3 ms·

What These Medical Journals Don’t Reveal: Top Doctors’ Ties to Industry

56 points by HillaryBriss 8y ago

doctorpangloss 8y ago
It would be interesting to expand this reasoning to other STEM disciplines. For example, would computer science researchers be more likely to express cynicism of self driving cars if there weren't lucrative jobs in industry or lucrative research contracts from car manufacturers (see https://www.csail.mit.edu/sponsors/strategic-partners https://www.csail.mit.edu/sponsors/strategic-partners for an example)? I mean there must be dozens of self driving car efforts thousands of highly compensated CS researchers. Millions of dollars in academic partnerships. Is that not influential? Would there be more cynicism about the safety narrative of these cars? Tenured academic computer science and AI researchers are the best positioned in society to comment on how realistic those claims are. But I'd argue the money has disincentivized them from saying so.
- danso 8y ago
  The FDA’s regulatory process for the approval and marketing of drugs is a factor in how this disclosure system/mentality in pharmaceuticals came to be. U.S. drug companies cannot advertise drugs for uses beyond what they’ve been explicitly approved for. But doctors have the freedom to prescribe whatever they want — e.g. fentanyl approved for cancer-related pain could theoretically be prescribed by a doctor for migraines. The ostensible purpose of financial disclosure is to mitigate the problem of doctors being incentivized to prescribe inappropriate based on their ties to a pharma company. Tech doesn’t operate under such strict regulation, e.g. Tesla’s Autopilot isn’t forced to issue verbose disclaimers like the kind you hear for a TV drug ad.
  - dogma1138 8y ago
    While that’s correct prescribing drugs outside of their approved protocols can open you to malpractice, the problem with painkillers is that as far as I know there haven’t been any successful malpractice suits due to addiction in all honesty the best way to stop to over prescription of opioids isn’t to take the pharmaceuticals to court it’s to take the doctors. A few cases that would set a precedence in pain management related addiction and doctors would be much less likely to prescribe them as freely as they do now. I never understood this oddly American thing about “comfort” when undergoing medical procedures form dental procedures to surgery it seems like while the rest of the world is OK with some pain and discomfort in the US they’ll pump you up with pain killers and anestetics until you don’t feel a thing. I got two root canals done with only a mild local anesthetic it wasn’t pleasant, but it wasn’t terrible and I see these videos of people coming out of the densit in the US high on I don’t know what barely knowing where they are and it’s simply mind boggling.
    - RcouF1uZ4gsC 8y ago
      >I never understood this oddly American thing about “comfort” when undergoing medical procedures form dental procedures to surgery it seems like while the rest of the world is OK with some pain and discomfort in the US they’ll pump you up with pain killers and anestetics until you don’t feel a thing. It was this oddly American thing about “comfort” that resulted in the invention of anesthesia for surgery in the United States. The reduction of patient discomfort has been one of the big themes of American medicine since.
    - codewritinfool 8y ago
      I'm in the U.S. and I've had a root canal. I was only given a local and nothing more. I've never experienced the high and not knowing where I was, and no pain meds for later. In fact, I drove myself home.
Gatsky 8y ago
I work in Oncology. A mobile battery service came over to replace a flat car battery. I was chatting to the guy while he was changing it over, and he said quite casually "Is it true what they say, that cancer has been cured and the pharmaceutical companies are hiding it so they can make money?" [1]. Obviously this is a silly question, but scandals like this ongoing COI drama probably do disproportionate damage to the public's perception of cancer care. Varying degrees of this mistrust must be dealt with each time a patient sees their oncologist. For that reason, Burris and the rest of them should be punished, he certainly should not become the next president of ASCO. [1] Never mind that I could have equally asked "Is it true what they say, that infinitely rechargeable batteries have been invented, and the battery companies are hiding it just to make money?".

56 points by HillaryBriss 8y ago

It would be interesting to expand this reasoning to other STEM disciplines. For example, would computer science researchers be more likely to express cynicism of self driving cars if there weren't lucrative jobs in industry or lucrative research contracts from car manufacturers (see https://www.csail.mit.edu/sponsors/strategic-partners https://www.csail.mit.edu/sponsors/strategic-partners for an example)? I mean there must be dozens of self driving car efforts thousands of highly compensated CS researchers. Millions of dollars in academic partnerships. Is that not influential? Would there be more cynicism about the safety narrative of these cars? Tenured academic computer science and AI researchers are the best positioned in society to comment on how realistic those claims are. But I'd argue the money has disincentivized them from saying so.

danso 8y ago
The FDA’s regulatory process for the approval and marketing of drugs is a factor in how this disclosure system/mentality in pharmaceuticals came to be. U.S. drug companies cannot advertise drugs for uses beyond what they’ve been explicitly approved for. But doctors have the freedom to prescribe whatever they want — e.g. fentanyl approved for cancer-related pain could theoretically be prescribed by a doctor for migraines. The ostensible purpose of financial disclosure is to mitigate the problem of doctors being incentivized to prescribe inappropriate based on their ties to a pharma company. Tech doesn’t operate under such strict regulation, e.g. Tesla’s Autopilot isn’t forced to issue verbose disclaimers like the kind you hear for a TV drug ad.
- dogma1138 8y ago
  While that’s correct prescribing drugs outside of their approved protocols can open you to malpractice, the problem with painkillers is that as far as I know there haven’t been any successful malpractice suits due to addiction in all honesty the best way to stop to over prescription of opioids isn’t to take the pharmaceuticals to court it’s to take the doctors. A few cases that would set a precedence in pain management related addiction and doctors would be much less likely to prescribe them as freely as they do now. I never understood this oddly American thing about “comfort” when undergoing medical procedures form dental procedures to surgery it seems like while the rest of the world is OK with some pain and discomfort in the US they’ll pump you up with pain killers and anestetics until you don’t feel a thing. I got two root canals done with only a mild local anesthetic it wasn’t pleasant, but it wasn’t terrible and I see these videos of people coming out of the densit in the US high on I don’t know what barely knowing where they are and it’s simply mind boggling.
  - RcouF1uZ4gsC 8y ago
    >I never understood this oddly American thing about “comfort” when undergoing medical procedures form dental procedures to surgery it seems like while the rest of the world is OK with some pain and discomfort in the US they’ll pump you up with pain killers and anestetics until you don’t feel a thing. It was this oddly American thing about “comfort” that resulted in the invention of anesthesia for surgery in the United States. The reduction of patient discomfort has been one of the big themes of American medicine since.
  - codewritinfool 8y ago
    I'm in the U.S. and I've had a root canal. I was only given a local and nothing more. I've never experienced the high and not knowing where I was, and no pain meds for later. In fact, I drove myself home.

Gatsky 8y ago

I work in Oncology. A mobile battery service came over to replace a flat car battery. I was chatting to the guy while he was changing it over, and he said quite casually "Is it true what they say, that cancer has been cured and the pharmaceutical companies are hiding it so they can make money?" [1]. Obviously this is a silly question, but scandals like this ongoing COI drama probably do disproportionate damage to the public's perception of cancer care. Varying degrees of this mistrust must be dealt with each time a patient sees their oncologist. For that reason, Burris and the rest of them should be punished, he certainly should not become the next president of ASCO. [1] Never mind that I could have equally asked "Is it true what they say, that infinitely rechargeable batteries have been invented, and the battery companies are hiding it just to make money?".