Wednesday April 25, 2007, 2:56 pm
Of course there are unethical physcians, just like there are dishonest people in all professions. Physicians who hide research data, spread misinformation, or alter their prescription practices based on drug company influence should be prosecuted. Physicians should not rely on drug companies as a sole source of information about their products. However, continuing education opportunities, patient education materials, and free samples have direct patient benefits. Some people could not afford medication if it weren't free.

Wednesday April 25, 2007, 3:31 pm
Of note, 25% received direct payments. All the rest received food in the workplace or sample prescription drugs. The direct payment group is the worrisome group, whereas the others often provide food at educational events and most of the samples go on to patients. The most worrisome statement worrisome to me is "drug and medical device manufacturers single out doctors in certain areas and doctors with influence over others to develop close relationships". Again, it's all about money. Thanks David.

Wednesday April 25, 2007, 3:40 pm
http://www.care2.com/c2c/share/detail/357319

I have a lot of stuff about this on a share and there is also a petition there to sign.
It is shocking what they have been doing and it affects everyone around the world. The also help flasify clinical trials and over 100,00 die each year in the US alone and over 2 million are suffering from drug related illnesses.
They are also using kids to test drugs on and a few other assorted things. This should be a concern to everyone. They are even faking new illnesses. This is just sick.

Wednesday April 25, 2007, 3:51 pm

Cynthia, I think it is much more than just simple ethics.
It's quota's, the bottom line, double and tripling of appointments for the same time slot, poor and tired listening skills, Celebrex for everything & everyone, and keeping the Corp happy, or the wife in her 4000 ft. home, and forgetting why they became doctors in the first place.

Wednesday April 25, 2007, 5:03 pm
Sadly, Carol, too many people become doctors because they see tthe profession as a meal ticket, but then the same applies to lawyers. I suppose 'ambulance chasing' is still a way of life for the insurance touts, and the poor, as Cynthia points out, can die on the sidewalk, for all that private practice doctors/hospitals (not forgetting the Bush Administration) care. I remember seeing a car window sticker in Florida, some years ago, saying "Become a doctor, Support a lawyer", which reminds us of the inflated healthcare bills due, in a great part, to the fact that doctors can be sued for not carrying out specific, often unnecessary tests, in case the patient does not get 'cured'.

Thursday April 26, 2007, 8:14 am

I don't get how this got pointed in the direction of lawyers. And the bumper sticker is the most meaningless and propagandasized hype. Did you by chance see it on a BMW, Porche, or a Hummer?
What B.S.
And here is why
But first I full heartedly agree with Cynthia and Mary's comments. I was only stating that with the pressures for profits and expansion of these health corporations buying all hosps. etc...H 1 B Visas, that even if you can find an ethical Dr. anymore, even he is limited to what he can practice.

Now David, this is why the bumper sticker is misguided and completely propaganda...

Report Finds No Link Between Doctors' Premiums and Malpractice Suits.

The hoax perpetrated by the insurance industry to the effect that the courts are filled with frivolous and petty medical malpractice claims is one of the most fraudulent and malicious propaganda campaigns ever foisted upon the public.

"Anyone who thinks that arbitrary damage caps will reduce doctors' premiums should take a long, hard look at California, where 10 years after the caps passed, rates had still gone up 400 percent. It was only when we started regulating insurance companies in 1988 (under Prop. 103), that rates started coming under control and, even then, they must still be monitored to this day.

Missouri Hospital Association in late 2002 concluded that the number and cost of claims had not contributed in a significant way to the sudden increase in medical professional liability coverage. Instead, the report said, premium increases had been driven by insurers declining bond portfolio income.

Cynthia sounds like a nurse who has seen both sides of the situation. I am a patient with a life long illness. I have been screamed at, yelled at, even blamed for my disability, because I refuse the impulse to ignore the risk of drugs and with tremendous suffering and limitations, have yet to see the benefits out weigh these risks. And the best doctors will agree with me, understand this, and are happy I do my own studying and engage them for more answers.

Drugs.
A young stand-up comic said,
You know we have more prescription drugs now
Every commercial on T.V. is a prescription drug ad
I can’t watch T.V. for four (4) minutes without thinking I have 5 serious diseases
Like … Do you ever wake up tired in the mornings?
..Oh my God, I have this, write this down I have this.
Half the time you don’t even know what it is.
There’s people running through the fields, flying kites, or swimming in the oceans,
Like that is the greatest disease ever.
How do you get that?
That disease comes with a hot chick and a puppy.

Thursday April 26, 2007, 9:11 am
Thanks, Carol, for bringing me up to date with current US medical insurance/doctor's fees. I saw the car sticker back in the 60's, by the way. Are doctors/hospitals not now sued for medical malpracrice as frequently as used to be the case, according to a BBC documentary shown several years ago here in the UK? Advertising of over-the-counter drugs is tightly controlled here in the UK, and 'prescription only' drugs are not allowed to be advertised at all. This means that most drug advertising is confined to mild analgesics, to be taken internally, or for topical application, or for mild (usually herbally based) laxatives, without any graphic depiction of their mode of operation!!.

Thursday April 26, 2007, 9:15 am
David, are you blocking my comments on this post? I made one yesterday and one today that did not post. There was nothing inappropriate in either so I don't understand why they're not here.

Thursday April 26, 2007, 9:16 am
David, are you blocking my comments on this post? I made one yesterday and one today that did not post. There was nothing inappropriate in either so I don't understand why they're not here.

Thursday April 26, 2007, 10:33 am

Cynthia, I had the same problem and had to rewrite my post a couple of times. Sometimes it is just a care2 glitch that I think I read they are aware of.

David, you report great news from the U.K. perspective of drug advertising. It is the complete opposite in the U.S.A. with drugs advertised sometimes before they are even approved, putting pressure to push them onto our market.

I lived in England and Germany as a civilian for 4 years. I love the medicine and doctors there. I felt safe, understood, and that my doctors took there work to heart.
Not so in the U.S.A. It is very difficult to find a good doctor, impossible to find a Specialist worthy of their credentials. But sadly they all want to see your money, before your illness no matter how critical you might be.
I found the opposite while living in Europe. It was always medicine first, and money was secondary though relevant.

Thursday April 26, 2007, 11:05 am
They also invest heavily in HMO's, having worked in a medical school for 15 years as a lab tech I can tell you no one fails to become a doctor. More students are their because they would be disiherited if they did not go into that profession , are there because a parent or relitive is an MD, Of course not all fall under that category but none the less many do. The rules are a bit better now, I was speakig from the 60's to the late 70's. Money and privelege was the standard then.
There are very good people in the profession for very good reasons, but many others that should have been put out...and were not. Just my opinion. Ethics should be a requirement for all college students period.

Thursday April 26, 2007, 11:39 am
Am I paranoid or what? Sorry, but this has happened to me (not by David - he enjoys lively discussion). Of course, I put this better on my lost posts, but I'll try again. Everyone talks about they, they, they, but who is they? How many doctors do you personally know who are only in it for a meal ticket or who prescribe a certain drug because a drug rep brought sandwiches to the office? In every profession, there are people who are only out for themselves, went into it for the wrong reasons, or should have been kicked out, but all I ever see on Care2 is criticism of doctors. As far as money is concerned, are doctors in Europe dependent on patient fees for income? Don't you expect to be paid 100% of your salary? I can assure you that many doctors do not receive 100% of their salary due to insurance companies and patients who do not pay. If they take Medicaid/Medicare, they may end up making a lot less than people who didn't spend nearly as much time and money preparing for their jobs. A lot of people don't realize either that for every hour spent with patients, just as much time, if not more, has to be spent studying, reading test results, writing reports, consulting with others, filling out paperwork, etc.

Carol Ann, I'm glad you mentioned the lawsuit issue. Insurance companies were heavily invested in the stock market and suffered large losses during the dive a few years ago. This is why they raised premiums. In fact, very few doctors are sued and when they are sued, they usually win. Personal injury suits are an important tool for consumer protection as corporations will continue to endanger people until it significantly affects their profits. When you see a report about a seemingly frivolous lawsuit, guess who put it there? The business lobby. The well-known McDonald's hot coffee case is a good example of this. Almost everyone has heard of this case and has a negative opinion, but very few people know the true details and evidence. Yet, they feel they are more qualified to judge the merits based on a news blurb than the jury who spent days listening to both sides. There are two systematic protections against law suit abuse - the attorney has to spend his own money to bring the case and receives nothing if he loses (pretty stupid to go around just filing suits) and there are 12 people who listen to and discuss all the evidence from both sides. Unfortunately, corporations and politicians have convinced the public that businesses should be able to maim and kill with only limited consequences. Although medical suits are often the most discussed when so-called tort reform is on the table, big business is the winner here.

Thursday April 26, 2007, 1:04 pm
the physician's integrity is compromised at the very moment he/she accept a free sample. this would apply even if the doctor gace that sample to one of his poorer patients. I do not know what the answer is to the problem. outside of a much stronger public health program for our less fortunate citizens.

Thursday April 26, 2007, 2:35 pm
YES THIS IS TRUE

Thursday April 26, 2007, 6:21 pm
Hello Cynthia, I can assure you that I have not blocked anyone's postings!! As you say, I do enjoy a lively discussion. By the way, if your posting seems to be deleted, try using the 'back' button, and then the 'forward' button. This seems to work for me, and I get the impression that if I try to submit a comment at the same time as a newly submitted story is being posted from someone else, this is the cause of the problem.

In the UK we have a comprehensive healthcare provision, it is called the National Health Service, and it is free at the point of use. NO MONEY changes hands. If someone wealthy enough wants to 'jump the queue', then he/she can pay for private medical care, that is their choice, but they are still liable for National Insurance, which funds the National Health Service for all UK citizens, whether they use it or not. What happens to those with a chronic ailment in the US when the money runs out? Is there a fall-back position, or are they left to rot? Private healthcare plans here in the UK exclude all chronic conditions, and the elderly, from cover, is it the same in the US? Most private hospitals here concentrate on cosmetic surgery, and the less complicated operations, such as hernias. If there are complications which they are not qualified to deal with, the patient can always be rushed off to the nearest National Health hospital, which probably accounts for the exclusions in private healthcare plans. Some years ago some of the private hospitals were found to be so bad that they were compulsorily closed down, or became 'Granny Farms' (homes for the elderly).

A few years ago, as a postgraduate student (researching Social Administration) I was attached to a large teaching hospital, where we had frequent visits from the legal drug pushers representing Big Pharma. They not only distributed drug samples, with glossy blurbs, to the staff and students, but bags of goodies also, and we were treated to expensive buffets, where the wine flowed freely. I believe this form of promotion is now illegal.

As a matter of interest, what are the full facts around the Mc Donalds' 'hot coffee' case? It even made the news here in the UK!

Thursday April 26, 2007, 10:48 pm
To Dr.Trey and all doctors who received payments from the big pharma. A bloody big SHAME on you all. That's why you live in big fancy homes, fly first class in any transportation, have expensive and unforgettable holidays etc... the list goes on.
Have you any conscience that while you have a nice lifestyle you are also putting our lives in jeopardy by giving us drugs based on the kickbacks you received which may not necessarily be good or right for the patients.
I want you next time when you go for holidays, decide to buy bigger houses or changed to the latest expensive car model, just give us a thought. Do you honestly think you can be all that comfortable? Knowing all too well you are living in a big cocoon of lies deceiving your patients all because of money.
Remember or have you all forgotten the oath you have taken that is to save lives and not to take dirty money.
Well you will all somehow pay for these damages sooner or later seen or unseen, it is a matter of time, nobody escapes the law of thruths.

Friday April 27, 2007, 7:47 am
Do not all newly qualified doctors in the US have to sign the Hippocratic Oath, before being allowed to go into practice?

Friday April 27, 2007, 8:10 am

I read in USA Today, back in the year 2001 an article about American doctors incomes.

The General Practioner across this fine country 6 years ago, was earning an average annual income of just over $300,000
While the so-called avg. specialist (Rheumatologist, Ortho, Cosmetic, ) was earning a definite 7 figure income.

How long do you think it takes toi pay off any student loans, with this income?

Poor sorry **explicits** -
They are so friggen spoiled. Continuing Education weeks are spent on the ski slopes of snorkeling.
They leave all the true education up to someone else, (their drug pushers, their subordinates & nurses, or us the patient).

In the U.S. there is no outside oversight or regulations. Every thing is reviewed within their own peer boards and good old cronism. There is no accountablity, no disclosure of mistakes or complaints, no genuine or meaningful continuing education, and a deafening Code of Silence among theirselves and their mistakes.

I know doctors in Europe are also wealthy or wealthier than most professionals. But, the European Medical Income does not come close to what we Americans are gouged for!!!

The salaries are much over zealous/generous, they blame others for their cost, and bury/hide the fact they are average and make mistakes, and now they fight hardest to keep all complaints secret and refuse to address a bad doctor. Then tell citizens we can not sue them, because we can not prove their errors and ommissions.

David you are very correct to observe that most do the profession for the money. It's a peer pressure thing that I think would be hard for them to ignore.

The Code of Silence is what is as and more terrifying than the drugs they dont read about and give out.

Friday April 27, 2007, 8:22 am

David,
The Hipporcratic Oath is one very large misnomoer.
i doubt any Dr. could even tell you what their oath is or how it was worded....
Really.
VERY GOOD QUESTION. I AM DELIGHTED THAT YOU ASKED.
I was astounded to find,

"First, Do No Harm" Is Not in the Hippocratic Oath

It is a widely held misconception that the familiar dictum "First, do no harm" comes from the Hippocratic Oath, the oath many physicans take when they enter medical practice.

However, the Hippocratic Oath does not and never did contain those words. It expresses a sentiment similar in general meaning, but never employs the words "First, do no harm."

It is the opinion of many scholars that Hippocrates did, in fact, originate the phrase, but in another of his writings, Epidemics, Bk. I, Sect. XI. One translation reads: "Declare the past, diagnose the present, foretell the future; practice these acts. As to diseases, make a habit of two things to help, or at least to do no harm."

It is true that "First, do no harm" is expressed "Primum non nocere" in Latin, but Hippocrates wrote in his native Greek. The Latin, then, is not the origin of the phrase, and no one seems to know for sure who coined the Latin. It is a translation of the original Greek, perhaps, but some sources attribute "Primum non nocere" to the Roman physician, Galen.

It should be noted that not all physicians take the Hippocratic Oath when they enter practice. Depending on where they earn their medical degrees, they may take an oath or pledge other than one of the several forms of the Hippocratic Oath.

Complicating the picture are the many "modernizations" of the oath which take into account changes in language, social mores, and medicine itself over the centuries.

Friday April 27, 2007, 8:23 am

....Again, I say:
It should be noted that not all physicians take the Hippocratic Oath when they enter practice. Depending on where they earn their medical degrees, they may take an oath or pledge other than one of the several forms of the Hippocratic Oath.

Friday April 27, 2007, 10:12 am
Thank you, Carol, for enlightening me on US practice. Hippocrates is considered the 'father' of modern medicine, but was also interested in surgery, and Galen was no less important in his time, having attempted to systematise all medical knowledge in over 90 'books', while his anatomical and physiological theories were not seriously challenged until the seminal work of Vesalius in the 16th centtury.

As you see, I am interested in the history of medicine, and therefore herbalism, which was still part of a physicians training right up to the beginning of the 20th century in this country!! You have also confirmed my impression that medicine, as currently practiced in the US, is still profit driven. What a shame in a 'caring' profession. But the same goes for private practitioners here in the UK, even if their numbers are much smaller.

Saturday April 28, 2007, 6:54 am
count canadian doctors and hospials as well, big pharma is loaded with $, they give away vacations in the caribean, lots of stuff. With that said the doctors are protected more in canada than the US because we have different structure, we actually pay with our tax dollars their malpractice insurance fees to keep us out of court. some in s on my profile, out dated now. that is also where the lawyers come in, and many are crooked themselves. the CMPA will pay $100,000.to keep a small $5,000. case out of court, even higher, to death of the patient, which is called premediated murder. They are protected here by a code of silence back my politicians, who brought some of the later laws in after tommy douglas died. I see a fellow Canadian posting sharings and info on the USA, which of course affects us, but none for Canadians and I myself am brain/body damaged and wake up to convulsions every day, none of which exists on my mediacal records, others to keep law firms away have been added and I left here and can't even take care of myself. Politicians, amensty the police everyone has been contacted, the politicians don't want to get involved and cover for the doctors, the law firms are scared of the CMPA,, so u have to have a forturne or a huge home to mortgage on to get one. mine was quoted at $80,000-$100,000 JUST TO START. They are all tied together and we allow, most people do until they or someone they love gets killed or damaged for life. I am still in for the fight of my life to be extended, lost many battles and looks like loosing the war. Oh by the way, many adverse effects are not reported from so called clinical trials, the drug companies hide them, often the worst ones, like several that happened to me which I found out later. How do u get a drug company to come forth with that, after u or someone is dead, or damaged for life, and u have enough bucks to get a law firm, let alone settle out of court which is extremely rare,, or make it part of the condition (if u win and have gotten this far, becase the doctors will drag the case out and wear u down as long as legally possible) that it get's included in the drug reations list, on their package, their insert and the info ur pharmachists gives. good luck and many prayers.

Saturday April 28, 2007, 7:34 am
Berwick runs a small, nonprofit organization in Boston called the Institute for Healthcare Improvement. The institute provided multimillion-dollar grants to hospitals that were willing to try his ideas for improving medicine.

Berwick, a former pediatrician, is an unusual figure in medicine. In 2002, the industry publication Modern Healthcare listed him as the third most powerful person in American health care. Unlike the others on the list, he is powerful not because of the position he holds. (The Secretary of Health and Human Services, Tommy Thompson, was No. 1, and the head of Medicare and Medicaid was No. 2.) He is powerful because of how he thinks

As Berwick explained, the organization had unravelled. The men had lost their ability to think coherently, to act together, to recognize that a lifesaving idea might be possible. This is what happens to all flawed organizations in a disaster, and, he argued, thats what is happening in modern health care. To fix medicine, Berwick maintained, *****we need to do two things: measure ourselves and be more open about what we are doing. This meant routinely comparing the performance of doctors and hospitals, looking at everything from complication rates to how often a drug ordered for a patient is delivered correctly and on time. *******And, he insisted, hospitals should give patients total access to the information. No secrets is the new rule, he said.

He argued that openness would drive improvement, if simply through embarrassment. *****It would make it clear that the well-being and convenience of patients, not doctors, were paramount. It would also serve a fundamental moral good, because people should be able to learn about anything that affects their lives.

Saturday April 28, 2007, 9:02 am
I am sorry to hear your story, Sunshine, and I hope you find a lawyer who will work for you on a 'No win, No fee' basis.

Here, under the Freedom of Information Act, all patients can demand to see their medical records, and this is surely a good thing. If nothing else, it will make physicians less inclined to record extraneous, judgemental remarks about their patients, on their medical records.

I would also like to say that ALL is not sweetness and light in the UK medical world. Family practitioners, and dentists, have been known to falsify their records - claim to be treating more patients (ghost patients) than they really have on their list, or dentists claiming for more dentistry than was actually carried out, for example. Greedy people exist everywhere, especially where money is thought to be some sort of status symbol.