I apprehend feelings run deep on this issue, and it isn't my first time in
this territory. If one wishes to propose controversial stands, one needs
thick skin. I feel I do need to declare my relationship to pharmaceuticals.

I own no pharmaceuticals stock or any other financial position for at least
10 years. I have no family working in the industry. I probably give
pharmaceutical reps a tougher time the 80% of physicians. I haven't attended
CME with pharmaceutical sponsor for over a year. I would estimate less than
10% of patients I see get a prescription.

I appreciate and RESPECT those who disagree with my philosophy, so why don't
we just let this thread die a merciful death.

Thanks,

thurman 

> -----Original Message-----
> From: [EMAIL PROTECTED] [mailto:hardhats-
> [EMAIL PROTECTED] On Behalf Of Kevin Toppenberg
> Sent: Friday, August 12, 2005 2:36 PM
> To: hardhats-members@lists.sourceforge.net
> Subject: Re: [Hardhats-members] RE: VistA Imaging FDA and NonCommercial
> Use Re: [Hardhats-members] Re: TIU Interface for Document Scanning
> 
> I'd like to add a few thoughts
> 
> 1. The FDA document linked above was interesting.  I asks the question
> as to what would happen if the system malfunctioned.  How likely is it
> that the patient would be harmed, or even killed?  Even if document
> imaging is not FDA regulated, this is a useful thought?  What if
> images don't contain patient identification, and get swapped.  A
> patient could be harmed by incorrect information.
> 
> 2. This debate about what the FDA will or won't do could perhaps be
> solved by putting together a document imaging system based on
> VistAImaging.  Do something to ensure that it can not be used for
> diagnostic purposes (i.e. disable DICOM interface).  Then submit it to
> the FDA.   At that point, they would likely come back and say "This
> product isn't really within out scope".  Just like they would say if
> we asked them to authorize VistA use in general.
> 
> 3.  Ruben, have your mom check into cutting pill.  I believe that
> Lipitor is "flat priced", meaning that 20 mg, 40 mg and 80 mg tabs
> cost the same.  80 mg, 1/2 tablet every other day is much cheaper than
> 20 mg daily.  And go easy on us doctors.  We really do have patient's
> best interests at heart.
> 
> Kevin
> 
> 
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