Recently, the world’s largest research-based drug company, Pfizer, announced that an automated packaging error led to a recall of the birth control medication, Lo/Ovral-28 and the generic counterpart, Norgestrel/Ethinyl Estradiol. The packaging issue had to do with the placebo pill being placed in the wrong order in the 28-day cycle and an inexact number of placebo (should be 7) or active forms (should be 21) of the medication. The placebo pill ...

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I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: "Your medication plan only pays for 30 days of pills, and your prescription was for five pills." The pharmacist continued: "Your PBM [that's an acronym for pharmacy benefits management company, the type of company that coordinates many peoples' medication coverage] only fills this medication ...

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Here are some of the most common questions I encounter regarding vaccines and my answers.  I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child. We give so many vaccines now and it seems like we are constantly adding more.  Isn’t this too much for my child’s immune system?  Isn’t it antigen overload?  The immune system is very complex, ...

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Julie Gralow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer. Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors. The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have ...

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Since I dedicated an entire issue of JAMA on Nov. 11, 1998 to the theme of Complementary and Alternative Medicine in an effort to move CAM into the mainstream, I keep hoping that some of the numerous CAM offerings will make it out of the realm of anecdotal and placebo-healer-effect, and successfully through randomized controlled clinical trials. So I got excited when I saw the BMJ Evidence Centre via ...

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Beginning work at Launceston General Hospital in Tasmania, orientation really, I noticed a lot of things missing: places to sign my name. For any given patient I’d sign: the completed chart note, perhaps a lab (sorry, pathology) and imaging slip, a prescription form (in triplicate – ok, so that was weird), and a GP letter. I didn’t have to sign (physically or electronically) multiple different "attestations," I didn’t have to generate multiple ...

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Betty was complaining at an escalating rate. She'd been in her nursing home for four years and wasn't happy. She kept coming up with new symptoms like aching, fatigue, nervous stomach, tingling, dizziness, etc. Her daughter Nancy was getting daily calls from Betty and the staff at the nursing home. Multiple trips to the doctor for diagnostic tests had ensued: blood counts, liver functions, x-rays, thyroid function, plus many others. ...

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People who regularly take medicine should know what we’re taking.  To me, this seems obvious, but there are always those who need everything stated explicitly.  People taking prescriptions, vitamins, herbs, and any other treatments should know what’s being taken and why. It’s pretty easy to make yourself a list and stick it in your wallet so that it’s always available.  If you need medical assistance (for instance, if you’re in a ...

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In response to low immunization rates in my community, I served on a task force to develop a community-based pilot to increase influenza vaccination. We worked in collaboration with the NYC Department of Health and Mental Hygiene, Department for Aging, Visiting Nurse Services of New York (VNSNY) and a local church health ministry. On a Sunday morning in late November (during the CDC's National Influenza Vaccine Week) nearly 100 African-Americans received ...

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I knew it was more than a tragic coincidence when two of my friends, middle-aged men without the usual risk factors of tobacco and alcohol use, developed late stage (IV) tongue cancer, reportedly the identical condition with which actor Michael Douglas was diagnosed last year. Cancers of the mouth and throat are growing so quickly that experts in the medical and scientific community are calling this an “epidemic,” for which ...

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