acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. One of the things that I dread the most about January 1 is that it’s the start of “prior authorization (PA) season” for prescription medications. It is time consuming and frustrating, plus it often jeopardizes patient safety and quality of care. A recent Viewpoint in the ...

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Dear pharmacist, You just paged me and, I must admit, I’m not feeling excited to call back. I estimate that I probably get paged, called, texted or stopped in person by you exactly X·102 per day, where “X” is the number of days I’ve been on service. Despite all of the interactions over the years, I have never stopped to really consider our relationship. Here are a few of our most ...

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asco-logo One of the questions that I face (and which I am certain many of us do) concerns the use of alternative therapies. Iron chelation therapy, high-dose vitamin C infusions, Chinese herbs — interest in these therapies and others like them are driven by word-of-mouth (“a friend of a friend”), claims on websites and patients curiosity. Cancer is ...

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The amount of prescribed medications and the number of individuals taking them are increasing rapidly. The share of Americans taking one or more prescription drugs has risen among all age groups. According to the IMS Health Study, the total spending on prescription drugs in the U.S.  reached $310 billion in 2015. This is almost three times more than total drug expenditures in the year 2000. It is forecasted that the ...

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The Mylan EpiPen debacle may have inadvertently weakened the grip of big pharma on U.S. lawmakers.  Recently, a bill proposed by Senator Bernie Sanders was narrowly rejected by a vote of 52 to 46.  Unexpectedly, 12 Republicans and 1 Independent voted with Senator Sanders in favor of allowing pharmacists and distributors to import cheaper prescription drugs from foreign countries.  The winds of change may finally blow in a bipartisan direction.  ...

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Years ago, after I suffered a deep personal loss, my doctor prescribed Prozac, and I joined the millions of Americans who have taken an antidepressant. A few weeks later, I had my first panic attack — heart racing, sweating profusely, gasping for breath — sensations of terror normally reserved for life-threatening events. Attacks continued every half-hour and were so incapacitating that I could not even leave my house. My doctors ...

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In the United States, the patent protection process — as it relates to the drug industry — has been distorted by the political system, intense lobbying and large campaign contributions. The result has been pricing contrary to the greater good of the nation. Patents originated in ancient Greece. This legal protection assumed greater importance in 15th-Century Venice as a means to protect the nation-state’s glassblowing industry. The first patent granted in ...

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My daughter and I were talking the other day and saying we would like to ask a doctor what his thoughts are about all these ‘natural’ remedies that are available. Recently a friend made the remark, ‘I do everything I can to avoid a doctor.’ I lean more toward the medical system and the knowledge they have acquired over the years rather than relying on these home remedies. What are ...

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A recent issue of the Journal of the American Medical Association (JAMA) reads like an expose. Well, at least three of the research articles do. So exciting! I don't want medicine — my field — to be ethically unsavory, but it is sometimes. It makes me proud to see that it polices itself and that such information is published in a high profile journal. The first article ...

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“Our son doesn’t get the flu shot, no one in our family does,” she said, with some emphasis on the "no one," inviting me to take a swing. Anticipating futility, I reminded myself that our pediatrics clinic was already forty-five minutes late. This was a scrap better deferred. “Alright,” I said flatly as I moved on with the encounter. This was of course not explicitly, but indeed, implicitly, approving the mother’s ...

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