The first thing Doctors and the Drug Industry should separate themselves
from are anti-depressants.     EVERYBODY is in danger of being prescribed an
anti-depressant.
The dangerous side effects of anti-depressants are not known to the drug
industry or the physician.   Because it is not scientific it is not accepted
if told to physicians.    That the damage is clear to note though is
evidenced by crohns and UC illnesses being caused by stimulants. (ie. xanax,
buspar, depakote, marijuana, cocaine, ALL ANTI-DEPRESSANTS, kava kava, st
johns wort,  all herbs with stimulants etc etc. etc)     And far beyond
crohns with symptoms occurring in any part of the body, and unexpected
deaths, and stillborns born to mothers on anti-depressants during pregnancy,
rumination happening to babies born to mothers on recreational drugs or
anti-depressants,  there is a mysterious mind/body connection, literally
that produces these illnesses.   Manmade illness probably from the beginning
of time, but never brpight to the attention of the world as such, until Dr.
Burrill Crohns and colleagues researched these mysterious ailments  in 1932
or before.
This is my personal theory of the cause of crohns and UC.    I am not a
doctor, just  an observer of many years and experience of these mysterious
illnesses  for which so far research in all the world has produced no cause.
Crohns and UC do not have a medical cause, but become a necessity for
medical treatment.
And to make it more strange, the people involved (one on a stimulant
affecting another that may be on no meds by the mind/body connection ) do
not have to be in the same room for the crohnie to suffer the damage, they
can be miles and miles apart, only the stimulant and the mind/body
connection is necessary.
Why stimulants have an unfavorable propensity for causing harm to others not
using the meds or drugs is a question that cannot be answered, only observed
for it to be known.
Research on children that have Inflammatory Bowel Disease are the easiest to
cure as they do not have friends on stimulants.   It is usually the mother
or caretaker or perhaps another friend or relative on a stimulant that can
cause the child to be ill.     This can prove the theory quickly and
effectively if the proper studies are done.
When a physican prescribes anti-depressants,  other relatives and friends
are  in jeopardy of becoming ill.
Of course, anti-depressants have their good use also, but the side effects
should become known so that proper measures can be taken to lessen the
numbers of illness they cause.
As in unstitutions and nursing homes, they are prescribed to many residents
and the others not on meds (if they are aware and can relate to one another)
are in dire straits of becoming ill with no one realizing what is happening.
Until this is recognized, the world will tend to mental/physical illnesses,
depression, fatigue, and all manner of  illness not recognized as those of
the use of anti-depressants by another person.
Yes, the effects of anti-depressants to another person is so weird, that it
is incomprehensible.
It is becoming aware that anti-depressants have a dangerous side effect, but
not soon enough for the numbers affected that suffer terrible damages,
surgery, death at the worst.
Health Canada is beginning to note this, citing Paxil as a harmful drug for
pregnant women, but it is not Paxil alone, it is ANY ANTI-DEPRESSANT.
I could say volumes on this, but as a beginning, the newspapers, researchers
should gear some of their research first on children with IBD, then to
everyone that suffers crohns and UC and to others that suffer undiagnosed
illnesses for which no reason is discernible for their illness.     Rule out
organic illnesses.     These are not organic illnesses as Dr. Burrill Crohns
pointed out.   He concluded they are environmental.
The health of millions  depend on this, plus billions of dollars spent on
research that brings better treatments.     But the core of the problem is
what is needed to be known, so that individuals, parents, institutions,
nursing homes  can adjust their policies.

Gail Michael
Chicago, Illinois
Advocate147@aol.com

Distance Sought Between Doctors and Drug Industry

By Ceci Connolly
Washington Post Staff Writer
Wednesday, January 25, 2006; Page A08

Declaring that the pervasive influence of drug industry money is
distorting doctors' treatment decisions and scientific findings, a
prestigious panel of medical experts called on their colleagues
yesterday to adopt far-reaching new conflict-of-interest policies.

In an article in the Journal of the American Medical Association, the
group said that voluntary efforts to limit corporate inducements have
failed, resulting in the overprescribing of some medications and the
withholding of negative discoveries about others. Highly publicized
cases involving the anti-inflammatory drug Vioxx, antidepressants for
children and spinal implants made by Medtronic -- all occurring while
voluntary guidelines were in place -- highlight the need for stricter
measures, they said.

Proposal Highlights
A physicians group called for new steps to sever ties between
manufacturers and practitioners at academic medical centers.

· Ban gifts to physicians from drug and device makers, including
meals and payment for travel and continuing education.

· Bar direct distribution of drug samples to physicians. Replace them
with vouchers for low-income patients.

· Exclude physicians with financial relationships to manufacturers
from committees overseeing preferrred drug lists.

· Ban physicians from speaking at manufacturers' events or publishing
articles ghost-written by industry employees.

· Post consulting and research contracts on a publicly available Web
site.

SOURCE: Journal of the American Medical Association
GRAPHIC: The Washington Post

Who's Blogging?
Read what bloggers are saying about this article.
symtym | main
For Doctors, Nurses, and the Medical Profession | Medical Talent
Health Care Renewal

Full List of Blogs (9 links) »

Most Blogged About Articles
On washingtonpost.com | On the web

"My mother told me never to accept gifts from strangers. If a stranger
wants to give you a gift, it's very likely they want something in
return," said Jordan J. Cohen, president of the Association of American
Medical Colleges and a co-author of the new proposal. "We've become
overly dependent on these kinds of blandishments to support our core
activities, and that is jeopardizing public trust and scientific
integrity."

The panel -- which includes Cohen, officials from several medical
schools and members of the Institute on Medicine as a Profession --
urged the nation's 400 teaching hospitals to impose stringent measures,
including a ban on accepting gifts, meals and drug samples and tight
restrictions on outside income. A series of articles published today in
the journal Academic Medicine reach similar conclusions, noting that
strict, standardized policies are needed to ensure patients receive
unbiased, evidence-based treatments.

Spokesmen for the pharmaceutical industry said the extra steps are
unnecessary and could deprive physicians of valuable information.

increasingly dominated by drug company salespeople proffering meals,
office supplies, entertainment and even cash to speak at conferences or
sit on advisory boards.

Some physicians have been paid lucrative consulting retainers for no
specific work; others are paid to put their names on articles
ghostwritten by industry employees. One congressional inquiry cited in
the report found that pharmaceutical executives steer research grants
to doctors and schools that promote their firms' drugs.

"The problem has gotten worse and worse and worse," Cohen said. The
relationships can prompt doctors to order unnecessary tests, prescribe
more expensive medicines or advocate adding certain medications to a
hospital's list of preferred drugs, he said.

Although most doctors say their relationships with drugmakers do not
affect medical decisions, numerous studies suggest otherwise.

"There is solid evidence it isn't the size of the gift, it's the
gifting itself that creates a sense of loyalty and indebtedness," said
Sharon Levine, associate executive director of Kaiser Permanente's
Northern California group practice. The 6,000-doctor practice and the
Yale University School of Medicine are among the only institutions in
the nation to implement policies similar to those outlined in JAMA.

"The industry is spending $13 billion per year on direct-to-physician
promotion," she continued. "That wouldn't be happening if it weren't
resulting in changing patterns of utilization. It doesn't necessarily
mean patients are getting bad care, but it does mean their influence is
out there."

Judging from the "grumbling" he has heard from physicians, Scott
Lassman, assistant general counsel at the Pharmaceutical Research and
Manufacturers of America, the industry's lobbying group, said voluntary
guidelines issued by industry, government and the profession in recent
years seem to be working. Modest gifts such as lunch or pens may
persuade a doctor "to listen to the presentation of information, not
necessarily to prescribe that product." And having those discussions
over a "working meal" is merely a timesaver for busy doctors, he said.

But the JAMA authors said it is a costly mistake to confuse marketing
with scientific data.

"Drug companies spend $13,000 per physician annually," said co-author
David J. Rothman, a professor of social medicine at Columbia University
Medical Center. "Those marketing tactics are very, very effective at
getting physicians to do what each drug company wants -- to prescribe
their product."

The team conducted focus groups with doctors who "came right out and
said if one drug rep is nicer than another, I'm going to prescribe that
person's drug, all else being equal," said co-author David Blumenthal,
director of the Institute for Health Policy at Massachusetts General
Hospital. In a second article, Blumenthal found that conflicts of
interest have contributed to growing secrecy in research, with some
scientists intentionally omitting negative findings about a drug or
device.

Rather than severing all ties to the pharmaceutical industry, the panel
suggested creating financial firewalls. Instead of paying a physician
directly for continuing medical education, it would be more appropriate
for drug companies to contribute to a central account that supported
educational programs, they wrote. In addition, payments for outside
work such as speeches or consulting should be explicitly defined and
posted on the Internet.

Finally, the group urged the nation's 125 medical schools and
affiliated hospitals to refuse drug samples and instead create a
voucher system or central distribution bank for poor patients.

"The availability of free samples is a powerful inducement for
physicians and patients to rely on medications that are expensive but
not more effective," the JAMA article said. In most cases, once
patients begin the expensive drug regimen, they are inclined to stick
with it.

Some industry experts said the recommendations underestimated the
ability of physicians and patients to think on their own.

"I subscribe to the crazy view that more information is better," said
Daniel Troy, former chief counsel of the Food and Drug Administration.
"This very sweeping proposed ban would really choke off an important
flow of information to physicians."

A drug sample handed out in a doctor's office is a good way to begin
treatment immediately, he said, rather than waiting to have a
prescription filled.

Cohen predicted the industry and many medical institutions would blanch
at the recommendations. But both could stand to improve their
reputations, he said. He added: "We need a strong, ethical, effective
partnership with industry."

***

TC