Genomics and personalized medicine: Is it really different this time?Another year and another annual meeting for the American Society of Clinical Oncology in Chicago. This is a meeting that regularly attracts many thousands of doctors, researchers, pharmaceutical folks and others interested in the science and business of cancer from around the globe to learn, to discuss, to persuade, to educate on the progress being made in clinical cancer ...

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Approval from the U.S. Food and Drug Administration to market a new drug is a critical waypoint along the path to profits for pharmaceutical manufacturers. Unfortunately, recent case studies have illustrated that FDA approval does not necessarily provide assurances of effectiveness and safety. In last month's Georgetown University Health Policy seminar, we discussed two examples, anemia drugs and the diabetes drug rosiglitazone (Avandia), which were ...

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The Food and Drug Administration was created in 1927 in order to carry out the mission of the Food and Drug Act put into effect by Theodore Roosevelt in 1906. In the early 1900's and before, medicines killed and maimed people in gruesome ways and adding chemical substances to foods to mask the fact that they were rotten or substandard was felt to need some sort of legal response. The ...

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As a physician in a rural health clinic, I frequently see patients who complain of anxiety. The majority of these patients are in their 20s to 40s. Some have never been evaluated by a mental health professional, and many of these patients take benzodiazepines on a chronic basis. After current review, I wonder if we as primary care physicians are good at treating anxiety, or are we contributing to drug ...

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Prescription labels need to come in languages other than English As the saying goes, "With great power comes great responsibility." That applies to physicians when prescribing medications, but it also should apply to pharmacies when they're dispensing medications. In December, after seven years of exams, lectures and rounds, I received my medical license. Finally, I had the power to prescribe medications without the co-signature of my supervisor. "Be careful," she advised, "remember the ...

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In America, the conventional wisdom is that we don't ration health care. But we do, and there's no better example than patients rationing themselves when it comes to the medicines they take. Recently, a young twenty-something I know had a nagging cough—seasonal allergies, her doctor said and prescribed a generic medicine for asthma and allergies. She did not fill the prescription—the $160 price tag was too steep. Although she had health ...

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One of the things that used to make physicians different from other providers is the ability to prescribe drugs.  This is not true anymore, but the majority of prescriptions are still written by doctors.  Prescribing practices of physicians vary widely across different populations and specialties.  If a doctor takes Medicare patients, his prescribing patterns are part of the mountains of data Medicare collects about it’s patients.  In 2003 the government ...

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From time to time I get asked about cleanses. What is typically meant by a “cleanse” is only drinking a juice concoction for several days. Some cleanses add things like cider vinegar, cayenne pepper, or other supposedly “healthy” substances. The most common reasons to “cleanse” that I hear from people who drink these things include:

  • Lose weight
  • Feel better
  • Remove “toxins”
Let’s start with weight loss. Cleanses are very low calorie and don’t contain protein ...

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I had been laid off a few months when my ulcerative colitis kicked in, and my doctor and I struggled to get it under control.  After trying a variety of medicines, my health continued to deteriorate and I agreed to take Remicade. Remicade is a potent drug, administered through an IV infusion at the oncology center that comes with a whole host of potential side effects.  The dosage requires an initial ...

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We want teens to know about emergency contraception The FDA announced recently that it is approving Plan B for all girls age 15 and up without a prescription. This is good news for girls in the US of A. The easier the access to contraception, the less likely girls will have an unintended pregnancy. As many as 80% of pregnancies in teen girls in the United States are unintended. Most pregnancies ...

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