Friday, December 23, 2005

Critical Condition-Introduction

Is US Organized Medicine Doomed?

Organized American Medicine as we know it remains in possible irreversible crisis. Former (canned) editor of the prestigious medical journal The Journal of the American Medical Association JAMA-George P, Lundberg MD use term “crisis” many years ago. See Severed Trust: Why American Medicine Hasn't Been Fixed by George D. Lundberg with James Stacey, 371 pp, ISBN 0-465-04291-0, New York, NY, Basic Books, 2000. The crisis is on many levels but none so indolent as the moral crisis of the profession. What once was profession embodying the most noble of human traits has now, because of greed, and intellectual stagnation has become a quintessential cultural paradox, which may actually be harming more people that it helps? Hospitals have become dangerous places as per the landmark IOM report of November 1999 “To Err is Human” Unnecessary surgery, procedures and testing abounds and yet a large and growing % of Americans experience no improvement in health outcomes or have no health insurance at all?

Nothing embodies this moral crisis in US Organized Medicine more than the recent revelations about the US or Multinational Pharmaceutical Industry, which has finally been both broadly chastised and had significant legal actions taken against it. This former miracle industry has “gone sour” through greed, excess, amoral behaviors and intellectual stagnation. They push pills for a variety of human social problems like unemployment, create markets for diseases that don’t exist (shyness, etc) and utilize unscrupulous marketing techniques such as physician “educational” dinners in very fancy restaurants, utilizing cheerleaders with possible sexual favors as sales “reps” and financially subsidizing “independent” research and presentations at highly visible medical conferences. Most egregious and paradoxical of all many of their products are not safe!

I worry about the end game. Vested interests are not changing fast enough. Yet bright, brave and moral leaders scientists and physicians from academia, The FDA, and pharmaceutical companies are beginning to step forward often at significant personal risk to their employability. We are very close to collapse and rebirth -not more failed incrementalism. Optimism remains a moral imperative.

For more physicians who are solution oriented go to Common Sense Medicine at and the Institute for Healthcare Improvement at Health Promotion Advocates
Also highly recommend Dr. Nortin Hadler’s book The Last Well Person (2004)


Anonymous C. Corax said...

To pick just one of the many ills you listed:

I read in the paper recently that some drug that Pfizer had given up on had been bought up by another company and will be marketed as an anti-stuttering drug. The article said it had few side effects, blah, blah, blah.

Wouldn't it be cheaper and safer to do away with the stigma associated with stuttering? Is stuttering a disease that needs to be cured? I understand that some people who stutter will welcome this seeming panacea, but I dread that down the road, side effects will turn up that will prove worse than the stuttering.

Anyway, can one of you explain a bit about how drugs are developed? Do drug companies routinely sell their failed experiments to other companies?

4:45 PM  
Blogger Cervantes said...

Okay C, I'll get on that question for you.

As for the stuttering, I am highly skeptical that a drug would be of much help, but I'll look into it. While I agree that it would be nice if people could be more patient with stutterers, I don't suppose it will happen. However, there are new learning technologies that are helpful for stuttering, though they require more time and effort than just popping a pill.

8:13 AM  
Anonymous Anonymous said...

C Corax- While Cervantes is researching your questions I can tell you that the practices of Big Pharma are explored in depth in many recent books. Among them are Jay Cohen's Over Dose:The Case Against the Drug Companies;OverDo$ed America by John Abramson to name a few. But yes drug companies DO engage in the practice you describe

Re Stuttering- I agree with Cervantes. But I also agree many normal "states" are medicalized by Big Pharma and "treated" with very dire side-effect consequences. Is shyness, baldness,and the big one, aging a disease? I think not! Blake

8:44 AM  
Anonymous Lon Jones DO said...

Thanks for the compliment for Common Sense Medicine.

You and your readers may be interested in our proposed solutions to both our health and healthcare problems we set out in "The Boids and the Bees: Guiding Adaptation to Improve our Health, Healthcare, Schools, and Society." The underlying problem in both is the analytical, reductionist model we wrongheadedly continue to use despite the fact that we are all living adapting agents.

6:29 AM  

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