Doctors / Medical Schools
Many physicians fail to report incompetent or incapacitated colleagues
An intoxicated co-worker in many workplaces might be more of a nuisance than a threat. But an impaired or incompetent physician can present a real risk to patients. The American Medical Association (AMA) asserts that all doctors have an "ethical obligation to report" colleagues who are suspected of being unable to safely fulfill their duties, whether because of mental health issues, alcohol or drug abuse or a lack of necessary technical skills.
More than a third of U.S. doctors surveyed last year, however, did not agree that it was their duty to report a "significantly impaired or otherwise incompetent" physician, according to a new report, published online July 13 in JAMA, Journal of the American Medical Association.
Sixty-nine percent of the 1,891 physicians who responded to the survey reported that they felt at least somewhat prepared to do the right thing when faced with an impaired or incompetent colleague.
Of the responding docs, 309 reported having known about an incompetent or impaired colleague, but about a full third of those did not inform the hospital, clinic or other organization about them.
Matthew Wynia, of the Institute for Ethics at the AMA, calls these statistics "jarring" in an editorial published in the same issue of JAMA. "This research is proof that individual physicians cannot always be relied on to report colleagues who threaten quality of care," he wrote.
He noted that although professional organizations and hospitals have a variety of systems to help detect potentially dangerous doctors—such as continued certification and performance monitoring programs—co-workers are generally considered the first line of defense.
"Our findings cast serious doubt on the ability of medicine to self-regulate with regard to impaired or incompetent physicians," study leader Catherine DesRoches, of the Mongan Institute for Health Policy at Massachusetts General Hospital, said in a prepared statement.
The least likely to report a colleague who was incompetent or impaired were doctors working in small practices, with just 44 percent of those in single-person or two-person practices reporting a fellow physician.
"Our results imply that the current system of reporting is functionally inadequate," Eric Campbell, an associate professor of medicine and research director for the Mongan Institute, said in a prepared statement. The most frequent reason doctors gave for not reporting a colleague was that they thought someone else was already addressing the situation. But, noted Campbell, many doctors think that their reports will not make a difference or are afraid of retribution.
John Fromson, a co-author of the paper and associate director of postgraduate medical education at Massachusetts General Hospital Psychiatry, said in a prepared statement that the issue ultimately comes down to patient safety. "This study underscores the need for the medical profession to educate its members on their reporting obligations to ensure safe and competent care to patients," he said.
Source: Scientific America 13th July 2010
LINK TO SOURCE
Harvard Med Hires Lilly Exec As Research Chief
By Ed Silverman // February 11th, 2010 // 8:51 am
Bill Chin, who was senior vice president of discovery research at the drug maker, will join Harvard Medical School as executive dean for research on May 1, and will not only oversee research efforts but will also work with affiliated hospitals and develop a strategy for scientific interactions with industry, such as the HMS faculty policy on conflicts of interest.
“Bill will engage the community in support of our key research initiatives designed to sustain HMS as the leading biomedical research institution well into the future,” Harvard Med School deal Jeff Flier, says in a statement. “There are very few people capable of rising to such a challenge.”
But one wag calls the appointment puzzling and suggests the move implies industry is actually co-opting academia. “Does this appointment signify that Harvard Medical School intends to even further strengthen its research ties to the pharmaceutical industry?” Arnold Relman, a professor emeritus of medicine and social medicine at Harvard and a former editor-in-chief of the New England Journal of Medicine, tells The Boston Globe. “If so, I think many people will worry that the separate roles for academic medicine and drug companies are becoming more confused, leading to more conflicts of interest.”
SOURCE Pharmalot (March 2010)
LINK TO FULL ARTICLE
Harvard Medical School in Ethics Quandary
Harvard Medical School students object to the influence of drug companies in the school’s educational curriculum.
In a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary as the professor promoted the benefits of cholesterol drugs and seemed to belittle a student who asked about side effects.
Mr. Zerden later discovered something by searching online that he began sharing with his classmates. The professor was not only a full-time member of the Harvard Medical faculty, but a paid consultant to 10 drug companies, including five makers of cholesterol treatments.
“I felt really violated,” Mr. Zerden, now a fourth-year student, recently recalled. “Here we have 160 open minds trying to learn the basics in a protected space, and the information he was giving wasn’t as pure as I think it should be.”
Mr. Zerden’s minor stir four years ago has lately grown into a full-blown movement by more than 200 Harvard Medical School students and sympathetic faculty, intent on exposing and curtailing the industry influence in their classrooms and laboratories, as well as in Harvard’s 17 affiliated teaching hospitals and institutes.
They say they are concerned that the same money that helped build the school’s world-class status may in fact be hurting its reputation and affecting its teaching.
SOURCE NY TIMES BUSINESS
LINK TO FULL ARTICLE
Drug Companies & Doctors: A Story of Corruption
By Marcia Angell
Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial by Alison Bass Algonquin Books of Chapel Hill, 260 pp., $24.95
Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen Sarah Crichton/Farrar, Straus and Giroux, 432 pp., $26.00
Shyness: How Normal Behavior Became a Sickness by Christopher Lane Yale University Press, 263 pp., $27.50; $18.00 (paper)
Recently Senator Charles Grassley, ranking Republican on the Senate Finance Committee, has been looking into financial ties between the pharmaceutical industry and the academic physicians who largely determine the market value of prescription drugs. He hasn't had to look very hard.
Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age.
Legally, physicians may use drugs that have already been approved for a particular purpose for any other purpose they choose, but such use should be based on good published scientific evidence. That seems not to be the case here. Biederman's own studies of the drugs he advocates to treat childhood bipolar disorder were, as The New York Times summarized the opinions of its expert sources, "so small and loosely designed that they were largely inconclusive."[1]
In June, Senator Grassley revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts. After the revelation, the president of the Massachusetts General Hospital and the chairman of its physician organization sent a letter to the hospital's physicians expressing not shock over the enormity of the conflicts of interest, but sympathy for the beneficiaries: "We know this is an incredibly painful time for these doctors and their families, and our hearts go out to them."
SOURCE A NEW YORK REVIEW OF BOOKS
LINK TO FULL ARTICLE
An intoxicated co-worker in many workplaces might be more of a nuisance than a threat. But an impaired or incompetent physician can present a real risk to patients. The American Medical Association (AMA) asserts that all doctors have an "ethical obligation to report" colleagues who are suspected of being unable to safely fulfill their duties, whether because of mental health issues, alcohol or drug abuse or a lack of necessary technical skills.
More than a third of U.S. doctors surveyed last year, however, did not agree that it was their duty to report a "significantly impaired or otherwise incompetent" physician, according to a new report, published online July 13 in JAMA, Journal of the American Medical Association.
Sixty-nine percent of the 1,891 physicians who responded to the survey reported that they felt at least somewhat prepared to do the right thing when faced with an impaired or incompetent colleague.
Of the responding docs, 309 reported having known about an incompetent or impaired colleague, but about a full third of those did not inform the hospital, clinic or other organization about them.
Matthew Wynia, of the Institute for Ethics at the AMA, calls these statistics "jarring" in an editorial published in the same issue of JAMA. "This research is proof that individual physicians cannot always be relied on to report colleagues who threaten quality of care," he wrote.
He noted that although professional organizations and hospitals have a variety of systems to help detect potentially dangerous doctors—such as continued certification and performance monitoring programs—co-workers are generally considered the first line of defense.
"Our findings cast serious doubt on the ability of medicine to self-regulate with regard to impaired or incompetent physicians," study leader Catherine DesRoches, of the Mongan Institute for Health Policy at Massachusetts General Hospital, said in a prepared statement.
The least likely to report a colleague who was incompetent or impaired were doctors working in small practices, with just 44 percent of those in single-person or two-person practices reporting a fellow physician.
"Our results imply that the current system of reporting is functionally inadequate," Eric Campbell, an associate professor of medicine and research director for the Mongan Institute, said in a prepared statement. The most frequent reason doctors gave for not reporting a colleague was that they thought someone else was already addressing the situation. But, noted Campbell, many doctors think that their reports will not make a difference or are afraid of retribution.
John Fromson, a co-author of the paper and associate director of postgraduate medical education at Massachusetts General Hospital Psychiatry, said in a prepared statement that the issue ultimately comes down to patient safety. "This study underscores the need for the medical profession to educate its members on their reporting obligations to ensure safe and competent care to patients," he said.
Source: Scientific America 13th July 2010
LINK TO SOURCE
Harvard Med Hires Lilly Exec As Research Chief
By Ed Silverman // February 11th, 2010 // 8:51 am
Bill Chin, who was senior vice president of discovery research at the drug maker, will join Harvard Medical School as executive dean for research on May 1, and will not only oversee research efforts but will also work with affiliated hospitals and develop a strategy for scientific interactions with industry, such as the HMS faculty policy on conflicts of interest.
“Bill will engage the community in support of our key research initiatives designed to sustain HMS as the leading biomedical research institution well into the future,” Harvard Med School deal Jeff Flier, says in a statement. “There are very few people capable of rising to such a challenge.”
But one wag calls the appointment puzzling and suggests the move implies industry is actually co-opting academia. “Does this appointment signify that Harvard Medical School intends to even further strengthen its research ties to the pharmaceutical industry?” Arnold Relman, a professor emeritus of medicine and social medicine at Harvard and a former editor-in-chief of the New England Journal of Medicine, tells The Boston Globe. “If so, I think many people will worry that the separate roles for academic medicine and drug companies are becoming more confused, leading to more conflicts of interest.”
SOURCE Pharmalot (March 2010)
LINK TO FULL ARTICLE
Harvard Medical School in Ethics Quandary
Harvard Medical School students object to the influence of drug companies in the school’s educational curriculum.
In a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary as the professor promoted the benefits of cholesterol drugs and seemed to belittle a student who asked about side effects.
Mr. Zerden later discovered something by searching online that he began sharing with his classmates. The professor was not only a full-time member of the Harvard Medical faculty, but a paid consultant to 10 drug companies, including five makers of cholesterol treatments.
“I felt really violated,” Mr. Zerden, now a fourth-year student, recently recalled. “Here we have 160 open minds trying to learn the basics in a protected space, and the information he was giving wasn’t as pure as I think it should be.”
Mr. Zerden’s minor stir four years ago has lately grown into a full-blown movement by more than 200 Harvard Medical School students and sympathetic faculty, intent on exposing and curtailing the industry influence in their classrooms and laboratories, as well as in Harvard’s 17 affiliated teaching hospitals and institutes.
They say they are concerned that the same money that helped build the school’s world-class status may in fact be hurting its reputation and affecting its teaching.
SOURCE NY TIMES BUSINESS
LINK TO FULL ARTICLE
Drug Companies & Doctors: A Story of Corruption
By Marcia Angell
Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial by Alison Bass Algonquin Books of Chapel Hill, 260 pp., $24.95
Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen Sarah Crichton/Farrar, Straus and Giroux, 432 pp., $26.00
Shyness: How Normal Behavior Became a Sickness by Christopher Lane Yale University Press, 263 pp., $27.50; $18.00 (paper)
Recently Senator Charles Grassley, ranking Republican on the Senate Finance Committee, has been looking into financial ties between the pharmaceutical industry and the academic physicians who largely determine the market value of prescription drugs. He hasn't had to look very hard.
Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age.
Legally, physicians may use drugs that have already been approved for a particular purpose for any other purpose they choose, but such use should be based on good published scientific evidence. That seems not to be the case here. Biederman's own studies of the drugs he advocates to treat childhood bipolar disorder were, as The New York Times summarized the opinions of its expert sources, "so small and loosely designed that they were largely inconclusive."[1]
In June, Senator Grassley revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts. After the revelation, the president of the Massachusetts General Hospital and the chairman of its physician organization sent a letter to the hospital's physicians expressing not shock over the enormity of the conflicts of interest, but sympathy for the beneficiaries: "We know this is an incredibly painful time for these doctors and their families, and our hearts go out to them."
SOURCE A NEW YORK REVIEW OF BOOKS
LINK TO FULL ARTICLE