shutterstock_32952331 As first-year family medicine residents, our patient care experiences really run the gamut, since our training truly encompasses “cradle to grave” care.  With the exception of most pediatric care, the issue of narcotic prescribing and addiction is seen in all specialties, as well as frequently in continuity clinic where we care for our own primary care patients.  As dangerous as opiate ...

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shutterstock_230894965 The New England Journal of Medicine (NEJM) called the question: Has criticism of the pharmaceutical industry, and of physician relationships with that industry, gone too far?  Are self-righteous “pharmascolds” blocking the kind of essential collaboration that brought streptomycin and other lifesaving treatments to market?  The editorial by Dr. Jeffrey Drazen and the lengthy threepart piece by ...

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shutterstock_150037820 Lately I've had the opportunity to work in an outpatient clinic where the regular doctor is out sick for a prolonged period of time. It is a breathtakingly beautiful little community, with green hills and a crystal clear river. It is also troubled by methamphetamine and prescription drug abuse. The little clinic in town is unwittingly a partner in this crime. Like ...

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Hepatitis C is one of the most common chronic infectious illnesses in the U.S. today and affects nearly 3.2 million Americans. Complications of hepatitis C infection include liver cancer as well as cirrhosis.  Many patients with chronic hepatitis ultimately develop liver failure and will die without liver transplantation.  In the last year,  a new drug class has entered the market and can produce cure rates in excess of 90 percent. These ...

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I recently was invited to participate in a research study, looking at the economic impact of a new drug for the treatment of Clostridium difficile infection. The new drug, called fidaxomicin, has been available for a few years and has proven efficacy in thousands of patients but is generally very expensive. The study will follow patients after their hospitalization and delve into analyzing the monetary costs associated with the medicine, ...

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I recently completed the buprenorphine waiver training. Buprenorphine, itself a partial opiate, is a medication that can be prescribed to patients who have opiate use disorders (e.g., taking Oxycontins or injecting heroin to get high). A physician must complete an eight-hour training and take an exam to become eligible to prescribe this medication. The physician must then apply for a specific “X license” through the DEA ...

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In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not through the sheer volume of their sales, but as a result of their staggeringly high ...

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I argue that pharmacist should fill prescriptions even if their own morals do not agree. Pharmacists should not be limiting someone from getting something they may need because they do not agree with it. Pharmacists have no right putting their business (ideology) where it doesn’t belong. Women struggle enough when going to the pharmacy to fill a prescription for birth control or emergency contraceptive, now with the added possibility of not ...

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Do you like to take pills? I don’t. I bet most family physicians would say they have some patients who should be better at taking pills and some who love taking pills too much. For people who don’t like taking pills, what would a trade-off look like? If you were given the option of living X months fewer, but in return you wouldn’t have you doctor twisting your arm to take pills every ...

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Alright, we need to talk. Those of you who follow my blog know that I don’t shy away from controversial topics and that I don’t have a problem speaking my mind. I try to do it in a respectful, informative, and somewhat humorous way. But I saw something this morning that needs to be addressed, and it’s not funny at all. As I was eating breakfast before work, I saw a ...

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