Marketing Healthcare

[+ Lucky]

hehehe...hopefully a huge orgasm.

[+ Lucky]

KMEM- the fact is that a doc can make big bucks if he wants to. Some are more money grubbing than others.

 

I have a doc friend that is always bitching about money. One day his financial statement was left on the desk, and, in that account alone, he had over a million bucks. So no sympathy from me, not that he didn't work hard for the money and do a lot of good for people.

[KMEM]

I understand your point. They certainly have opportunity, whether they take advantage of it or not. However, somehow lower paying jobs that require one to be a licensed physician are filled and I don't think always for entirely altruistic reasons.

 

What do they call the person who graduates last in his or her class in medical school? Answer: doctor.

 

The opportunity is certainly available.

 

Best regards,

KMEM

[+ purplekow]

>KMEM- the fact is that a doc can make big bucks if he wants

>to. Some are more money grubbing than others.

>

>I have a doc friend that is always bitching about money. One

>day his financial statement was left on the desk, and, in that

>account alone, he had over a million bucks. So no sympathy

>from me, not that he didn't work hard for the money and do a

>lot of good for people.

Guess he has been saving that lunch money and selling that stationery.

Or perhaps he is just adept at handling those kickbacks he has taken to foist unnecessary drugs are unsuspecting patients.

He should have known better than to leave you alone with personal information.

 

I have never seen a purplekow;

I never hope to see one;

I can tell you anyhow;

I'd rather see than be one

 

Help there is a purplekow in my mirror

[seaboy4hire]

Today I was hanging out with some of my coffee buddies and we were talking about health care. One of them suggested I check out the following story that was on PBS http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ I encourage everyone to watch. None of these health programs are perfect they all have their flaws but is it really wrong when everyone is covered and no one claims bankruptcy? Think of the millions if not billions saved. And not to mention when more people are healthy the billions gained in productivity. Call me a pinko socialist commie but I say lets give it a shot! It's gotta be better then what we have now.

 

Hugs,

Greg

[email protected]

http://seaboy4hire.tripod.com http://www.daddysreviews.com/newest.php?who=greg_seattle

http://img182.imageshack.us/img182/6707/lebec084a9ad147f620acd5ps8.jpg

Five months and counting!

[+ Lucky]

Did you know that Medicare pays surgeons to fix their own mistakes? Neither did I.

 

http://www.nytimes.com/2008/10/01/us/01mistakes.html?hp

[+ Lucky]

Tuesday's Science Times section of the NY Times was one of the best patient info sections yet. A real keeper.

 

If you have read this far, you might like this anecdote. Today I was doing the cardiac stress test on the treadmill, with the cardiologist and the technician behind me, in my mind they are watching the machine spill out my heart info. The tech said to the doc: "He's a walking time bomb!"

Naturally I inquired abruptly as to whom they were speaking of, and the doc tried to joke it off, but in truth they were not talking about me. We're probably all walking time bombs though.

[+ Lucky]

Danger Rx

 

The most dangerous prescription drugs are now listed. Prescription meds have caused 4825 deaths and 21,000 injuries in just the first three months of this year:

 

http://www.latimes.com/news/nationworld/nation/la-sci-drugs23-2008oct23,0,3729962.story

 

The most dangerous for injury was varenicline for cessation of smoking.

The most dangerous for death was oxycodone, followed by Zanax and Tylenol.

[Guest zipperzone]

RE: Danger Rx

 

>The most dangerous for death was oxycodone, followed by Zanax

>and Tylenol.

 

Lucky: I read the article twice and couldn't find any referance to Tylenol. Am I missing something?

[Lookin]

RE: Danger Rx

 

> The most dangerous for death was oxycodone, followed by Zanax and Tylenol.

 

Good gosh! Throw in a couple Cialis and there go my weekends. :+

[+ Lucky]

RE: Danger Rx

 

acetaminophen is Tylenol's generic name

[seaboy4hire]

RE: Danger Rx

 

>> The most dangerous for death was oxycodone, followed

>by Zanax and Tylenol.

>

>Good gosh! Throw in a couple Cialis and there go my weekends.

>:+

 

Only if I'm on the receiving end of that weekend >

 

Hug,

Greg

[email protected]

http://seaboy4hire.tripod.com http://www.daddysreviews.com/newest.php?who=greg_seattle

http://img182.imageshack.us/img182/6707/lebec084a9ad147f620acd5ps8.jpg

Four months and counting!

[+ bigjoey]

recently i had dinner with two people from holland, one from germany and two from israel and health care came up. they all complained that they were taxed too much and got back too little from their government "universal" health care. then i got the real shocker: they all paid for private insurance to get additional coverage!!!!

 

it seems that the "free" government care was limited in a number of aspects and if you wanted to go beyond the basics, you either paid out of pocket or had insurance. for example, i was told that israel's government only had limited approved cancer drugs; if you wanted the newest and best drugs that were not on the government list, you had to pay for them out of pocket and if you could not pay or if you did not have insurance you did not get the drug and died.

 

in canada, about 30% of the people have private insurance with american companies so if they do not want to wait months for an MRI, they just pop down to the US and get one paid for by the insurance company. the waiting lines in canada are famous. there is a documentary that played in theaters a few years ago called "dead meat" about the problems in the canadain system (which does not cover dental care which i find strange).

 

no place has unlimited free health care. there is either rationing by "lining up" as in canada or by price like in the US or by strict limits on services that are available.

 

in the US, currently about 85% of the population has insurance; it is the other 15% that we need to be concerned. a large part of those are young who just do not want to pay for it as they feel healthy (and forgetting about an accident or injury). yes, it is a problem but to me the issue is getting coverage for those who want it but can not afford it.

[+ Lucky]

You On Placebos?

 

Commercials like to say 4 out of 5 doctors recommend such and such, but today's study reveals that 5 out of 10 American doctors routinely prescribe placebos to their patients. Fascinating stuff:

 

http://www.nytimes.com/2008/10/24/health/24placebo.html?hp

[Guest]

As of January 1st, pharmaceutical companies will no longer be able to supply physicians with "goodies" such as pens, notepads, or taking them out to dinner. The one loophole is that they will still be able to sponsor promotional lectures (by physicians) at restaurants, inviting groups of doctors. You may be happy to hear that. Pharmaceutical companies have both positive and negative effects on physician prescribing. It's pretty well-documented and hardly disputed that pharmaceutical marketing increases pharmaceutical spending. Duh. They wouldn't do it if it didn't.

Certainly much of this extra spending is unnecessary and sometimes even harmful. A good example of unnecessary or even harmful prescribing is the use of needlessly expensive antibiotics when less expensive ones, or even no antibiotics, will do. Some, however, is helpful. One may be as cynical as one wants, but a medication has to do SOMETHING helpful for the FDA to approve it.

If a pharmaceutical company, for example, educates a physician about, say, restless leg syndrome or impotence, spending may go up, but patients may get very real relief of symptoms.

Placebo prescribing is a tough subject. Unfortunately, patients often think they know more than doctors, and it is very difficult and often impossible to convince some of them otherwise. Some patients, for example, are absolutely convinced that if their boogers turn green, or if they cough up green stuff, that they need antibiotics. The simplest thing, to do, of course, is to hand over the Rx. My own practice is to explain why antibiotics won't help until they either understand, or until I'm convinced they won't listen any further.

Most patients will eventually understand, but there will always be those who are convinced they know better. I'm popular enough as a physician to not care about these latter patients, and am happy to show them the door. But I can understand those physicians who succumb to the temptation of writing the Rx (I don't agree at all with them, but I understand).

As for Lipitor, I personally don't prescribe it that often, since it's not on most of my formularies. Nevertheless, the data that it prevents cardiovascular events are fairly undisputable. I will agree that so far Zetia doesn't seem to do anything helpful except change lab values and make a doctor's patient statistics look better. However, the data on the helpfulness of statins in general, and especially Lipitor, is VERY robust from multiple double-blinded placebo-controlled studies. And I'll tell you I've never received so much as a pen or pad of post-it notes from the Lipitor people (probably not too surprising since I don't prescribe it that often).

[+ Lucky]

Unicorn, thanks for the post.

[Guest]

In case anyone wants references to actual studies, there are many studies on pre-Lipitor statins which showed 20-35 % reductions in coronary events and death. Lipitor was mainly marketed after these studies had come out, so most studies compared Lipitor to older statins and came out favorably (it would have been unethical to compare lipitor to placebo). The ALLIANCE study with 2442 patients compared Lipitor to other statins and showed a 17% reduction in CV events (heart attacks, cardiac arrests, revascularization, unstable angina). The TNT study which compared high to low dose Lipitor showed a 22% reduction in 1st major CV event and 21% reduction in stroke. The PROVE IT-TIMI trial (4165 patients) which compared pravastatin to Lipitor (funded by the pravastatin manufacturer Bristol-Myers-Squibb, by the way), showed a 16% reduction in CV events, 14% reduction in angioplasty or bybass, 14% reduction in heart attack, angioplasty, bypass, or death. There was one older Scandinavian study (ASCOT-LLA) which compared Lipitor at the lowest dose (10 mg) to placebo and found 36% reduction in non-fatal heart attacks and from cardiovascular deaths, as well as 29% drop in total coronary events. That study was stopped at 3.3 years and had over 10,000 patients.

Back on the subject of placebos, while I generally do not favor prescribing them, their use is not entirely unethical. I think most doctors probably prescribe them only when patients cannot be convinced that the placebo won't work. These are the patients for which placebos are, in fact, most likely to work (there is a real placebo effect found in all studies).