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Healthy Skepticism Library item: 17501

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Electronic Source

Brody H
Getting a Pharm-Free Education: What Works?
Hooked: Ethics, Medicine and Pharma 2010 Mar 8

Full text:

A conversation has been going on recently on the Healthy Skepticism list-serv about how hard or how easy it is for physicians to stay up to date on new drugs and therapeutics without relying on sources that are controlled or heavily influenced by the pharmaceutical and device industries and their marketing juggernauts. Dr. Mark McConnell, who practices internal medicine in LaCrosse, WI, offered a set of highly practical tips that seemed too good not to share with all readers. He’s given me permission to reproduce his how-to list, to which I have just a couple of additional suggestions.

Dr. McConnell states that by adhering to his program the necessary investment of time needed to stay reasonably informed and up to date is about 5-10 hours per month. (Like anything else, I’ll add, when you just begin to start using any of these sources, it will take a bit longer; once you become used to how each works and where to locate the information you need, your time will shrink.) Dr. McConnell notes that he does not have a specific set-aside budget for CME and so he uses his own funds for these programs and sources.

His core resources:

Oakstone’s Practical Reviews in internal medicine

InfoPOEMs from Essential Evidence Plus

Therapeutic Initiatives Drug Therapy review course

Prescriber’s Letter

I just have two additional resources to comment on. One is a service that provides a monthly CD with an audio presentation and evidence-based discussion of 40 recent articles pertinent to primary care, along with a database that allows you to store all 40 abstracts each month on your computer and later search them—Primary Care Medical Abstracts,, $279/year. Rick Bukatra and Jerry Hoffman present, discuss, and argue about the abstracts in a manner somewhat reminiscent of “Car Talk” on NPR.

Second, I have been a long-time satisfied subscriber of The Medical Letter,, $98/year. This is supposed to be the Granddaddy of all U.S. non-commercially-sponsored publications on therapeutics, having been founded in 1959. The Medical Letter was being criticized on the HS list for not being truly independent and for allowing companies to review its assessments of their drugs. All I can say in defense of my longstanding use of this source (when I was in practice, which I am not currently) is that the publication hardly ever endorses a new drug, and most often says that a new drug is really no better than an older drug. The few times I have mentioned this publication to a drug rep, he has pooh-poohed it vigorously and given me numerous reasons why I should pay no attention. So if the drug companies are allowed to see the reviews, it does not appear that they have much influence over what is eventually published. I’d appreciate more discussion of this in the Comments.

None of the above sources accept ads from industry.


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909