Calling all Medical personnel...

[Justforfun000]

I try to be careful with claims of what basically amounts to "conspiracy theories", but sometimes I'm sure there has to be a kernel of truth to some of them. This is a recent example of something I suspect might be one of them, but I would like some opinions from anyone out there who might be in the know. Lagmonster & Captain Admiral come to mind...

This is not the entire article, but the first part that interests me most. Are these statistics accurate? How would you find out?


http://www.vitalitymagazine.com/indoctrinated_doctors

Tough Questions About Modern Medical Education
By Helke Ferrie

Becoming a doctor takes many years. They learn an awful lot.But just exactly what do they learn? And who decides what they are supposed to know? Any discussion of medical education starts with Dr. William Osler, who originally set the standard. In fact, McGill University is now trying to re-introduce an Osler-based program "to make doctors more humane" (Medical Post, Oct. 18, 2005). Dr. Osler's 1892 textbook, Principles and Practice of Medicine, trained doctors throughout the world until 1950, at which time Harrison's Principles of Internal Medicine, now in it's 16th edition, replaced it. Sir William Osler is generally acknowledged to have been one of the greatest doctors in history.

Last year, my husband, who specializes in Post Traumatic Stress Disorder, discussed with a fellow doctor the possibility of having a workshop on PTSD for local physicians in our area. "Sure!" was the reply. "Contact a drug rep and have him set it up. All you need to do is mention a couple of drugs and they'll pay for the event." My husband, who is in his 37th year of practice and never allowed a drug rep into his office, said: "What?!", to which his colleague replied, "That's the way we get our continuing medical education now. They always give us a nice dinner."

My husband's presentation on how to treat PTSD successfully would have gone over like a lead balloon with Big Pharma, as it would have included the recent research results which show why it is best to never prescribe SSRI antidepressants; the risks include increased rates of suicide, murder, cancer, heart disease, sexual dysfunction, weight gain, diabetes, birth defects, and babies born with a full-blown addiction syndrome. Instead, his work focuses on truly effective treatment for PTSD which always includes getting the patient off drugs safely; he agrees with Dr. Osler who observed a century ago, "The person who takes medicines must recover twice: once from the disease and once from the medicine."

Considering the quality of Big Pharma's "education" of our modern doctors, it is revealing that the German Institute for Evidence-Based Medicine found that 94% of the information in the manufacturers' brochures sent to doctors on the 520 most commonly used drugs had "no basis in scientific evidence." (Arznei Telegram, March 2004).


Dr. Osler had clear advice on this in the late 1900's: "One of the duties of the physician is to educate the masses not to take medicines. Consider what surprising reactions may occur in the laboratory from the careless mixing of unknown substances. Be as considerate of your patient as you are of the test tube. To modern pharmacy we owe much, but the profession has no more insidious foe than the large hinterland pharmaceutical houses who have become a huge parasite. We all know too well the bastard literature which floods the mail, every page of which illustrates the truth of the axiom: the greater the ignorance the greater the dogmatism."


In Dr. Osler's days, most deaths were due to tuberculosis and pneumonia. Today, according to research from Johns Hopkins Medical School, which he co-founded, the leading cause of death is improperly prescribed drugs and inappropriate surgery, annually killing about 800,000 people in North America. (Heart disease and cancer kills about 700,000 and 500,000 respectively. Sources in Dean 2004.)

The British Medical Journal reported on June 10, 2000, that death rates in Israel dropped by close to half when physicians went on a three-month strike. Funeral homes complained to the government, asking to have the contractual dispute settled. The same decrease had occurred during the 1983 strike. Only in the city of Netanya did death rates remain "normal"; doctors there have a "no-strike" clause in their contracts.



Medical Schools Financed by Big Pharma
Given these startling facts, we are entitled to ask some hard questions about current medical education. One answer comes from Dr. Drummond Rennie, one of the editors of the Journal of the American Medical Association, who said that "medical education is down the toilet" because the research taught to the medical profession cannot be trusted anymore; its data are "doctored"
to satisfy the drug companies, which pay for about 60% of all medical research, as well as for most continuing medical education programs. In the year 2000, 314,022 pharmaceutical industry sponsored conferences were held, but only a few hundred independent events took place. The medical schools themselves are largely financed by Big Pharma as well, and 70% of the
committee members generating practice guidelines have direct financial ties to the drug companies whose products they recommend. JAMA's Dr. Rennie observed: "This practice stinks."

According to Drs. Marcia Angell and Jerome Kassier, both editors at the prestigious New England Journal of Medicine for many years, medical education relies completely on Big Pharma. Most universities have even eliminated courses in pharmacology, so "doctors aren't even taught basic
principles of drug action and use". In fact, medical school administrators refer to "students as consumers" and "to education and research as products" (J. Washburn). The free hand-outs and perks cost Big Pharma about $30,000 per year, per doctor, in the US. Is this the education we want our doctors to have? Especially when the evidence suggests that for Big Pharma, "human
life is just road-kill on the highway to profit", as former Health Canada safety expert, Dr. Michelle Brill-Edwards, puts it. The milestones on that highway are as follows:


In the early 1970's, drugs companies went onto the stock market, and sickness — not health — became a profitable commodity.

In the 1980's Prime Minister Brian Mulroney extended drug patents to 20 years (previously only 6 months at the turn of the century) inviting the full-scale gouging of patients and Medicare.

On January 6, 1996, Diana Marlow, Health Minister at the time, had an Order in Council passed without public or parliamentary debate, which made all safety information on drugs "proprietary information", and thus protected from public scrutiny. Accountability in the health care system was thus flushed down the toilet.

Direct-to-consumer-advertising started in the US and New Zealand a few years ago and increased spending dramatically; a lot of gullible, healthy people could start to wonder if maybe they were sick after all. It is no surprise that by 2001, drugs and medical mistakes were recognized as the major cause of death.

In 2005, Canada's drug bill was $28.4 billion, compared to $3.8 billion in 1985 (CMAJ July 4, 2006). Since the 1970's, drug profits surpassed all other Fortune 500 companies and outperformed Standard & Poor's 500 Index by 10% every year. The industry hopes to grow to $842 billion by 2010; but maybe Big Pharma's profitability has peaked, just as the world's oil has. The Wall Street Journal reported on September 9, 2006, that Brystol-Myers Squibb's shares have dropped by 56% since 2001, Pfizer's share price is down by 43%, and roughly 100,000 law suits are currently running against unsafe drugs. Maybe killing customers is not good for business after all.

Sources and Resources:
M. Angell, MD, The Truth About the Drug Companies, Random House, 2004
M. Bliss, William Osler A Life In Medicine, University of Toronto Press,
1999
C. Dean, MD, Death by Modern Medicine, Matrix Verite, 2004
S. Ellison, Health Myths Exposed, Author House, 2005 (single best source
by a former drug designer showing how standard treatments are fraudulent and
which treatments can be trusted)
D. Healy, Let Them Eat Prozac, Lorimer, 2003
J. Kassirer, MD, On The Take: How Medicine¹s Complicity With Big Business Can Endanger Your Health, Oxford, 2005
R. Moynihan & A. Cassels, Selling Sickness, Nation Books, 2005
W. Osler, MD, Sir, The Principles and Practice of Medicine, 1892, Classics of Medicine, 1978

J. Washburn, University Inc.: The Corporate Corruption of Higher Education, Basic Books, 2005
[quote][/quote]

[Johonebesus]

In the 1980's Prime Minister Brian Mulroney extended drug patents to 20 years (previously only 6 months at the turn of the century) inviting the full-scale gouging of patients and Medicare.

Is Canada's healthcare program called "medicare"? I'm not sure how a prime minister's act would have such a huge impact on the U.S. system.

[Geodd]

I like big pharma about as much as I liked the disturbingly persistant fungal infection in my groin I had a few years back, but that article is full of shit. 800000 dead per year due to medicines and surgery seems absurdly high, but I'm not even gonna bother tracking down statistics to disprove it when the webiste you linked to has gems like this in its articles:

In nature, wherever there is heat, the molecule will expand. If the body generates heat, it will travel upward in the body. Heat can produce toxic waste. When the toxins get stuck in those lymph nodes, the activity of antibodies in those areas will be affected. If there is stomach heat, cancer cells accumulate easily within the breast, especially in the summer time when the weather is hot. Depression can lead to liver qi stagnation, liver qi stagnation can lead to liver heat. Besides all the symptoms, breast cancer can be formed easily. Modern society is very complicated with a lot of negative emotions and loneliness. This is the major cause of liver qi stagnation.

Seriously, if that website claimed that the sky is blue I wouldn't believe them until I checked for myself, and even then I'd get a second opinion in case I'd developed colour blindness over the night.

[Justforfun000]

Seriously, if that website claimed that the sky is blue I wouldn't believe them until I checked for myself, and even then I'd get a second opinion in case I'd developed colour blindness over the night.

Oh I'm well aware many of their writings are pie in the sky, but there are many different columnists and some of them ARE consequently accurate and respectable, so I won't discount this specific article based on others.

[Broomstick]

This is not the entire article, but the first part that interests me most. Are these statistics accurate? How would you find out?

Research.

Last year, my husband, who specializes in Post Traumatic Stress Disorder, discussed with a fellow doctor the possibility of having a workshop on PTSD for local physicians in our area. "Sure!" was the reply. "Contact a drug rep and have him set it up. All you need to do is mention a couple of drugs and they'll pay for the event." My husband, who is in his 37th year of practice and never allowed a drug rep into his office, said: "What?!", to which his colleague replied, "That's the way we get our continuing medical education now. They always give us a nice dinner."

Yes, that is ONE way to set up an educational seminar... but not the only one.

Considering the quality of Big Pharma's "education" of our modern doctors, it is revealing that the German Institute for Evidence-Based Medicine found that 94% of the information in the manufacturers' brochures sent to doctors on the 520 most commonly used drugs had "no basis in scientific evidence." (Arznei Telegram, March 2004).

Is that limited to just Germany, or are they making a statment about manufacturers' brochures world-wide?

In the US, what manufacturers' can and can't say in their brochures is regulated and they usually provide citations because they can be penalized if they are unable to back up their claims.

Today, according to research from Johns Hopkins Medical School, which he co-founded, the leading cause of death is improperly prescribed drugs and inappropriate surgery, annually killing about 800,000 people in North America. (Heart disease and cancer kills about 700,000 and 500,000 respectively. Sources in Dean 2004.)

Untrue, at least in the US.

In the US, heart disease is the biggest killer, followed by cancer, followed by accidents. Medical mishaps do occur in numbers much larger than is acceptable, but I doubt they're in the top ten.

One answer comes from Dr. Drummond Rennie, one of the editors of the Journal of the American Medical Association, who said that "medical education is down the toilet" because the research taught to the medical profession cannot be trusted anymore; its data are "doctored"
to satisfy the drug companies

Yes, that is true. JAMA has been beating that drum for several years now.

In the year 2000, 314,022 pharmaceutical industry sponsored conferences were held, but only a few hundred independent events took place.

What about the years since? Why pick 2000 and not, say 2004 or 2005?

How are they defining "sponsored"? There are some major medical conferences where pharma has representatives, seminars, etc. -- but that does not mean they're in control of the event. (Sometimes yes, sometimes no)

[Lagmonster]

My husband's presentation on how to treat PTSD successfully would have gone over like a lead balloon with Big Pharma...

I'll state up front that I can't confirm or deny all of what is being presented here, but I do know how to dissect an article critically, and that's the first step you should take before you decide what you really need to research. Even simply confirming her facts isn't enough - you need to understand how the numbers translate into real life, not just that the numbers are true.

I do know for certain that Pharmaceutical companies, being businesses, will do absolutely anything to get doctors to just look at ads for their products; product placement for these companies is cutthroat and recruitment for drug sales reps is very high among students; I've seen a fair share of career fairs and a lot of grads get inticed into the business by promises of huge payouts for hungry promoters. So I believe entirely the claim that major drug manufacturers want desperately for the claims in this article to be true, and certainly will use whatever wedge seems acceptable to get their products in the door (but this is true of nearly any business, so it's hardly cause for alarm so long as you can show that the professionals doing the actual buying adhere to intelligent standards of practice and ethics).

I also know that there has always been a contingent that fights against this and pounces like a hungry lion on every piece of information that comes up that links poor health standards or practices to drug use. These people are not wrong in calling attention to the problem nor in advising that reliable medicine be practiced in preference to loading up people with medication. It's a lot like fringe members of the anti-smoking advocacy; they're right, but not always for the reasons that they think they are and sometimes purely by coincidence.

Considering the quality of Big Pharma's "education" of our modern doctors, it is revealing that the German Institute for Evidence-Based Medicine found that 94% of the information in the manufacturers' brochures sent to doctors on the 520 most commonly used drugs had "no basis in scientific evidence." (Arznei Telegram, March 2004).

So marketing is steeped in bullshit. This is news? How much of this stuff is part of the bags of flyer ads and such tossed into the recycling bin every day by medical admin staff? Much like people who buy beer for how it tastes rather than because the ads show hot chicks, how much of it influences purchasing?

In Dr. Osler's days, most deaths were due to tuberculosis and pneumonia. Today, according to research from Johns Hopkins Medical School, which he co-founded, the leading cause of death is improperly prescribed drugs and inappropriate surgery, annually killing about 800,000 people in North America.

I can't confirm or deny it, but I don't fucking think so. If physicians in Canada and the US were offing patients out of sheer ignorance with a greater frequency than most single natural causes, you wouldn't hear about it here first. How much do you want to bet that it is patients gulping down meds or taking medication inappropriately that leads to the vast majority of these reported deaths?

The British Medical Journal reported on June 10, 2000, that death rates in Israel dropped by close to half when physicians went on a three-month strike.

Did they link cause and effect? Was there a cease fire on between Palestine and Isreal that spring by any chance? Is this a noticeable difference compared to other years? Which professionals were on strike, and did it make any difference to the quality of care patients recieved? Does it make any difference? Why am I asking questions of nobody in particular?

In the year 2000, 314,022 pharmaceutical industry sponsored conferences were held, but only a few hundred independent events took place.

What was the subject of the independants? How much non-drug professional development is available each year that is essential knowledge for the profession? What is the impact of the marketing conferences on actual practice? How many doctors hit these conferences just for a free trip to Vegas and to hit on cute marketing advisors?

I don't have the answers you want, but I can give you some of the questions you should be asking.

[Justforfun000]

Broomstick wrote:

Quote:

Today, according to research from Johns Hopkins Medical School, which he co-founded, the leading cause of death is improperly prescribed drugs and inappropriate surgery, annually killing about 800,000 people in North America. (Heart disease and cancer kills about 700,000 and 500,000 respectively. Sources in Dean 2004.)

Untrue, at least in the US.

In the US, heart disease is the biggest killer, followed by cancer, followed by accidents. Medical mishaps do occur in numbers much larger than is acceptable, but I doubt they're in the top ten.

& Lagmonster wrote:

I can't confirm or deny it, but I don't fucking think so. If physicians in Canada and the US were offing patients out of sheer ignorance with a greater frequency than most single natural causes, you wouldn't hear about it here first. How much do you want to bet that it is patients gulping down meds or taking medication inappropriately that leads to the vast majority of these reported deaths?

I thought that sounded ridiculous. How can someone trying to come across as accurate and authoritative toss that little piece of info out and expect it to be believed if it is that easy to show as false? It definitely doesn't help their case any.

Lagmonster wrote:

So I believe entirely the claim that major drug manufacturers want desperately for the claims in this article to be true, and certainly will use whatever wedge seems acceptable to get their products in the door (but this is true of nearly any business, so it's hardly cause for alarm so long as you can show that the professionals doing the actual buying adhere to intelligent standards of practice and ethics).

I guess that's the big question here. How can we be sure that the professionals are actually using good science and proper scope of potential treatments out there including lesser known alternative therapies that have good track records of success but no big money behind them? Ultimately a person's health is the most important issue first and not the modality of the treatment and who profits from it.

So marketing is steeped in bullshit. This is news? How much of this stuff is part of the bags of flyer ads and such tossed into the recycling bin every day by medical admin staff? Much like people who buy beer for how it tastes rather than because the ads show hot chicks, how much of it influences purchasing?

That in itself doesn't bother me so much because as you say, marketing is marketing...but I WAS concerned when they also referenced other sinister trends like a drop in courses on pharmacology. If doctors aren't going to continue to receive the full knowledge enabling them to truly understand drugs, let alone interactions with body systems, then the hype is the only information they are going to have tossed at them they might be able to comprehend. IF this is truly happening, it would be great cause for concern I would think.

Quote:
The British Medical Journal reported on June 10, 2000, that death rates in Israel dropped by close to half when physicians went on a three-month strike.

Did they link cause and effect? Was there a cease fire on between Palestine and Isreal that spring by any chance? Is this a noticeable difference compared to other years? Which professionals were on strike, and did it make any difference to the quality of care patients recieved? Does it make any difference? Why am I asking questions of nobody in particular?

Lol. I agree. Without knowing more information, it's not a definitive statement, but it COULD be true. That's what is frustrating. For anyone to know this, they'd have to do a mountain of research corroborating all of these claims with many, many factors. These types of system-bashing magazines should seriously consider covering all of these related questions so they can come across as truly being comprehensive and authoritative with their data. It might actually get them some serious recognition outside the fringe scene if they know their stuff and it's true.

[brianeyci]

Is Canada's healthcare program called "medicare"? I'm not sure how a prime minister's act would have such a huge impact on the U.S. system.

The PM has very little control over healthcare. It's the responsibility of the provinces to pay for healthcare and the only thing the Federal government is supposed to do is enforce the Canada Health Act. Patients in general have to pay for their own drugs anyway. The provinces have control of the hospitals, pay the doctors, and so on. The doctors are also private practitioners, not government employees.

[Tsyroc]

Interestingly enough it is "Pharmacy Week" at work so every day this week at least one meal is provided to pharmacy personnel by various drug reps. We're supposed to listen to their speal while we eat.

Tuesday morning's breakfast sandwiches was brought to us by Lovenox (Enoxaparin). They brought free pens and markers too.

I always found it distasteful that the department routinely does this year in and year out. What's even better is I really question the intelligence of the drug reps doing it. Two Thirds of the people in the department aren't pharmacists and have no say or input about what drugs the hospital uses. The pharmacists might have some say or influence but mostly it comes down to clinical information, what the physician's want, availability, and cost.

What's even better is Enoxaparin is already on our formulary and we use a boatload of the stuff. So why are they brown nosing us? It's not like we're going to switch back to Dalteparin. It was hardly ordered when it was our formulary drug of choice.

[PainRack]

Untrue, at least in the US.

In the US, heart disease is the biggest killer, followed by cancer, followed by accidents. Medical mishaps do occur in numbers much larger than is acceptable, but I doubt they're in the top ten.

I can't recall which group sponsered the study, but in 1995, the death toll in hospitals from medicine error was greater than the death toll from traffic accidents.
From this site:

Holland et al (1997) 3 estimates as many as 1 million patients are injured while in the hospital and approximately 180,000 die as a result. This leads to a cost estimate of more than $136 billion a year. The article cites the list of medications most frequently causing adverse reactions in order of incidence:

wrong diagnosis
Perhaps she was using the 1 million figures instead?

[PainRack]

Accck...... left out this bit

The Institute of Medicine (IOM) reports on two studies estimating the hospital deaths due to medical errors at 44,000 to 98,000 annually, which would place medical errors in the top ten causes of death in the USA.

common mistakes

So, it may not be the numero 1, but it is in the top ten.

[Broomstick]

I'd like further clarification on the "adverse" drug reactions - are those true errors, or are they bad reactions due to individual physiology to drugs that are appropriate for a condition and dosed appropriately?

See, that's one of the problems in determining deaths due to medical error - in many occupations if someone dies something clearly went wrong, but in medicine you may do everything correctly and the patient still dies. So death alone is not a determination that an error occured.

Estimates of deaths due to medical errors vary significantly and will continue to have a wide margin of error.

[PainRack]

I'd like further clarification on the "adverse" drug reactions - are those true errors, or are they bad reactions due to individual physiology to drugs that are appropriate for a condition and dosed appropriately?

See, that's one of the problems in determining deaths due to medical error - in many occupations if someone dies something clearly went wrong, but in medicine you may do everything correctly and the patient still dies. So death alone is not a determination that an error occured.

Estimates of deaths due to medical errors vary significantly and will continue to have a wide margin of error.

I don't know what the study says per se, but from the article

About half of these adverse events were due to errors: 58% and 53% respectively.

That's for the IOM estimate, which was the one I felt more relevent than the more alarmist figure.

The reference points to this nugget.

Health care is not as safe as it should be. A substantial body of evidence points to medical errors as a leading cause of death and injury.

• Sizable numbers of Americans are harmed as a result of medical errors. Two studies of large samples of hospital admissions, one in New York using 1984 data and another in Colorado and Utah using 1992 data, found that the proportion of hospital admissions experiencing an adverse event, defined as injuries caused by medical management, were 2.9 and 3.7 percent,1 respectively. The proportion of adverse events attributable to errors (i.e., preventable adverse events) was 58 percent in New York, and 53 percent in Colorado and Utah.2

• Preventable adverse events are a leading cause of death in the United States. When extrapolated to the over 33.6 million admi ssions to U.S. hospitals in 1997, the results of these two studies imply that at least 44,000 and perhaps as many as 98,000 Americans die in hospitals each year as a result of medical errors.3 Even when using the lower estimate, deaths in hospitals due to preventable adverse events exceed the number attributable to the 8th-leading cause of death.4 Deaths due to preventable adverse events exceed the deaths attributable to motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).5

IOM report

[PainRack]

I should add the caveat that this is before JCI standards were made.

Accredited hospitals should be much better off, especially since half a decade has gone into revamping patient safety.

Still, from the JCI resource centre, we gain nuggets of info like this.

(OAKBROOK TERRACE, Ill. – August 23, 2005) Recognizing that health care errors seriously harm one in every 10 patients around the world, the World Health Organization (WHO) is designating the Joint Commission on Accreditation of Healthcare Organizations and Joint Commission International (JCI) as the world's first WHO Collaborating Centre dedicated solely to patient safety. This action is aimed at reducing the unacceptably high numbers of serious medical injuries around the world each day.

WHO to work with JCI in establishing patient safety