BACK of the BOOK
Are Drugmakers Getting a Pass on the Opioid Problem ?
Opioid abuse is a problem plaguing Americans , and some lawmakers are now suggesting that pharmaceutical manufacturers need to accept at least some of the responsibility for this problem . In Morning Consult , senators discussed recent legislative efforts , asking opioid manufacturers to help fund addiction treatment .
Why Is the NIH Closing Vital Clinical Research Centers ?
“ One of the most successful research enterprises funded by the National Institutes of Health ( NIH ), the Clinical Research Center ( CRC ) program , is dying , its highly productive life cut short with virtually no discussion in the scientific community . … The CRCs have been ‘ homes ’ for physician – scientists who wish to work with living patients and find new diagnostic methods and treatments that will help them . The future of personalized medicine will require more , not less , careful patient study . We disagree with this poorly considered decision to let the CRCs drift away . That would be a particularly painful loss for the medical community .”
— David M . Nathan , MD , and David G . Nathan , MD , mourn the decision to cut off funding for the NIH ’ s CRC program in STAT News
Doctors Getting ‘ Pimped ’
“‘ Pimping ’ [ is ] a core aspect of teaching on the hospital floors . The term refers to asking students a rapid series of questions , from thought-provoking and relevant to esoteric and unanswerable . It continues until teachers run out of questions , or doctors in training run out of answers . … But medical training ’ s emphasis on demonstrating how many facts we know – typically in front of colleagues , nurses , patients and families – is problematic . It encourages us to learn to show , not grow – to project confidence , and dismiss uncertainty . But uncertainty remains an integral part of medicine . … We ’ re educated in a model that demands certitude , confidence , and rightness . But we work in a profession imbued with uncertainty . Ultimately , training doctors to grow – instead of show – may lead to more curious physicians , and more honest patient interactions .”
— Dhruv Khullar , MD , MPP , on the need for newer education models beyond “ pimping ,” in The New York Times
“ Opioid producers have made billions of dollars selling these drugs over the past several decades . This amendment asks them to contribute a small portion of their profits to help pay for the treatment for the 2.1 million Americans who are addicted to their products .”
“ I would say the problem has deepened and broadened into a full-scale public health hurricane , or epidemic . The word epidemic is so overused these days that it ’ s practically lost its impact as a term , but it is truly an epidemic . … The marketing practices and the off-label advertising has become a much bigger cause .”
— Senator David Blumenthal of Connecticut
— Senator Joe Manchin of West Virginia
“ I think the drug industry has made a hell of a lot of money off of a product that has arguably done just as much harm as it has done good . … Everybody ’ s going to need to pony up money . The federal government , states , the medical profession , and the drug industry .”
— Senator Chris Murphy of Connecticut
“ As consumers bear more of the cost of health care out of pocket , they should be , and are becoming , increasingly engaged in managing their health care . We absolutely support them in doing so .”
— David King , chief executive officer of LabCorp
“ I ’ m afraid there ’ s a growing sense that the path to health is through testing . But you don ’ t test yourself to health . Health is much more about how you move , what you eat , and finding joy and purpose in life .”
— H . Gilbert Welch , MD , MPH , from the Dartmouth Institute
The Downsides of DIY Blood Tests
It is legal to order diagnostic blood tests without consulting a doctor in about two dozen states , but in NPR ’ s “ Shots ” blog , critics and proponents of DIY blood tests ask the question , “ Should you ?”
“ If you simply run medical tests in large numbers of people who don ’ t have the signs and symptoms of a certain disease , then many of the results you get will be false positives . The model of offering a wide assortment of tests [ is ] a recipe for disaster . … And , if it ’ s difficult for medical students and residents to appropriately order tests , it ’ s even harder for the layperson .”
— Norman Paradis , MD , professor of medicine at Dartmouth College
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