Something huge happened at the American Medical Association House of Delegates meeting. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of CME out of existence. Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is ...

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There's been plenty of buzz about a recent New York Times story, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy" by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist who has a private practice in Doylestown, Pa. It is a poignant example of a common situation in psychiatry. Older psychiatrists were trained during a time when there ...

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Recently, the FDA has rejected another anti-obesity drug, Contrave, because of concerns that it might cause heart attacks in patients who take it for years. FDA's excessive caution was motivated by its experience having been burned by the Fen-Phen fiasco. This was a weight loss drug widely prescribed in the 90s that was pulled from the market after studies showed it caused fatal ...

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The non-profit media organization ProPublica last year announced a new website/database called Dollars for Docs. It lists cash payments made to 17,000 U.S. doctors by seven large drug companies. I’ve been browsing through the database and I have some thoughts about its strengths and weaknesses—and how it might be useful for patients. First, here’s what these journalists did. Rather than waiting for the provisions of the Physician’s Payments Sunshine Act ...

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An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc. It may be hard for people to imagine that drug reps can get us to prescribe a particular drug by simply giving us a meal or being nice to us. The process is subtle, but ...

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An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc. My own education in pharmaceutical marketing began during my second year of residency at Massachusetts General Hospital. Suddenly, I noticed that Paxil bagels began appearing everywhere. I first saw them in the break room of the ...

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I recently debated Steve DiFillippo, owner of Davio's and Avila's restaurants, on the WGBH program Greater Boston, hosted by Emily Rooney. The topic? The effect of the Massachusetts Gift Ban law on area restaurants. On one level, it was a friendly debate on the economic impact of the law on those restaurants that depend on drug company sponsored dinners for a chunk of their income. But on another level, this is a ...

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An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc. In 1993, the FDA approved Neurontin for the treatment of epilepsy. This should have been a cause for celebration at Warner-Lambert, the drug company that introduced it, but the celebration was muted. The FDA had ...

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As originally reported in a New York Times article recently, with more coverage in MedPage Today, the University of Michigan School of Medicine has decided to end all industry support of CME as of January 1, 2011. According to the dean of the medical school, "the decision was based on a review of literature about the influence on clinical faculty of industry-funded CME." Apparently the decision was made after a ...

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I want to touch on what is probably the hottest topic in psychiatry: whether psychologists should obtain prescription privileges. This is topical because Oregon just overwhelmingly passed a law authorizing prescriptive privileges for psychologists, although it is unclear whether the governor will sign the bill. I endorse psychologists prescribing, and here’s why: it would be the single best thing that could happen to psychiatry. Yes, I know it sounds ridiculous, but ...

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