One of the most challenging and difficult parts of my professional day is trying to determine if my patients are actually taking their as prescribed.
I ask my patients to bring their medications to each visit in the original pill bottles, and we count pills. I ask them to bring their medication lists as well, and we go through the time-consuming practice of reviewing each medication against the prescribing date and …
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 …
A 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 …
I have written about pain medicine, previously on this blog, and it generated some spirited responses. Let me be clear that I am completely against all forms of pain, whether foreign or domestic, physical, spiritual, psychic or even phantom. The medical profession has superb tools to combat and relieve pain, and physicians should utilize them, within the boundaries of appropriate use. We now have an actual specialty — …
Most everyone has had the experience of sitting across from a doctor, being offered a prescription and walking out the door. Most patients will accept the instructions — maybe ask a few questions — and move on. For some of those patients, the medications are more than a one-off; they are intended to be taken indefinitely.
One of the most common of these medications is a statin. Imagine you exercise four …
In our current health care system, doctors should get to decide what medication is prescribed. Typically, the patient and doctor decide what is the best, then the prescription gets sent off to the pharmacy. When the patient goes to pick up the prescription, often they find a different one instead or are told that their health insurance coverage is not covering that prescription. Instead of receiving the best medication for …
I have already opined on my disapproval of a medical marijuana law recently passed in Ohio. Once of my points in that piece is that I did not want legislators making medical decisions for us. They can’t even do their own jobs.
I am not against medical marijuana; I am for science. The currency of determining the safety and efficacy of a medicine should be medical evidence, not faith, …
In March, 2016, the CDC released guidelines for prescribing opioids. The guidelines were a response to a serious and growing problem: millions of pain patients became addicted to prescribed opioids, and hundreds of thousands died as a result.
Since the guidelines were released, reports of pain patients being abruptly cut off of their medication or having their medication abruptly reduced have become rampant. These patients report they were using opioids long …
One of the most difficult things I deal with as a physician is patients’ demands for pain medications. I treat patients with cystic fibrosis, a genetic disease present at birth with no cure, and its issues are indeed complex. There are legitimate causes for misery from the chronic coughing, abdominal pain, and joint pain recognized as common symptoms of the disease.
But the associated issues of depression, stress with family, and …
Say the words, “drug addiction,” and most of us think of heroin, alcohol, cocaine, or opiates. However, lurking in the shadows is a less talked about epidemic: addiction to benzodiazepines, commonly known as “benzos.” I should know because after taking a nighttime dose of lorazepam (Ativan) for about ten years; I finally weaned myself off this and all other prescription sleep medications.
About twelve years ago, my father died and then …
I sometimes worry that my wife Paula won’t be able to see me grow old. Not that I expect to outlive her. She is four years my junior and has the blood pressure of a 17-year-old track star. It’s her eyesight I’m worried about, because she is at risk for a form of blindness called macular degeneration. Paula is the youngest in a long line of redheads, several of whom …
Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.
I have a proposal to make: over-the-counter antibiotics.
(Insert tongue-in-cheek here.)
Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I …
On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and …
The microbiome is among the hottest topics in medical and scientific research. The National Institutes of Health and private foundations have invested hundreds of millions of dollars in research to define and characterize the human microbiome. In the next decade, billions more will be devoted to deciphering how microbes influence human health in a positive manner. The White House even issued a national call to action for …
Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD.
Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?
THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to …
Addyi (flibanserin), the drug to increase female libido had a timid entry into the market with very few prescriptions considering the “hype.” Bloomberg Business reported 227 prescriptions in the first month. That’s a pittance considering Valeant paid $1 billion for the drug.
I am unlikely to help Valeant recoup their investment, because the more I read about this drug, the worse it looks. Here’s why:
It barely works
One of the study endpoints (meaning …
The letter from the insurance company was addressed to my patient. The two pages of information boiled down to one simple sentence: “After a thorough review, our decision to not cover the medication Provigil (modafinil) is unchanged.”
The letter went on to explain that there was no further recourse, and that the medication would not be approved because it was not Food and Drug Administration–approved for the condition my patient had: …
A brief article recently posted the name and picture of a neurosurgery resident accused of smoking marijuana on the job. Dr. Gunjan Goel, MD is a neurosurgery resident at University of California, San Diego, and the list of her awards and publications alone is almost as long as my entire CV. The article is brief, and rather uninformative. The only facts that are known are this: The …
While studying for a certification exam, I came across a question that stayed with me well after taking the practice test. The case discussed a patient who was prescribed antibiotics by his physician for a presumed bacterial illness and then returned the following week with an antibiotic-associated diarrheal infection. The test question then asked what could be concluded from this case. The answer: informed consent (i.e., patient permission for a …
It was only a matter of time before Kim Kardashian posted a picture on her Instagram account with a bottle of Diclegis, basically announcing her brand partnership with Duchesnay, the manufacturer of the prescription medication for nausea and vomiting in pregnancy. Duchesnay had been tweeting for ages that they were so relieved Kim had found help with Diclegis — so much so that I was wondering if Ms. …
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