Bohemian polypharmacy – with a nod to Queen

Bohemian Polypharmacy

Sit back for six minutes or so and enjoy every line of Bohemian Polypharmacy – a parody of Queen’s classic, Bohemian Rhapsody. This time around, it’s a song all about polypharmacy – which is what we call it when we are taking more medicines than we need to.  This is yet another brilliant gem from Canadian pharmacist and professor Dr. James McCormack, with lyric help from David Scotten and creative input from Pete McCormack.  Great vocals are by local Victoria band Aivia members Liam Styles Chang (lead) and Shae Scotten (background).

Dr. James McCormack is half of the brains behind Therapeutics Education Collaboration (TEC), home of the highly entertaining (and educational) BS Medicine podcast (the BS stands for, of course, Best Science). His partner in crime is family physician Dr. Michael Allan. Here’s how they describe TEC:

“The best way to describe us is that we are the ‘mythbusters’ of drug therapy.”
Continue reading

Statin guidelines we love to hate – and the docs who write them

Here at Ethical Nag World Headquarters, it’s been quite the week ever since the American Heart Association and the American College of Cardiology released their new cardiovascular disease treatment guidelines, which I have taken the liberty of sub-titling:

“If you have a detectable pulse, you need to be taking statins!”

For more specifics on the guidelines – including the list of four newly-identified  groups of people whose heart health will benefit from taking cholesterol-lowering medicationoops, I mean statins only – every day for the rest of their natural lives, read yesterday’s Ethical Nag post, Can Statins Prevent My Head From Exploding?

What happens next? Your doctor will now review all 284 pages of the new guidelines, and then, in a bonding moment of shared decision-making, the two of you will soon sit down together to decide upon just the right course of action – oops, I mean drug prescription – based on what the guideline authors have recommended, in turn based on an (allegedly) flawed risk calculator that’s predicted to significantly increase the very large pool of daily statin-using drug takers, even among healthy individuals formerly considered low-risk for future cardiovascular disease.

But first, let’s set off for a behind-the-scenes visit to the people who actually write these treatment guidelines.  Continue reading

Key Opinion Leaders in medicine are paid to have an opinion

It seems that there are enough physicians out there who aren’t even a tiny bit embarrassed about referring to themselves out loud as “Thought Leaders” or “Key Opinion Leaders” to keep Canada’s Dr. Sergio Sismondo busy writing about them.

I first wrote about his work in A Philosopher’s Take on Big Pharma Marketing. Focusing on what he calls the pharmaceutical industry’s “corruption of medical knowledge”, the Queen’s University professor now has a new paper in The Journal of Law, Medicine & Ethics.

In it, he warns us about physicians and academic researchers who willingly become financially enmeshed in Big Pharma’s marketing efforts:(1)  Continue reading

The rule of seven touches

Dr. Atul Gwande tells the story in his New Yorker column of asking a pharmaceutical rep how he persuades “notoriously stubborn” doctors to adopt a new drug he’s promoting.  The rep’s response:

“Evidence is not remotely enough, however strong a case you may have. You must also apply the rule of seven touches.”

“Personally ‘touch’ the doctors seven times, and they will come to know you; if they know you, they might trust you; and, if they trust you, they will change.”

That’s why, explained Dr. Gwande, this drug rep stocked doctors’ closets with free drug samples in person.  Continue reading

Big Pharma targets Nurse Practitioners and Physician Assistants

According to a recent study in The American Journal of Managed Care, nearly 97% of Nurse Practitioners (NPs) now prescribe medications, and each one of these writes, on average, between 19-25 prescriptions each day.  That’s about 6,200 prescriptions per NP prescriber per year. In addition, Physician Assistants (PAs) are writing more than 250,000,000 prescriptions each year.In total, these health care providers are responsible for a significant whack of drug prescriptions each year.

That’s why organizers of the annual Maximizing Relationships with Nurse Practitioners and Physician Assistants Summit provide a platform for the pharmaceutical industry to build cozy relationships with all of these NPs & PAs. Here’s what the summit’s pitch promised:  Continue reading

“Punytive” damages: the biggest corporate fines ever

Since I’ve discovered the website called Information is Beautiful, I’m afraid that all my available free time for at least the next year or so will be consumed by pouring over this fascinating time-sucker of a site. The book of the same name has been published across the world in nine languages. All of it was conceived and designed by David McCandless, a London-based author, information designer and data journalist. As he explains:

“I’m into anything strange and interesting. A passion of mine is visualizing information – facts, data, ideas, subjects, issues, statistics, questions – all with the minimum of words. Love pie – hate pie-charts.”   Continue reading