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Healthy Skepticism Library item: 19713

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: news

Peckham C
2011 Most-Read Articles by Primary Care Physicians
Medscape Today 2011 Sep 12

Full text:

10. The “Ugly Duckling” Sign: An Early Melanoma Recognition Tool For Clinicians and the Public

The key to preventing deaths due to invasive melanoma (MM) remains detecting the disease early, at a stage when surgical excision of the tumor is still curative. One clinical clue to diagnosis is the “ugly duckling” sign — a useful indicator for MM screening with implications for healthcare workers and the lay public alike. Given certain limitations of the established ABCDE acronym for early melanoma recognition, this study suggests a new, broader way of thinking about the ugly duckling concept and its place in MM detection.

9. Tea and Coffee Consumption and MRSA Nasal Carriage

In this study, consumption of hot tea or coffee was associated with a lower likelihood of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage. The findings raise the possibility of a promising new method to decrease MRSA nasal carriage that is safe, inexpensive, and easily accessible.

8. 10 Physicians Charged in Fed Sweep of Medicare ‘Fraudsters’

In September, a federal bust of Medicare fraud in 8 cities has yielded criminal charges against 91 individuals, including 10 physicians as well as nurses, physical therapists, and family counselors. The defendants allegedly billed Medicare for $295 million in false claims with the help of kickbacks, illegal pain medication prescriptions, imaginary psychotherapy sessions, and other ploys. The US Department of Justice called the bust “the highest amount of false Medicare billings in a single takedown in Strike Force history.”

7. Six Biggest Gripes of Employed Doctors

The 6 biggest complaints according to this article were:

Lack of job security;
Changes in compensation;
Call schedule is too burdensome;
Lack of business control;
Lack of clinical autonomy; and
The tyranny of noncompete clauses.
This article offers a discussion where you might want to share ideas on this volatile subject

6. What’s Killing Us? The 4 Deadliest Diseases

This Medscape One-on-One between Eli Adashi, MD and Tea Collins, Executive Director of The Non-Communicable Diseases (NCD) Alliance, discussed the importance of the new global initiative against four major NCDs that are responsible for 60% of deaths worldwide: cancer, diabetes, cardiovascular disease, and pulmonary disease.

5. I’m Struggling to Live on $160,000 a Year: MD Lament

Whereas most Americans would consider a $160,000 income a fortune, many physicians find it a challenge to live on that amount. Why can some manage easily while others are struggling to pay the bills?

4. Updated Influenza Vaccine Recommendations Issue

New for the 2011-2012 season is a more-permissive influenza vaccination recommendation for persons with egg allergies. The CDC Advisory Committee on Immunization Practices now recommends that people who have experienced only hives from consuming eggs can receive the trivalent inactivated vaccine intramuscularly as long as they are treated by a healthcare provider who is familiar with the potential manifestations of egg allergies and can be observed by a healthcare professional for at least 30 minutes after receiving each dose. Live-attenuated influenza vaccine should not be used in these patients. Read the full CDC commentary.

3. FDA Approves New Drug for Type 2 Diabetes

In May, the US Food and Drug Administration approved linagliptin (Tradjenta™) for improving blood glucose control in adults with type 2 diabetes, either as a stand-alone or in combination with other therapies.

2. Doctors’ 5 Worst Financial Mistakes

Physicians do their best to manage their money and investments wisely, but a few common mistakes keep cropping up. Are you guilty of any of these?

1. FDA Restricts Use of Simvastatin 80 mg

In early June 2011, the US Food and Drug Administration (FDA) issued a drug safety communication on the 80-mg dose of simvastatin because of an increased risk for muscle toxicity. “Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug,” the agency stated.

It advised physicians to limit using the 80-mg dose unless the patient had already been taking the drug for 12 months and there is no evidence of myopathy. In addition, the FDA requested that additional changes be made to the drug’s label. The label changes include the new dosing recommendations as well as warnings not to use the drug with various medications, including itraconazole (Sporanox), ketoconazole (Nizoral®), posaconazole (Noxafil®), erythromycin, clarithromycin, telithromycin (Ketek®), HIV protease inhibitors, nefazodone, gemfibrozil, cyclosporine, and danazol. In addition, the 10-mg dose should not be exceeded in patients taking amiodarone, verapamil, and diltiazem, and the 20-mg dose should not be exceeded with amlodipine (Norvasc®) and ranolazine (Ranexa®).

As a result, there was concern that physicians would not be comfortable escalating to branded statins because of resistance from managed care and sometimes the necessity for prior authorization. In addition, it was thought that many patients would also be distressed by the added cost of a more expensive statin. The availability of generic atorvastatin in November should help address these issues for many patients.


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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963