shutterstock_90934610 I recall a talk on imaging biomarkers for Alzheimer’s disease (AD). “Take this with a pinch of salt. I have a financial conflict of interest (COI) in the success of these markers,” the speaker warned. I glanced at the audience -- MDs and PhDs with a cumulative IQ higher than the French intake of wine. I looked for pinches. I searched ...

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shutterstock_223709917 I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person. I developed dependence on opioids several ...

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We, like many in the hemophilia community, were excited to see extended half-life (EHL) factor VIII and IX products start coming to market over the last few months. These products -- and expected future products -- promise equivalent or greater prophylactic bleeding control with fewer infusions, and so could greatly enhance patients' quality of life. Yet, as we noted in our recent editorial in Haemophilia, we are greatly concerned that ...

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shutterstock_282098786 Everyone has an angle. Everyone. Your doctor? Sure. But, he or she isn’t the only one. The pharmaceutical company? Of course. The medical device company? The hospital? The insurance company? You get the point. Everyone has an angle. Everyone has a conflict of interest. Know it. Get over it. It’s time to focus on something else. Like filling up your car with gas. In ...

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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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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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shutterstock_202121116 I suffered from extreme nausea during my pregnancy; I had triplets, and I’m pretty sure I had a triple dose. I never threw up, but you know how your mouth salivates the moment right before you vomit, that sensation that sends you running to the bathroom? I had that. All. Day. Long. For four weeks. By day four or five I was ...

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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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