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Opioid makers made payments to one in 12 U.S. doctors

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Re: Opioid makers made payments to one in 12 U.S. doctors

#51

Post by bionoid »

tiggybear wrote: post #26
11thEarlOfMar wrote: post #21

I don't like the 'pigs at the trough' image of this type of report. There are almost certainly pigs, but there is much more to resolving it than just revoking some licenses or throwing some people in jail. Standard practice in business of all types is to take clients out for a meal to talk business. Usually, the meal setting enables a different type of legitimate, sober interaction. Many types of business are conduct…

I think that is ridiculous. Learning about new medicine is continuing education for physicians. It is their job. Having a third party paying them or even just offering dinner to them so they can do their jobs is a huge conflict of interest. Further, they are getting a completely biased education on these new drugs in addition to being "taught" by pharma reps who often do not even have a BS in life sciences...so they…

> Having a third party paying them or even just offering dinner to them so they can do their jobs is a huge conflict of interest.

Not directly related, but my sister studied to become an audiologist some 15 years ago (in Norway). I was absolutely stunned at the corporate sponsorship - full on weekend trips with a nice hotel room and paid drinks and fun activities (plus a conference). Not once, but many times during the studies, for all students, sponsored by different companies (I'm not sure if they were competing companies, but you'd think so..)

There must be a lot of money in hearing aid for that to make financial sense.. Is/was this type of sponsorship common for students in other areas, medical or elsewhere?

Re: Opioid makers made payments to one in 12 U.S. doctors

#52

Post by tylersmith »

ddebernardy wrote: post #10

Is this really news? John Oliver ran a piece on the topic and the industry's many other dubious practices over 2 years ago, and I'm quite sure he wasn't the first to try to raise awareness. https://www.youtube.com/watch?v=YQZ2UeOTO3I

Not everyone watches John Oliver. Lots of things you and I know would be news to a lot people and many things they know would be news to us.

Re: Opioid makers made payments to one in 12 U.S. doctors

#53

Post by csr12928834 »

zjaffee wrote: post #33
lr4444lr wrote: post #27

Maybe it's because Americans just have this cognitive dissonance that their trusted doctor could be any less than 100% conscientious about their health, but we need to plainly face the fact that if members of the press were able to write exposés about drug makers' fudging the data about the addictiveness and effectiveness of their products, that doctors with their medical training and responsibility over actual peopl…

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

The problem in my mind, that the parent is intimating at, is that we confer far too much control to and assume far too much competence and beneficence on the part of physicians.

I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it.

The entire drug regulation system is predicated on the idea that you have certain providers, namely physicians, who are competent to make decisions, and shifting that decision-making power to those providers protects us from harm.

The opioid crisis has demonstrated that whole paradigm is faulty.

The problem is that no one profession should be entrusted with that level of power or command over decisions.

Imagine, instead, a system where there was no drug regulation. Rather than assuming that physicians were making the best decisions about opioid use and sweeping the problem under the rug, such use would be constantly scrutinized.

We need more competition, and fewer gatekeepers. Gatekeeping means there's only one thing that needs to be breached.

Re: Opioid makers made payments to one in 12 U.S. doctors

#54

Post by svachalek »

refurb wrote: post #12

This should be kept in context. Let's say the manufacturer presented new data at a conference. During that presentation they provided lunch and refreshments. Everyone of those doctors that attended will now show up in the CMS database. Do we think that a $15 lunch is going to influence a physician to over-prescribe a drug?

Cognitive dissonance actually means that a small payment can be stronger than a large one. If you accept a large payment to listen to a pitch, it's easy to tell yourself it's just for the money. If it's not enough to believe that, then you must actually be interested in hearing about it.

Re: Opioid makers made payments to one in 12 U.S. doctors

#55

Post by microcolonel »

ransom1538 wrote: post #50

Feel free to browse doctors' opioid counts here. I was able to match them to their actual profiles. Take into account their field, but, even with that the numbers are ridiculous. If you are in "Family Practice" and prescribe opioids 9167 times per year you probably have a very sore hand. https://www.opendoctor.io/opioid/highest/

> If you are in "Family Practice" and prescribe opioids 9167 times per year you probably have a very sore hand.

Though Bruce D. Mackey works at a Family practice, he specializes in Pediatric Occupational Therapy[0] (pediatrics broadly covering patients up to 21 years of age). It's fairly common for a Family Practice to have some specialty staff, and some such clinics have very large patient throughput. I used to be registered to one which specialized in sports medicine, others specialize in things like dietary/lifestyle intervention.

[0]: https://www.opendoctor.io/bruce-d-mackey-otr-1146468

Re: Opioid makers made payments to one in 12 U.S. doctors

#56

Post by curun1r »

zjaffee wrote: post #33
lr4444lr wrote: post #27

Maybe it's because Americans just have this cognitive dissonance that their trusted doctor could be any less than 100% conscientious about their health, but we need to plainly face the fact that if members of the press were able to write exposés about drug makers' fudging the data about the addictiveness and effectiveness of their products, that doctors with their medical training and responsibility over actual peopl…

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

> Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day...

I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equanimity...distancing myself from the pain and just observing it rather than feeling it, it all but goes away.

I have more chronic pain than I've ever had and, yet, I haven't taken a single pain killer in the past 3 years. I want to believe that somehow my pain is less than everyone who's getting caught in the net of opioids and that they do really need pharmaceutical help to deal with their pain, but my experience leads me to believe otherwise...that much of their need for drug help comes from their mental state and the unproductive way they accept pain into their lives. I also can't help but wonder whether today's increasingly disconnected society leads people to seek connection with a substance rather than other people. Would we still have an opioid epidemic if people spent more time having in-person conversations and less time liking things on Facebook?

Re: Opioid makers made payments to one in 12 U.S. doctors

#57

Post by emiliobumachar »

curun1r wrote: post #56
zjaffee wrote: post #33

Earlier quoted context omitted.

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

> Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day... I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equa…

Good for you, but, even if - if!- meditation would work for everyone,it's unrealistic to expect everyone to start meditating.

Exercise is good for virtually everyone, and that's common knowledge. Yet relatively few go through the trouble.

Re: Opioid makers made payments to one in 12 U.S. doctors

#58

Post by Clubber »

ransom1538 wrote: post #50

Feel free to browse doctors' opioid counts here. I was able to match them to their actual profiles. Take into account their field, but, even with that the numbers are ridiculous. If you are in "Family Practice" and prescribe opioids 9167 times per year you probably have a very sore hand. https://www.opendoctor.io/opioid/highest/

Also, consider that doctors must re-subscribe them every month or so. I think federal law requires the patients to have an office visit every 3 months. It's probably shorter now.

I dare say if someone went to the doctor's office and said they were hooked on pain killers and would like to be subscribed a step down prescription, they would be denied and told to tough it out, out of fear of DEA retribution. That's one of the problems with government in healthcare.

Re: Opioid makers made payments to one in 12 U.S. doctors

#59

Post by abakker »

mnm1 wrote: post #37
lr4444lr wrote: post #35

Earlier quoted context omitted.

I think you're raising an interesting point, but I disagree with your example - what pain that is so bad its sufferer needs "to lay in bed in agony" can be relieved by ibuprofen, acetaminophen, or any other OTC pain reliever? The Great Binge[0] ended long ago - perhaps for the wrong reasons, but ended nonetheless, until recently when legal opioid prescriptions spiked. This is about doctors putting their patients at r…

Headaches can easily be that bad and relieved with ibuprofen. Otherwise yeah, it's lay in bed and try to sleep and hope they don't last into the next day.

Or, sometimes, they're not. My wife gets bad migraines. For the most part, nothing works.

She has not tried, and is not interested in trying opioids for them, though.

Re: Opioid makers made payments to one in 12 U.S. doctors

#60

Post by curun1r »

emiliobumachar wrote: post #57
curun1r wrote: post #56

Earlier quoted context omitted.

> Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day... I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equa…

Good for you, but, even if - if!- meditation would work for everyone,it's unrealistic to expect everyone to start meditating. Exercise is good for virtually everyone, and that's common knowledge. Yet relatively few go through the trouble.

I'm not saying that everyone should meditate. I'm only bringing it up because I think it sheds a light on the true nature of pain and why simply removing it with chemicals at all costs is a very dangerous thing to be doing. We need to better understand that nature of pain and understand how to deal with it both physiologically and psychologically rather than taking the naive approach using chemicals, because a mind-body solution will be so much more successful than one that only considers one side of the equation.
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