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Thoughts on potentially missing the continuity of family medicine

April 24, 2011

Analysis of:What ‘Big Medicine’ Means for Doctors and Patients | well.blogs.nytimes.com

As one of the few family physicians who practices birth to grave medicine a reflection what will be missed.

Contrave is not significantly different from currently available medications

December 7, 2010

Analysis of:Orexigen's Diet Pill Has Unclear Benefits, an FDA Staff Review Indicates | www.bloomberg.com

Contrave is a new combination formulation of two currently available medications.

The patient component of poor economy

July 4, 2010

Analysis of:Financial strain lingers despite signs of improving economy | www.modernhealthcare.com

The payment reductions from insurance will be troublesome as will the new investments and paperwork and bean counting that will go on. This review however addresses another factor that people do not always consider regarding patient motivations.

Designing effective medications for populations depends on how easy it is to diagnose the populations.

December 1, 2008

Analysis of:Personal medicine is goal of Eli Lilly & Co. | www.azcentral.com

The article indicates that medications will be designed to be effective for particular populations.  This will prevent the need to try medications which are effective for 50% of the population or less.

C. difficile not linked to antibiotics will change how I order stool studies

October 13, 2008

Analysis of:C. Difficile And Antibiotics Not Necessarily Linked, Study Finds | www.sciencedaily.com

C. difficile is only linked to antibiotic use about half the time.  In addition c. difficile can complicate IBS more that previously thought.  This may be why antibiotics that cover c. difficile have been useful in treating irritable bowel syndrome.  

Clinical Trials Go Unpublished

October 6, 2008

Analysis of:Many Trial Reports on FDA-Approved Drugs Go Unpublished | www.washingtonpost.com

The articles more often go unpublished if the study indicates that there is no benefit to new drugs over older drugs.

Heart attack and Cardiovascular disease increased with anticholinergics

October 3, 2008

Analysis of:COPD Medicines: Risky or Safe? | www.webmd.com

How can we best determine if the correlation is a direct cause an effect.  Do the anticholinergics cause increase MI and cardiac disease or do the anticholinergics lead to something else that results in MI and carddiovascular disease.

ADHD parent training programs will not likely be effective in the US

October 3, 2008

Analysis of:Parents 'need lessons about ADHD | news.bbc.co.uk

The article summarizes the best treatment for ADHD in children; training the parents and teachers how to more effectively interact with the child.  The article is written for the BBC.

TNF worked in dogs but not humans

May 5, 2008

Analysis of:Can biologic drugs tackle antibiotic resistance? | www.pharmaceutical-business-review.com

Immunomodulation especially with antibodies is difficult.  Proteins are not as easily given and distributed through the body as low molecular weight compounds.  I believe that the first drug to be effective will pave the way for many others

Expensive to see representatives in the office

January 28, 2008

Analysis of:19 Percent of Office-Based Physicians Refuse to See Pharmaceutical, Biotech and Medical Device Sales Reps | www.drugs.com

The time taken away from seeing patients is expensive.  The physicians do not feel like they are trained well enough in understanding scientific studies and so they may be biased by information provided by the representatives that is not scientific.  They believe that innovations by pharmaceutical companies do not justify the increased cost of the medications.

medicare should pay for well exams

January 25, 2008

Analysis of: CDC: Too few adults get their vaccines | news.yahoo.com

It is disappointing that Medicare does not pay for well exams where vaccines like this would be given.  It is unfortunate that in an attempt by medicare to save money, they are probably losing money.  It is at the annual well exam where I counsel patients on the vaccinations that they should receive.  Some commercial insurance also do not pay for well exams.

Patients out of the ER into the clinic

January 25, 2008

Analysis of:Blue Cross proposes fix for uninsured Americans | news.yahoo.com

I work as both an ER physician and a Family Physician in a clinic and something needs to be done so that I do not need to see patients in the ER for problems that could easily be handled in the less expensive clinic.  Other countries have better health plans because patients have an incentive to use the clinic instead of the ER for minor problems.  This is a step in that direction.  It may or may not be the best way but it is one way.

thiazolidinedione demise will support Januvia use

December 10, 2007

Analysis of:Diabetes drug link to weak bones | news.bbc.co.uk

This makes it easier for me to avoid mention or suggestion to my patients to try glitazones. I am having an easier time now with prior approvals of Januvia after only a trial of Metformin and sulfonylureas

Alternative medications available

August 29, 2007

Analysis of:GlaxoSmithKline updates prescribing information for Avandia in the US | www.pipelinereview.com

With so many other medications available to help control diabetes, who will risk prescribing Avandia? 

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