Stanford Med School rejects industry funding for continuing education

Stanford University's medical school announced this week new restrictions on educational contributions by drug and medical device companies, which turn out to be among the strictest in the nation.

The rules are an effort to limit industry influence on physician practice. Currently, the continuing education programs tend to follow the market's needs and not necessarily the best advancements for optimal patient care.

"The school will no longer accept funds from pharmaceutical or device companies that are targeted to specific programs, as industry-directed funding may compromise the integrity of these education programs for practicing physicians," a press release states.

SiliconValley.com reported that "Drug and medical-device company contributions for continuing medical education have surged nationwide from $302 million in 1998 to $1.2 billion in 2006, according to the Accreditation Council for Continuing Medical Education. Stanford officials said about $1.87 million — or 38 percent — of the medical school's budget for continuing education came from industry sources in fiscal 2006-07."

That should be law or common policy (as well as stopping direct to consumer advertising). The industry sponsored CMEs are actually not that bad (esp. when you stay aware that they are biased toward the sponsoring company's product), but they are just so selective in their topics (in my specialty, it is treatment of neuropathic pain, epilepsy, migraine, MS over and over and over and over), instead of having a didactic approach (e.g. symptom based education).

Posted by: rbar | Aug 28, 2008 7:50:12 AM

Good for Stanford! This is long overdue. A difficult decision but the consumer benefits.

Posted by: Jonathan Woodward DC | Aug 28, 2008 8:24:12 AM

Bravo Stanford! AAMC is out front on this one, and hopefully more AMC's will follow...

http://www.aamc.org/newsroom/pressrel/2008/080619.htm

Posted by: Gregg Masters | Aug 28, 2008 2:07:48 PM

The more important thing though is the limited value of CME in general which for the most part right now is like pouring money down a hole.

Posted by: MG | Aug 29, 2008 5:21:57 PM

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The other Michael Jackson mega-mix

By Matthew Holt

Never ones to be shy with an interesting view into celebrity pharmacology (and truth be told responding to a little tickle from me) the inventive folks at PharmaSurveyor have added Michael Jackson to their celebrity drug cocktail page.

It’s an interesting way to show the dangers of multiple drug regimens, and a great way to show off PharmaSurveyor’s computational capabilities of analyzing multiple drug regimens at once. (PharmaSurveyor calls those assessments surveys). You can find it on http://www.michaeljacksondrugs.net/ which has a static picture of Michael Jackson's survey and links to the interactive one on PharmaSURVEYOR.com. (FD I’m an advisor to PharmaSurveyor with a few stock options)

July 6, 2009 in Health 2.0, Pharma, pharmaceuticals, Technology, Web/Tech | Permalink

We've also covered Jackson's medical conditions as well as those of other celebrities. Please have a look.

Posted by: DrB | Jul 7, 2009 7:15:01 AM

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Viagra prescribed more safely online than in regular practice?

They looked at records of questionnaires taken and prescribing decisions made by a licensed, regulated online pharmacy called KwikMed — that is trying very hard to establish itself as ethically and legally different from those fly by night guys whose spam comments will rapidly attach to this post! They looked at the various outcomes and end points including safety and level of counseling and found that the online system produced results as good as or better as those found from a big records review in an unnamed (not surprisingly!) large multi-specialty clinic in Salt Lake City, UT.

Now obviously the ability to create an online questionnaire for specific conditions with clear inclusion/exclusion criteria (like ED or hair loss) means that as clear a picture can be gained in most cases from a good history taken online--and probably the history will be given more honestly by the patient. Plus the rigor of the history is probably better than one taken in a rushed office visit. And then it gets reviewed by a doctor who may recommend another approach but most times agrees and sends the Rx on to be filled.

I met with the Kwikmed folks randomly last week (and yes they were excited about the article). They've got a pretty sizable business in terms of ED drugs and hair loss drugs and are keeping quite a few doctors busy. The next question is can this type of study justify more online prescribing in different drug categories, or of course can they extend online visits into other categories, such as allowing people to order their own lab tests.

They of course think the answer is both. 

Of course, the core savings that Kwikmed delivers is that you don't have to pay for the doctor visit and the prescription, as they bundle it together. When it's a cash visit and a cash prescription as many of those lifestyle drugs are, then it makes sense for the patient. Of course the same is true for those paying in a high-deductible scenario.

But the more general point is that it'a another piece of evidence that at least some medical care can effectively go online at a lower price point than traditional care.

And why not? The world's flat, right?

Why shouldn't every benefit, including pricing leverage, wholesale access to provider or supplier services, and user friendly quality "indicia", be accessible to those in need?

As mentioned elsewhere on THCB in the "The Affordability Factor" [which has been met by silence from the author], why not extend the value of group purchasing to the general public and specifically those not represented by third party "aggregators", e.g., health plan, insurance company, TPA, MSO, MCO, PSN, PHO, OWA, etc? Why does one have to be enrolled in a diminishing benefits health plan or variant thereon in order to benefit from market pricing via purchasing entities?

Why are private plans, and the government the sole beneficiaries of paying $.15 to $.30 on the dollar while the uninsured must operate in the world of retail medicine?

If the web can facilitate legitimate pharmaceutical access, and perhaps encourage a greater level of diagnostic honesty then so be it.

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Posted by: Rick | Dec 6, 2009 2:39:05 AM

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What’s up doc?: The ’squabble’ over ’squalene’

A single injection of squalene may not sound like much, unless you look at the pathological, medical evidence

Why is it that many health professionals working in a local hospital refuse to get the new H1N1 flu vaccination?

watch?v=zhQ-Tu4ljEo

The uninjectable suddenly has become injectable

The reason – the inclusion of squalene.

Squalene may be safe in certain environments but rumor has it that it should never, repeat never be “injected”.

Well, if it’s in a flu vaccination, how are we supposed to believe it enters our system – correct – it’s injected!

According to the examiner.com:

Squalene has been shown to cause severe autoimmune disorders like multiple sclerosis, reheumatoid arthritis and Lupus. Furthermore, Blaylock claims this particular vaccine adjuvant is connected to the Gulf War syndrome that killed thousands of soldiers and caused a 200% increase in Lou Gehreg’s disease.

Another issue of similar proportion is that of the Gardasil treatment for teenage girls to prevent cancer.

Is there a pattern here? Are we becoming human guinea pigs?

Who, including which drug companies are we supposed to trust?

And why is the vaccine for pregnant women different than that for the rest of us?

H1N1 is no joke. It seems to be taking it’s toll, and the biggest risk group seems to be teenagers that have not been exposed to this flu that has been around in the past, making the older generation less likely to get sick.

But like a loaded gun, and the effect on those that were injected with squalene in the Gulf war that now have health problems, are we asking for bigger trouble?

Squalene is mixed into the formula for one reason and one reason only – more bang for the buck! It all boils down to the “almighty dollar”.

I’m starting to feel like that human guinea pig, or rat:

A 2000 study published in the American Journal of Pathology demonstrated a single injection of the adjuvant squalene into rats triggered “chronic, immune-mediated joint-specific inflammation,” also known as rheumatoid arthritis.

People don’t know the facts and understand the implications. It reminds me of the insurance industry, where the real issue is finding an agent to trust, and not knowing all the ins and outs. The question is, is the medical word trustworthy when the soldiers of the U.S. military continue to be exploited medically, and in every other way too.

  Shouldn’t we all  start asking the hard questions?

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POLICY/PHARMA: DEA's insane persecution of pain patients continues

Just in case you needed to be reminded that the DEA is a refuge of evil scumbags and needs to be abolished, here's another exhibit (from the good people at DRCNet):

Federal agents arrested Dr. Stephen Schneider, operator of the Schneider Medical Clinic, and his wife and business manager, Linda, on a 34-count indictment charging them with operating a "pill mill" at their clinic. The indictment charges that Schneider and his assistants "unlawfully" wrote prescriptions for narcotic pain relievers, that at least 56 of Schneiders' patients died of drug overdoses between 2002 and 2007, and that Schneider and his assistants prescribed pain relievers "outside the course of usual medical practice and not for legitimate medical purpose."

Darren Baker is another patient who swears by Dr. Schneider. The operator of a tree gardening service, Baker has bone spurs in his knees from years of climbing, and two years ago, he fell out of a tree, shattering both his heels. "They put all kinds of hardware in my heels, and I have to have pain medications just to walk," he said. "With the pain meds, I can't walk real well, but without them, I can't walk, period. Dr. Schneider was the only one who would treat me."

Now, like Sauers, Baker is in search of a doctor. "I haven't found one yet," he said. "I got a list today, but most of them are turning you away if you're associated with Dr. Schneider. If I can't get another doctor, I won't have any option except to retire and go on disability. I take my medicine to be a productive member of society," he said angrily. "I need my meds to survive and pay my bills and fight the daily grind. This really goes against our constitutional rights. How the hell can I pursue happiness lying in bed?"

The DEA has repeatedly lied about its own opiate prescribing guidelines and has gone after soft “targets” like doctors—from whom it can easily steal assets—not to mention people legally dispensing marijuana in states where its legal. And don’t talk to me about “the law”. All Democratic candidates say they’ll stop the DeA raiding med marijuana clinics. Are they advocating that the DEA breaks the law? Perhaps the DEA should arrest them.

Clearly the DEA couldn’t give two shits about the lives of the patients for whom opiates is the effective solution. This organization is beyond salvage and needs to be abolished. Its administrative duties can be absorbed into the (hopefully newly funded and reformed) FDA.

Just one more piece of work awaiting the next rational occupant of the White House…..if we get one.

I agree that the DEA must be restrained in these matters. However, every pharmacist (and I'm a pharmacist) in a particular area can tell you exactly which doctors are are legitimately managing pain, which are completely naive about dishonest patients, and which are running pill mills. Just ask 5 of your local pharmaicsts, and I guarantee you'll discover which are the truly bad eggs.

Posted by: adam | Feb 7, 2008 4:51:05 PM

We do not know enough facts. The DEA does not usually go after people who merely cut corners. They may just call to discuss practices. They usually prosecute docs after people have died of overdoses, in this case 56. I would like to hear more facts or to read the charges. The licensing board also tried to suspend the license, so it is not solely the DEA complaining.

Posted by: Supremacy Claus | Mar 3, 2008 5:11:49 AM

The DEA is an out of control agency. Because of these evil scumbags legitimate pain patients cannot get adequate doses of medication necessary to manage their pain. This agency serves no legitimate purpose and seems to be a repository for sociopaths. A quick google search will reveal millions of websites and posts documenting their corruption and propensity for violence against non violent offenders not to mention stealing assets from innocent victims of this evil agency.

Posted by: j davis | Mar 13, 2008 9:24:02 AM

The DEA is an out of control agency. Because of these evil scumbags legitimate pain patients cannot get adequate doses of medication necessary to manage their pain. This agency serves no legitimate purpose and seems to be a repository for sociopaths. A quick google search will reveal millions of websites and posts documenting their corruption and propensity for violence against non violent offenders not to mention stealing assets from innocent victims of this evil agency.

Posted by: j davis | Mar 13, 2008 9:24:27 AM

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Flacks peddle false "reality"

Such a pity that the NY Times has been so beaten up by the commies amongst us that it actually now feels that it has to point out where Peter Pitts and Janet Trautwein get their money. Although, as per the last time it let Pitts write an op-ed, it didn’t mention his day job as a PR man for pharmaceutical companies. After all, who could be opposed to “Medicine in the Public Interest” — after all it is in the interest of the public to pay for all and any medicine at any price that PhRMA chooses, right?

And let’s not get started on underwriters (for whom Trautwein is the main flack). After all Grace-Marie Turner thinks that they’re the health care heroes! Perhaps they’re heroes because they drive sick people into the uninsured population so that the under-paid clinical staff working in America’s public and community health system get to show their worth by caring for them —even if they’re less heroic than underwriters.

But that’s OK, Pitts & Trautwein can be printed in the NY Times cherry-picking problems with other countries health care systems. Because as we all know there’s absolutely nothing wrong with ours, eh?

And why should Pitts quote the peer-reviewed 2007 Commonwealth Fund study that showed that waiting times for surgery were longer in the US than in the communist hell-hole of Germany, when instead he was able to cite an 11 year old study about longer waiting lists for one specific type of surgery in the Netherlands, which has completely revamped its health care system since then. Something he and Trautwein have helped stop us doing — preserving a dismal status quo they obviously want to maintain.

Those two wouldn’t last 92 seconds in a debate with Uwe Reinhardt or Hillary Clinton.

On the other hand, there’s no letter from Karen Ignagni to make up the trifecta. Did she negotiate some summer vacation time along with her $1.3m salary?

WEIRD

The Times has many faults (too much B.S. about alleged "single-payer") -- but this is NOT one of them. Anyone dumb enough to believe that a Ralph Nader fan wrote that after this tagline --

"The writer is president of the Center for Medicine in the Public Interest, a nonprofit organization that receives financing from pharmaceutical and biotech companies."

deserves to live in the U.K., France or Canada.

This was just freakin' weird.

Posted by: Russell | Aug 15, 2008 11:18:02 AM

Russell--

No, it wasn't weird.

It's part of a pattern at the NYT (where I have worked.)
The lack of discosure on where op-ed writers are coming from is disgraceful.

Posted by: Maggie Mahar | Aug 15, 2008 8:34:18 PM

Madam, with a 1000 respects -- what the heck are you talking about?

Any normal American who has actually worked a real job (e.g., McDonald's) knows when she/he is being spun. As in, when the boss asks for a volunteer -- don't volunteer until the details are known.

Someone who gets $$$ from the pharms is NOT going to oppose the pharms. This is Comm 101, madam.

My God -- I cannot believe valuable electrons are being wasted in stating the plainly obvious. What is next -- there are no illegal immigrants in the USA?

Weird. Just frackin' weird.

Posted by: Russell | Aug 16, 2008 10:32:09 AM

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