Life as a drug rep ain't what it used to be:

Doctors seem to be getting fed up with the reps, said Andrew Brana from the sales research firm TNS. Fifty-one percent of doctors responding to a survey complained about "over-aggressive sales practices," said Brana, while 87 percent of drug companies say they're taking a "smarter" approach towards wooing physicians, primarily by trying to understand what medications specific doctors ...

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Schwitzer seems to think so:

In today's WSJ, the front page of the "Marketplace" section, page B1, has a story on the "blockbuster drug plavix" and a pack of new rivals on the horizon.

But negative findings on two other drug studies are relegated to pages B6 and B7, deep in the paper and deeper in that section.

Stents take a hit

From the ACC meetings, the results that were supposed to be released tomorrow were leaked early:

For patients with stable coronary artery disease, treatment with angioplasty and bare-metal stents does not reduce the risk of heart attack or a composite of death, heart attack and stroke.
Let's see if this study will change medical practice or not. Stent supporters are on the defense:
The key quote about Courage ...

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In these trying times for the Edwards' family, Adam Hanft wonders if John Edwards' past as a malpractice attorney has helped create an environment that forces physicians to practice less than ideal care:

The media has covered the Edwards' story in terms of the painful decision they faced about whether or not to continue the campaign. But conspicuously absent has been any real attention paid to the relationship between ...

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Believe it or not, there is a bill in Massachusetts suggesting just a thing. A plaintiff malpractice lawyer's dream? Surprisingly, they are against the idea as well.

Well, when you look at the reimbursement patterns, this is no surprise:

"Typically, people will spend between $300 and $1,000 for a Botox treatment," says Resneck, all of which is paid for by the patient (given it's for cosmetic reasons), usually at the time of service. By comparison, a skin checkup might net a dermatologist an eventual insurance payment of anywhere from $30 to $100.

Does it make a difference? A study present at the ACC Meetings suggest so:

Female physicians are better than men in treating fellow women with high-blood pressure and cholesterol, and they also are better at helping men control cholesterol, the Swedish study found . . .

. . . One reason for the better cholesterol-control may be that the women doctors studied were more likely to prescribe lipid-lowering ...

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Death favors the insurance companies - why health insurers drag their feet on paying elderly policyholders.

It's no secret that the financial burden is weighing heavily on the minds of medical students and residents:

Kaufman said that physician pay, while good compared with other professions, varies by regions. He recently saw a job posting in the Midwest that would double his salary. Medical students with hundreds of thousands of dollars of debt gravitate toward places like that in order to survive. The physician climate in ...

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It has been removed from the bill, for now. This ridiculous idea has been hashed out in a previous post.

Finding a doctor that accepts Medicare is getting increasingly difficult - a situation that will only worsen:

"One of the main culprits is the 'overpromise/underfund' dilemma of offering public health-care programs such as Medicaid (for the poor and disabled) and Medicare (for people 65 and over) without sufficient funding, then standing back as demand skyrockets."

As with most things in life, it gets down to dollars. Operating a physician ...

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Scott Gottlieb wonders whether her treatment would have been as aggressive:

While recent trends in cancer survival cannot be ascribed to the new drugs alone, it is undeniable that more effective, less toxic medicines are having real impact.

Yet these improvements are not being realized around the world. Europe should be sharing in the progress against cancer, but large bureaucracies have been erected to contain costs, by slowing ...

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The WSJ reports the findings of this once-promising drug from the ACC meetings:

This morning the curtain was pulled back on study results the company had hoped would support its eventual approval. The experimental drug raised patients' good cholesterol by 61% when taken with Lipitor, compared with those taking Lipitor alone. But that increase in good cholesterol didn't halt or reverse narrowing of arteries, a disappointment that casts doubt ...

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Dr. Wes says that as doctors practice more at satellite offices, patients are increasingly being seen by their colleagues.

Of course, the concept of interchangeable doctors is already in full force with the hospitalist movement.

Maria with some observations from the recent Washington State Psychiatric Association meeting. Like most medical meetings, the reliance on drug money is needed to run the show.

Old inhalers will be banned in 2008, there is lots of behind-the-scenes action in the pharmacy as people switch to HFAs.

Combine it with a name-brand drug and resell it, aka the Caduet approach.

Gallbladders

Surgeon Sid Schwab starts the first of a series of posts on gallbladder surgery.

Pitt Med did one. Now another The Office parody from medical students at UPenn:

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ER waiting

The Boston Globe writes the obvious story saying that ER waits are getting longer:

But the doctors said in interviews that progress has been uneven and more hospitals are spending millions of dollars to expand their emergency rooms as a possible solution.
A band-aid solution. The money would better be spent strengthening primary care instead. Better access to primary care will cut down on ER overuse.

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