors think they won't be influenced by these financial relationships, but the research shows that they are."

Eric Campbell, an associate professor of health policy at Harvard Medical School, put it a different way.

"Let's say your investment counselor went on a trip to Aruba paid for by a certain company," he said. "Then he comes home and recommends you invest in that company. Wouldn't you be concerned?"

If you want to know whether your doctor has financial ties to industry, and how that might color his or her treatment recommendations, experts have this advice:

1. Pens, pamphlets and attractive people in suits

"Look around for hints that your doctor sees a lot of drug reps," advised Dr. Daniel Carlat, an assistant clinical professor of psychiatry at Tufts University Medical Center who blogs about the industry's influence on physicians.

If you want to know whether your doctor has been influenced by industry sales people, Carlat advises patients to look for anything branded with a drug company's name, such as pens and pamphlets.

"And if you see an extremely attractive, impeccably dressed, polite person with a briefcase in the waiting room, watch out! That's most likely a drug rep," he said.

2. Ask questions about devices

Device companies -- those that make heart stents, for example, or artificial knees -- spend millions on fees to physicians.

If you're considering getting an artificial knee or hip, you can check with the Association for Medical Ethics to see whether your doctor has a financial tie to Dupuy Orthopaedics or Zimmer Inc., Biomet Inc., Smith & Nephew Inc. or Stryker Orthopedics. All were required last year by the U.S. Department of Justice to disclose consulting agreements with physicians.

3. Ask questions about drugs you'll take long-term

Brand-name drugs taken long-term -- antidepressants, for example, or cholesterol drugs -- are often heavily marketed to physicians.

If you're suspicious that your doctor's prescription might be based on ties to a certain company rather than on your health, you can ask questions.

"Ask the doctor what's the scientific evidence for prescribing that particular drug over another one. They must have a scientific reason, especially if it's a high-price brand-name drug instead of a generic," Campbell said.

4. Know when not to worry

Is it worth trying to figure out whether every prescription is based on a tie to a pharmaceutical company?

"There are circumstances where you want to take this extra step, and there are other times where you really don't want to bother," Findlay said.

For example, Findlay says, pharmaceutical companies usually don't heavily market antibiotics; they're taken for short periods of time and aren't usually huge money-makers.

The American Medical Association stresses the need for disclosure of doctor-drug company relationships. "The first priority of physicians is the health and well-being of our patients," said Joseph Heyman, M.D., the AMA's board chair.

Lewis says that if she had known that Regan had financial ties to the Charite disc, she would have sought a second opinion about her back pain.

According to a financial conflict-of-interest disclosure released by the North American Spine Society, Regan received "direct or indirect remuneration" in the form of royalties, consulting fees and research support for staff and materials from DePuy Spine, a division of Johnson & Johnson, which makes the Charite disc.

In addition, Regan and his co-authors "acknowledge a financial relationship" with DePuy Spine in a note in a research study they published last year in The Spine Journal.

Lewis is a plaintiff in a lawsuit against DePuy. A company spokesman declined to comment on the litigation but said the Charite disc "preserves some motion and avoids pain at the donor site."
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Jim Scott

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Re: "Don't become a victim of medical marketing" article from cnn.com
« Reply #1 on: August 21, 2008, 04:16:59 pm »
Thanks, Phyl:

Interesting article.  I think the most significant point is that it's another case of caveat emptor - let the buyer beware.  You have to trust your doctor not to be pushing something on you for his (or her) financial gain and of course, you have to be pro-active about your treatment and not be too intimidated to ask 'why?' when he (or she) tells you you 'need' to do this or that or says he'll prescribe a certain drug for your condition.  Why?

My wife uses some prescription drugs but she 'lives' on samples the doctor's office stockpile and give to her.  Anyone can do this, it's not illegal or immoral (the drug companies give the doctors the drug samples for free) you just have to ask a doctor if he has any samples of whatever it is he may be prescribing for you, then keep calling and asking for more when you need them.  My wife has absolutely no hesitation in doing this and most of her doctors don't seem to mind a bit.  She does pay for her Neurontin and one or two other drugs, but many she gets for free, courtesy of 'evil' Big Pharma.  ;)

Still, the warning to question a doctor's connection to a company that may be selling something he is recommending is valid.  Again, the take-away is this: be pro-active and not too timid to ask "why?"

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

lori67

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Re: "Don't become a victim of medical marketing" article from cnn.com
« Reply #2 on: August 21, 2008, 07:05:33 pm »
That is an interesting article, Phyl.  Thanks.

My only comment would be that you can't really judge a doctor's ties to a drug company just by the amount of free stuff in the office.  I worked in family practice as a nurse and I can tell you, the drug reps would come bring us "crap" (as I called it) all the time.  Sometimes the doctors would prescribe their stuff and sometimes they wouldn't - but doctors can be very cheap about providing office supplies - so if someone is giving you free pens, sticky notes and boxes of tissues - you take them no matter what they say on them!   ;D  As an added benefit, the drug "pushers" (another term I used) usually treat the whole office to lunch or breakfast if you let them come in to give their sales pitch.  I know that didn't make our doctors more likely to prescribe that particular drug - they just appreciated a free lunch!

I agree with Jim - you have to have enough trust in your doctor to know he or she is not going to just prescribe you something so they can make a quick buck.

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

leapyrtwins

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Re: "Don't become a victim of medical marketing" article from cnn.com
« Reply #3 on: August 21, 2008, 09:50:35 pm »
I agree 100% with Lori  :)

Jan
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ppearl214

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Re: "Don't become a victim of medical marketing" article from cnn.com
« Reply #4 on: August 22, 2008, 02:34:53 pm »
agreed.. and trust me.. I speak up at  my PCP's office for the Imitrex samples (Captn Deb, btw, she's been out of samples lately.....). 

Now, one discussion I remember that has floated around these forums that I thought about when I saw the article was.... Univ of Pitt and their relationship with Elekta for GammaKnife. Now, I'm not looking to start anything good or fugly.... but, I know others in the past have noted their push on GK treatments due to a family member affiliated with Elekta and the University.  this article made me think of the past discussions.........

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"