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	<title>Reality Base &#187; doctors</title>
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	<link>http://blogs.discovermagazine.com/realitybase</link>
	<description>A blog about science, politics, and how to let each help the other without compromising them both.</description>
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		<title>Bye Bye Freebies! Drug Companies Ax Free Goodies to Doctors</title>
		<link>http://blogs.discovermagazine.com/realitybase/2009/01/05/bye-bye-freebies-drug-companies-ax-free-goodies-to-doctors/</link>
		<comments>http://blogs.discovermagazine.com/realitybase/2009/01/05/bye-bye-freebies-drug-companies-ax-free-goodies-to-doctors/#comments</comments>
		<pubDate>Mon, 05 Jan 2009 17:16:58 +0000</pubDate>
		<dc:creator>Melissa Lafsky</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[drug companies]]></category>
		<category><![CDATA[greed]]></category>
		<category><![CDATA[money]]></category>

		<guid isPermaLink="false">http://blogs.discovermagazine.com/realitybase/2009/01/05/bye-bye-freebies-drug-companies-ax-free-goodies-to-doctors/</guid>
		<description><![CDATA[We&#8217;re back from a brief holiday hiatus, just in time for some heartening news to kick off 2009: As of Jan. 1, the Big Pharma companies have all agreed to stop producing and issuing the gobs of free loot—everything from pens to mugs to flashlights to T-shirts—they&#8217;ve been passing out to doctors for years.
Critics poo [...]]]></description>
			<content:encoded><![CDATA[<p>We&#8217;re back from a brief holiday hiatus, just in time for some heartening news to kick off 2009: As of Jan. 1, the Big Pharma companies <a href="http://www.nytimes.com/2008/12/31/business/31drug.html?_r=1&amp;partner=rss&amp;emc=rss&amp;pagewanted=all" target="_blank">have all agreed to stop producing and issuing the gobs of free loot</a>—everything from pens to mugs to flashlights to T-shirts—they&#8217;ve been passing out to doctors for years.</p>
<p>Critics poo poo the measure as little more than lip service, a PR move that doesn&#8217;t address the far bigger issue: that the drug industry and medicine are hopelessly financially intertwined. (Want proof? Exhibits <a href="http://blogs.discovermagazine.com/realitybase/2008/12/19/is-nothing-sacred-nobel-prize-engulfed-in-drug-company-scandal/">A</a>, <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/drug-company-pocket-padding-the-latest-chapter/">B</a>, and <a href="http://www.americanchronicle.com/articles/view/81594" target="_blank">C</a>.) Doctors, meanwhile, brush off the idea that logo-ed pens and Post-Its could alter their prescribing habits.</p>
<p>Still, there&#8217;s plenty to be said for the influence of everyday objects, not to mention the power of advertising. Surround yourself with enough Burger King merchandise, and you&#8217;d be amazed at how often you start craving Whoppers. Wouldn&#8217;t the same principle apply <a href="http://nofreelunch.org/requiredinfluence.htm" target="_blank">when it comes to physicians and drugs</a>?</p>
<p>(Full disclosure: RB is the child of two doctors, and our childhood desk was filled to overflowing with pens, paperweights, magnets, notepads, and countless other booty emblazoned with words like Diflucan, Avandia, and Provigil. We never went to med school, but we&#8217;d probably prescribe Lipitor simply because of their awesome mousepads.)</p>
<p><span id="more-377"></span></p>
<p>The pendulum has <a href="http://blogs.discovermagazine.com/realitybase/2008/12/04/clinic-to-reveal-all-doctor-drug-industry-ties-on-the-internet/">already started shifting</a> towards <a href="http://www.cbc.ca/cp/health/080911/x091102A.html" target="_blank">greater disclosure</a> in the medical industry, and eliminating freebies is a good move in that direction—not to mention an acknowledgment by the industry that the <a href="http://www.slate.com/id/2119712/" target="_blank">obscene amounts</a> they&#8217;ve been spending on marketing may not be good for medicine.</p>
<p>Now if we could just get them to do something about those free lunches.</p>
<p>Related:<br />
RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/12/19/is-nothing-sacred-nobel-prize-engulfed-in-drug-company-scandal/">Is Nothing Sacred? Nobel Prize Engulfed in Drug Company Scandal</a><br />
RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/12/04/clinic-to-reveal-all-doctor-drug-industry-ties-on-the-internet/">Clinic to Reveal All Doctor-Drug Industry Ties on the Web</a><br />
RB:<a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/drug-company-pocket-padding-the-latest-chapter/"> Drug Company Pocket-Padding: The Latest Chapter</a></p>
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		<slash:comments>80</slash:comments>
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		<title>Another Facet of the Health Care Crisis: Miserable Doctors</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/</link>
		<comments>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comments</comments>
		<pubDate>Wed, 19 Nov 2008 20:26:12 +0000</pubDate>
		<dc:creator>Melissa Lafsky</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[economy]]></category>
		<category><![CDATA[happiness]]></category>

		<guid isPermaLink="false">http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/</guid>
		<description><![CDATA[ 
Not only are doctors becoming increasingly, frighteningly scarce, but they&#8217;re also hating life. A recent survey of 11,950 primary care docs and specialists done by the Physicians&#8217; Foundation found that 60 percent would not recommend medicine as a career, while 42 percent said professional morale is either “poor” or “very low.”
The reasons for all [...]]]></description>
			<content:encoded><![CDATA[<p> <script src="http://w.sharethis.com/widget/?wp=2.3.1&amp;publisher=67cc06de-58af-40be-9e8e-7c994abde46a" type="text/javascript" charset="utf-8"></script></p>
<p>Not only are doctors <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">becoming increasingly, frighteningly scarce</a>, but they&#8217;re also hating life. A <a href="http://www.physiciansfoundations.org/news/news_show.htm?doc_id=728872" target="_blank">recent survey</a> of 11,950 primary care docs and specialists done by the Physicians&#8217; Foundation found that 60 percent would not recommend medicine as a career, while 42 percent said professional morale is either “poor” or “very low.”</p>
<p>The reasons for all this depression can be boiled down to insurance companies and policy headaches:</p>
<blockquote><p>&#8220;The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships.&#8221;</p></blockquote>
<p>Food for thought, Obama? As for all those <a href="http://wonkroom.thinkprogress.org/2008/10/06/medicare-cuts/" target="_blank">Medicare cut proposals</a> being thrown around, 82 percent said their practices would be “unsustainable” if pay cuts were made. A whopping 94 percent reported that the time they spend on non-clinical paperwork has gone up in the past three years, with 63 percent saying the paperwork leads to less time spent on each patient.</p>
<p>And of course, there&#8217;s the <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">shortage</a>, which is already alive and well: 78 percent of the physicians surveyed believe there&#8217;s an existing dearth of primary care doctors, while 49 percent say they plan to reduce the number of patients they see, or even stop practicing over the next three years. Yikes.</p>
<p>Related:<br />
RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">Get Thee to Medical School!</a></p>
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		<slash:comments>9</slash:comments>
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		<title>Drugonomics: Cash-Strapped Americans Taking Fewer Prescription Meds</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/10/23/drugonomics-cash-strapped-americans-taking-fewer-prescription-meds/</link>
		<comments>http://blogs.discovermagazine.com/realitybase/2008/10/23/drugonomics-cash-strapped-americans-taking-fewer-prescription-meds/#comments</comments>
		<pubDate>Thu, 23 Oct 2008 16:16:53 +0000</pubDate>
		<dc:creator>Melissa Lafsky</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[economy]]></category>
		<category><![CDATA[medication]]></category>

		<guid isPermaLink="false">http://blogs.discovermagazine.com/realitybase/2008/10/23/drugonomics-cash-strapped-americans-taking-fewer-prescription-meds/</guid>
		<description><![CDATA[
The American health care rule for prescription drugs is generally: Ask (or just go online) and ye shall receive.
But with an economic meltdown comes serious resource reallocation, and lost jobs and slashed earnings/net worths mean less money to pay for all those Trazodone and Ativan refills. Consequently, as the New York Times reports, consumers are [...]]]></description>
			<content:encoded><![CDATA[<p><script src="http://w.sharethis.com/widget/?wp=2.3.1&amp;publisher=67cc06de-58af-40be-9e8e-7c994abde46a" type="text/javascript" charset="utf-8"></script></p>
<p>The American health care rule for prescription drugs is generally: Ask (or just <a href="http://www.canadadrugs.com/" target="_blank">go online</a>) and ye shall receive.</p>
<p>But with an economic meltdown comes serious resource reallocation, and lost jobs and slashed earnings/net worths mean less money to pay for all those Trazodone and Ativan refills. Consequently, as the <em>New York Times</em> reports, <a href="http://www.nytimes.com/2008/10/22/business/22drug.html?em" target="_blank">consumers are cutting back on prescription drug use</a> in an effort to curb spending. And the effects are already hitting drug companies: Pfizer says that sales of Lipitor, the world&#8217;s largest-selling prescription med, has seen sales drop 13 percent in the third quarter, and Merck just announced it&#8217;s <a href="http://www.huffingtonpost.com/2008/10/22/merck-to-slash-7200-jobs_n_136953.html" target="_blank">slashing 7,200 jobs</a>.</p>
<p>Of course, there are plenty of reasons why this is bad:</p>
<p><span id="more-294"></span></p>
<p>We have an <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">aging population</a> with more health problems requiring medication, letting those people drop their meds may lead to an increase in preventable medical emergencies. Our health care costs—<a href="http://blogs.discovermagazine.com/realitybase/2008/06/18/reality-check-health-care/">already skyrocketing</a>—could go up even more, and our standard of living could go down (though given the <a href="http://news.bbc.co.uk/2/hi/business/7687101.stm" target="_blank">events of the last few months</a>, that&#8217;s somewhat inevitable).</p>
<p>Still, it&#8217;s hard not to argue that there could be a silver lining—specifically, that an already over-medicated population might rethink the question of just how necessary all those <a href="http://www.healthcentral.com/anxiety/find-drug.html" target="_blank">anxiety</a> and <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=89429" target="_blank">restless leg syndrome</a> pills really are. As the <em>Times</em> notes, the number of filled prescriptions has increased 72 percent in the last decade, to 3.8 billion. It&#8217;s worth asking—particularly in the wake of umpteen <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/drug-company-pocket-padding-the-latest-chapter/">scandals involving doctors and drug companies</a>—whether eliminating some, or many of these prescriptions might leave us <a href="http://www.oftwominds.com/journal08/Prescription-Drugs.htm" target="_blank">better off in the long run</a>.</p>
<p>Related:</p>
<p>RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">Get Thee to Medical School!</a><br />
RB:<a href="http://blogs.discovermagazine.com/realitybase/2008/07/16/the-meds-made-me-do-it-drug-side-effects-include-gambling-risky-sex/"> The Meds Made Me Do It! Drug Side Effects Include Gambling, Risky Sex</a><br />
RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/drug-company-pocket-padding-the-latest-chapter/">Drug Company Pocket-Padding: The Latest Chapter</a><br />
RB: <a href="http://blogs.discovermagazine.com/realitybase/2008/08/25/note-to-politicians-prevention-may-cost-more-than-treatment/">Note to Politicians: Medical Prevention May Cost More Than Treatment</a></p>
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		<slash:comments>869</slash:comments>
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		<title>Medical Brain Drain Slams Iraq</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/10/20/medical-brain-drain-slams-iraq/</link>
		<comments>http://blogs.discovermagazine.com/realitybase/2008/10/20/medical-brain-drain-slams-iraq/#comments</comments>
		<pubDate>Mon, 20 Oct 2008 17:35:23 +0000</pubDate>
		<dc:creator>Melissa Lafsky</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Science in Wartime]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[Iraq]]></category>

		<guid isPermaLink="false">http://blogs.discovermagazine.com/realitybase/2008/10/20/medical-brain-drain-slams-iraq/</guid>
		<description><![CDATA[
The doctor shortage is looming in our future, and the exodus of top scientific talent out of the U.S. may be just a few years away. But imagine the scenario if you added a domestic war, ethnic violence, and an unstable (relatively speaking) government to the equation. Cue the current situation in Iraq, in which [...]]]></description>
			<content:encoded><![CDATA[<p><script src="http://w.sharethis.com/widget/?wp=2.3.1&amp;publisher=67cc06de-58af-40be-9e8e-7c994abde46a" type="text/javascript" charset="utf-8"></script></p>
<p>The <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">doctor shortage is looming</a> in our future, and the <a href="http://blogs.discovermagazine.com/realitybase/2008/07/24/historians-foretell-our-demise-as-a-scientific-superpower/">exodus of top scientific talent</a> out of the U.S. may be just a few years away. But imagine the scenario if you added a domestic war, ethnic violence, and an unstable (<a href="http://www.washingtonpost.com/wp-dyn/content/article/2008/10/19/AR2008101901571.html?hpid=topnews" target="_blank">relatively speaking</a>) government to the equation. Cue the current situation in Iraq, in which legions of educated workers—including doctors and other health professionals—are high-tailing it to safer pastures, as <em>Newsweek</em> <a href="http://www.newsweek.com/id/164496/page/1" target="_blank">reports</a>. And who can blame them: Since the U.S. invasion began, doctors have been prime targets for violence, including assassination, ransom kidnapping, and torture.</p>
<p>Unsurprisingly, around 30,000 doctors, plus some dentists and pharmacists, have fled the country as a result, and despite the fact that things have calmed down since the near-chaos of 2006, only about 800 have returned. To put that number into perspective, the total population of Iraq is around 28 million, compared to over 300 million in the U.S. The expected American doctor shortage, which could be enough to throw our health care system into crisis, is <a href="http://blogs.discovermagazine.com/realitybase/2008/06/19/get-thee-to-medical-school/">projected to be 50,000 to 100,000 doctors</a>—not that much more than what Iraq has already lost.</p>
<p>Then there&#8217;s the other urgent dilemma: With all the experienced doctors fleeing the country, who&#8217;s left to train the med students?</p>
<p><span id="more-286"></span></p>
<p>One physician is quoted as saying that younger residents and interns are literally &#8220;studying the textbooks and searching the Net.&#8221; Just imagine your orthopedic surgeon Googling &#8220;knee replacement&#8221; as a nurse puts you under.</p>
<p>Efforts to lure the expat doctors back to their home include tripled salaries, back pay for time spent outside the country, free land, and even newly-renovated &#8220;doctor living communities&#8221; that would be guarded for safety. Still, as our own financial meltdown has shown, all the money and property in the world can&#8217;t buy security.</p>
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