Re: [Futurework] How Pharma Took Over Medicine: Research and Practice_ BMJ / NYT

[Ray Evans Harrell]

Years ago when my father was Superintendent of  Schools on the local reservation he used to warn me about salesmen who would come even to our home and try to give gifts to my father, mother and even his son.    How incredibly protected the doctors have been in the past not to be as sophisticated as my country father was around conflicts of interest and the importance of knowing the right product for the job.      I think that is another reason he was a lifelong Democrat.    The Republican salesmen believed their hype while the Democrats were no more moral but seem to know more, that what they were doing was immoral and a subversion of the truth as well as an attempt to corrupt a school official with bribes.     My father made $3,500 a year as upper management which translates to around $21,500 in today's dollars.   How much have the MDs made over the years that they are taking so long to find the knowledge of conflict of interest and bribes in their own business?   REH     ----- Original Message ----- From: Karen Watters Cole To: [EMAIL PROTECTED] Cc: eric stewart Sent: Saturday, January 04, 2003 9:55 PM Subject: RE: [Futurework] How Pharma Took Over Medicine: Research and Practice_ BMJ / NYT Eric, it is encouraging that a backlash is developing within the medical and psychiatric professions against marketed diagnosis and prescriptions.  Perhaps after all those years of medical school and practice doctors are tired of patients coming in telling them they want this and that drug they saw on TV so that they feel like nothing more than handmaidens to the drug companies.    I will send you separately an article that the Oregonian did this summer about Boston Tea party-style rebellions by doctors groups who are walking away from the addiction of seminars, coffee mugs, notepads, free samples and other freebies that obligate them to what has become in some eyes, a parasitic relationship.  Some doctors are going cold-turkey.  Providence and Kaiser are beginning to set up in-house pharma libraries, courtesy of the internet, so that their doctors can get the information that the drug reps originally provided.  For some reason I didn’t save the url but I have the doc.    Harry will probably give me heck for saying this, but there is no free market - in the pharmaceutical trade these days - as evidenced by the fact that most ‘new’ drugs in recent years have not really been new but repackaged versions of older drugs already on the market.  They got the message about recycling, allright.  In other words, there is a growing dissatisfaction with drug prices accelerating the demise of managed health care systems in this country, and even though it may be the handiest scapegoat, drugs for profits has certainly earned it’s reputation.  Such is the House that Jack Built.    An even better sign is that hospitals and managed care systems are themselves looking for better alternatives to the risk management they are beginning to drown under.  Some of them are even talking about how they covet the public market that is Medicare to add to their pool of payers.  Ten years after Bill and Hillary Clinton stuck their necks out there is a political appetite to look at much of the same reforms and sweeping change they were ridiculed for overselling prematurely.  Things just had to get that much worse for the right people to admit it wasn’t working – we’ll have to wait to get confessions that much of the drug profession has been old-fashioned piracy.     If I’ve said anything misleading here, Ed Weick will set me straight.    Here are some links for those who may not have seen these stories in their own community papers: Some Tenative First Steps Towards Universal Health Care @ http://www.nytimes.com/2002/12/07/business/07CARE.html Strong Medicine @ http://www.boston.com/dailyglobe2/335/focus/Strong_medicine+.shtml Merged Hospitals gain both power and critics @ http://www.nytimes.com/2002/09/26/business/26HOSP.html Health of Americans calls for new system, report says @ http://www.oregonlive.com/news/oregonian/index.ssf?/xml/story.ssf/html_standard.xsl?/base/news/103710586599510.xml   JAMA has done its own reporting on this grassroots rebellion by the medical profession.  There is dissatisfaction that new disorders are identified in professional coding subsequent to the marketing of a drug to treat a symptom, ie. what was once shyness is now Social Anxiety and there is a pill for it.    All of this recent, and I mean recent, movement was before Lott made it possible for Frist to become Senate Majority Leader, something Karl Rove might be guilty of inflaming in the press to expedite a pink slip.  But the “buzz” in the mainstream press is that Frist will advance health care reform and Bush will get the credit for it.  I’m willing to let Bush claim credit for getting on the bandwagon late, as he did education in Texas, when others have been pushing for just this discussion and reforms when GDubya was still getting business loans from daddy’s friends.  2003 is going to be very interesting politically, and that’s because in just a little over 365 days, the early primaries will be underway - and mostly done by March 2004.  In fact, we may be looking at a stampede for health care and drug reform.    Karen East of Portland, West of Mt Hood Outgoing mail scanned by NAV 2002