A confluence of events has occurred in the United States that could help to save the lives of many patients as well as the lives and careers of many physicians. The solution is to apply the use of micropractices to address the current opioid addiction crisis. A micropractice is a small medical practice that is run efficiently to keep overhead low and put the patient first. The patient is given ...

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There’s a clear culprit in the rising drug overdose death count in Massachusetts — the synthetic opioid fentanyl. More powerful and more deadly than heroin, fentanyl has sparked a new set of survival rules among people who abuse opioids. About 75 percent of the state’s men and women who died after an unintentional overdose last year had fentanyl in their system, up from 57 percent in 2015. It’s a ...

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Why are the costs of prescription drugs so high? While I have prescribed thousands of them, I can’t offer an intelligent answer to this inquiry. Of course, all the players in this game — the pharmaceutical companies, pharmacy benefit managers, insurance companies, consumer activists and the government — offer their own bromides, where does the truth lie? While I don’t fully understand it, and I don’t know how to fix it, ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. One of the things that I dread the most about January 1 is that it’s the start of “prior authorization (PA) season” for prescription medications. It is time consuming and frustrating, plus it often jeopardizes patient safety and quality of care. A recent Viewpoint in the ...

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The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted.  The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year to that effect.  Private insurers are following suit, in many cases refusing to pay for ...

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asco-logo One of the questions that I face (and which I am certain many of us do) concerns the use of alternative therapies. Iron chelation therapy, high-dose vitamin C infusions, Chinese herbs — interest in these therapies and others like them are driven by word-of-mouth (“a friend of a friend”), claims on websites and patients curiosity. Cancer is ...

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Sometimes medicine offers us wonderful, almost unimaginable gifts. Heart attacks that were devastating, life-altering events a few decades ago are now treated with expediency and skill that our grandparents couldn’t imagine. A couple of days pass, and the victim is home with stents in occluded arteries and directions to modify activity and diet. Pneumonia, once the "old person’s friend" (so called because it took the aged to eternity), is far less ...

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Early in our careers, few of us imagined a vaccine could one day prevent cancer. Now there is a vaccine that keeps the risk of developing six Human Papillomavirus (HPV)-related cancers at bay, but adoption of it has been slow and surprising low. Although it’s been available for more than a decade, as of 2014 only 40 percent of girls had received the full three doses of the vaccine, ...

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The amount of prescribed medications and the number of individuals taking them are increasing rapidly. The share of Americans taking one or more prescription drugs has risen among all age groups. According to the IMS Health Study, the total spending on prescription drugs in the U.S.  reached $310 billion in 2015. This is almost three times more than total drug expenditures in the year 2000. It is forecasted that the ...

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The Mylan EpiPen debacle may have inadvertently weakened the grip of big pharma on U.S. lawmakers.  Recently, a bill proposed by Senator Bernie Sanders was narrowly rejected by a vote of 52 to 46.  Unexpectedly, 12 Republicans and 1 Independent voted with Senator Sanders in favor of allowing pharmacists and distributors to import cheaper prescription drugs from foreign countries.  The winds of change may finally blow in a bipartisan direction.  ...

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