“Doctor, what do you think of alternative medicine?” a patient with chronic fatigue syndrome asked me the other day. She was interested in doing something more for her severe fatigue. “Would acupuncture help me?” I paused and, as I have done many times before, answered that my training and most of my clinical experience has been in Western, allopathic medicine. (Ironically, the word “allopathic” was first used as a derogatory term ...

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Doing drugs no longer requires a dealer on the street corner. Between the late 1990′s and 2010 sales of narcotic pain medicines quadrupled in the United States. Hydrocodone use increased by 280%, methadone by 1300%, and oxycodone by 900%. As the consumption of these medicines increased, so did ER visits and deaths from overdose -- up by about 500%. A whole lot of these medicines are not going to medical use. And ...

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As of September 2, CVS -- the ubiquitous pharmacy/convenience store -- has stopped selling tobacco products, including both cigarettes and smokeless tobacco. This is a bold move from the retailer, which is also planning to rebrand itself as “CVS Health” to emphasize its place in the health care delivery chain. I personally applaud the decision, because there are simply no benefits to tobacco use in any form. And it’s also ...

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My brother and I, both optometrists, had a heart-to-heart discussion about the loss of one of our patients. We discovered he was not taking his medications as prescribed, which was leading to vision loss. When pressed, the patient said he had a choice of eating, supporting his family, or purchasing his medication. He was under the impression that the $150 price for his generic Lipitor was “about the same” at any ...

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Check out the prices for nebulizer solutions of albuterol and budesonide (generic Pulmicort). They are totally affordable. $4 for a month for albuterol. $14 for a month for budesonide respules. Pulmicort respules used to be very expensive. Now even the branded budesonide is  less than 10% of a monthly cable bill. Then check out the prices of inhaled steroids delivered through meter dose inhaler (MDI) or dry powder inhaler (DPI). These ...

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I recently wrote about a hospital system in Colorado that had discovered a way to cross market its more profitable emergency room services if a patient first came to its urgent care center. Pretty clever! Then recently I came across another health care marketing trick close to home and just as sly. As I sat on a New York subway one sizzler of a day, an ad for an ice cream ...

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My patients lie to me every day. Some tell me that they have been taking their medications regularly when they haven't. Some say that they have been eating a healthy diet and exercising for at least 30 minutes every day and don't know where the extra pounds are coming from. Some lie that they are using condoms every time they have sex, that they have quit smoking, and if they ...

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I must not be the only person to wonder how pharmaceutical companies succeed with direct to consumer advertisements when, stuck in the middle of all their TV ads, are those long lists of side effects.  You know what I mean.  After watching a smiling and attractive person running through a field after receiving some wonder pill, the narrator tucks his voice down an octave and intones that the medication “could ...

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Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients -- at a profit. The medical profession has struggled with this controversial practice  for more than 150 years. In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it. Around ...

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It is clear that patient compliance with prescribed medications is critical to success in the treatment of any chronic disease process.  In addition, patient engagement and co-management of their disease has been proven to improve outcomes.  A new study from the Annals of Internal Medicine suggests that any changes in the appearance of a medication may result in a decrease in compliance; when a pill looks differently patients often simply ...

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