Medical school prepares physicians to prescribe medications for prevention and treatment of disease, but little to no time is spent teaching something just as important: de-prescribing. In our current system of auto-refills, e-prescriptions, and mindless “checkbox” EMR medication reconciliation, patients may continue taking medications years after their original prescriber intended them to stop. There is no doubt that many Americans are over-medicated, and the problem
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At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual? At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital and in the outpatient setting, one of the cases was about a patient who developed an abnormal cardiac rhythm as a result ...

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Long before the Internet and direct-to-consumer advertising, the medical profession tried to reassure people about their health concerns. Remember “take two aspirins and call me in the morning?" Flash forward to today’s online “symptom checkers.” They are quizzes to see if someone has a certain disease and exhortations to see their doctor even if they feel fine. Once drug makers discovered that health fears and even hypochondria sell drugs, there seems ...

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A small study published this month showed that most Epipens retain their potency for at least 4 years after their expiration date. That’s no guarantee, of course. I’d still recommend as a “best practice” that families replace them as they expire. But it’s reassuring to know that they’ll usually be effective even when expired. And using an expired EpiPen is almost certainly better than using nothing ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. One thing about me that even my closest friends are unaware of is that I am a zombie fighter. Unlike the ones in video games, TV series, or movies, the zombies that I fight in my practice are prescriptions that won’t die. They ...

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“Pigs get fat, but hogs get slaughtered,” the saying goes. And so may it prove to be true for the pharmaceutical industry. Three articles, all published May 3, illustrate the greed and egregious pricing by certain drug companies that are gaining public recognition and scrutiny. As an example, Marathon invested $370,000 to obtain the license for the data on “deflazacort,” a steroid available for about $1,200 a year in the United Kingdom. ...

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Imagine that you are gasping for breath, literally on the verge of death. Then someone injects you with a medicine and -- miracle! -- you are perfectly healthy again. Would you pay $300 for that injection? The treatment is epinephrine; your illness was a life-threatening allergy. And that $300 price? That reflects a six-fold increase from a couple of years ago. It’s one thing for medications to be ...

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More than a decade ago, the job of the pharmaceutical rep was enviable. Direct-to-consumer advertising pre-sold many drugs so doctors already knew about them. Medical offices welcomed the reps who were usually physically attractive and brought lunch. In fact, reps sometimes had their own reception rooms in medical offices. By 2011 thanks to drug safety scandals and new methods of marketing, the bloom had fallen off the pharma reps’ roses. ...

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Recently, another local family buried their young adult child due to a drug overdose.  Sadly, this same story is playing out daily across the nation. Upon reading the headline, I paused to think about an encounter leaving work one Friday evening. As I was walking in the dimly lit street to my car, I found a small group of shadows huddled over something lying in the adjacent alley. Once closer, I saw that ...

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Why are the costs of prescription drugs so high? While I have prescribed thousands of them, I can’t offer an intelligent answer to this inquiry. Of course, all the players in this game — the pharmaceutical companies, pharmacy benefit managers, insurance companies, consumer activists and the government — offer their own bromides, where does the truth lie? While I don’t fully understand it, and I don’t know how to fix it, ...

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