Having a healthy level of respect for opioids is critical for any physician. For those of us who prescribe or recommend this class of medicines on a daily basis, this statement rings all the more true.Recent events and research reinforce this reality.
“Oxycontin, Other Opioid Painkillers Tied to Higher Health Risks” was the title of a recent BusinessWeek article …
Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.
Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.
Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout. A mistake recognized at the time of purchase can be easily …
I decided to dedicate a medical blog on smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That’s one in five people. And this number contributes to Omaha’s health ranking of 142 out of 182 cities in …
Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.
This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is …
by Marianna Rakovitsky, RPh
Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart. All medications carry a risk of adverse effects. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects …
The other day, I happened to be talking to Mark, a sales representative from one of the pharmaceutical companies. He’s the type of rep that many doctors don’t mind seeing – someone who is careful of your time, is happy to hunt down the answers to questions that come up on the medications his company makes, and brings by useful information about new drugs that seem to be practice-appropriate. He …
An excerpt from White Coat, Black Hat.
by Carl Elliott
Many of us have a relatively simple, commonsense view of the way that drug development and marketing work.
People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a drug …
Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.
What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.
Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and …
Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of ancillary revenues.
Why dangerous? For a number of reasons.
One, physicians still grapple with the perception that it is improper for a physician to make money from …
There is a lot of press about a study recently published in the New England Journal of Medicine that shows that adding tiotropium (Spiriva) to an inhaled steroid might have benefit in asthmatic patients. This study is creating a lot of buzz due to recent concerns of ICS/LABA safety and might prompt doctors and patients to start switching (some already have before this study came out). However, this …
Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.
And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and …
by Daphne Swancutt
Two people in the United States just died in the last hour. Seventeen more will die in the next 7 to 8 hours. Over a year, that number will accumulate to about 7,000.
The reason? Medical errors that include misread or otherwise misinterpreted handwritten prescriptions. Believe it. This means that doctors are being sloppy, pharmacies are making mistakes and people are getting dead.
Even more …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 70-year-old woman with hypothyroidism fell and fractured her hip. During preoperative evaluation for hip fracture repair, she mentions recent mild fatigue, which has not significantly limited performance of her daily activities, and ongoing right upper-quadrant abdominal pain after eating. She takes levothyroxine, 0.075 …
Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve.
Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, …
Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.
The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:
Costco: $27
Walgreens (with Saver Card): $325 (without Card): $380
CVS: $361
Walmart: $347
Target: $340
These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …
by Arnon Krongrad, MD
The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.
Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. …
Advertising is everywhere.
That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these …
I am a medical doctor. I am also called an allopath, someone who practices “Western medicine.”
We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials. We want to know the “mechanism of action.” We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them. We feel more confident about …
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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