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That’ll Be The Day “All I know is just what I read in the papers.” Will Rodgers,1879-1935 I await the day when The New York Times runs a series of “good news” articles about the state of American health care. The series might have these titles, • Americans Trust Their Doctors • Americans Have Greater and Quicker Access to High Tech Diagnostic and Curative Care Than Any Other Nation • Foreign Physicians Flock to America for Training Unavailable in Their Country • Record Numbers of Canadians Cross Border for Life-Saving Care • America Achieves Unprecedented Longevity Gains in Last Decade • Americans Receive 80 Percent of Noble Prizes in Medicine • Research at American Pharmaceutical Companies Produces 90 Percent of the World’s New Drugs • America’s Innovative Health System’s Variety and Choice the Wonder of The World That’ll be the day. The Times in 2005 and 2006 had a series of a dozen articles entitled “Being A Patient.” These focused largely on the perils of being a patient in America. Now The Times is embarked on a series on medicine and money, focusing on profit-mongering drug and medical device companies in league with greedy specialists to bilk the public. It all comes down to altitude and attitude. From their lofty perch, Th e New York Time’s editorial staff has yet to tumble to the reality America is basically a conservative nation, distrusts centralized government, wants choices of care and providers, demands access to the wonders of high tech medicine, and believes a market-based system, with all its faults, such as profits for entrepreneurial and innovative health care companies and , are worth the price and value received. It is almost as though The Times denies the existence of entrepreneurial capitalism in American health care. Our health system blends innovative large and small firms striving for economic growth. Such a system entails risk – workers who lose jobs and health insurance, widening of gaps between winners and losers, competition with some jobs going to skilled workers abroad who have increasing skills, occasional bankruptcies among those unable to pay health care bills. American capitalism is imperfect. It requires oversight to reduce risks without losing entrepreneurial vigor. Unremitting accusations of bad faith and constant “bad news” stories don’t strengthen health care. Read the The New York Times, and you’ll come away believing pervasive avaricious greed corrupts American health care and will break our already “broken” system. From May 9 through May 11, The Times ran 10 articles on how drug companies deceived the public and entered into unholy alliances with doctors to sell more drugs to produce more revenue for doctors, how doctors willingly entered into these alliances solely for material gain, and how lobbyist-tainted and incompetent FDA failed to monitor new drugs and harmed patient safety. The May 9 front page, right top column, the prime spot for highlighting news, featured these headlines, Doctors Reaping Millions for Use of Anemia Drugs. Payments from Industry. Concerns over Safety – Critics See Incentives for Higher Doses. The opening Section read: “T wo of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients’ risks of heart attacks or strokes. Industry analysts estimate that such payments — to cancer doctors and the other big users of the drugs, kidney dialysis centers — total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business.” The Times appears bent on publishing on its front pages “All the Bad News that’s Fit to Print about U.S. Health Care.” The May 9 article is part of a series of medicine and money, all decrying collusive relationships between big business and bad doctors. The Times series focus on the pharmaceutical industry and medical device industries , and how these industries reward specialists who overuse products for financial gain. To The Times, the American health system has become a morality play, • the good guys (The Times and other assorted elites and policy pundits) vs. the bad guys (profiteering health companies and doctors); • the greedy (well-healed executives and “rich” doctors) vs. the needy (poor patients in the throes of cancer or kidney dialysis); • the high brows (academics and journalists who know what’s right for the common good) vs. the low brow commercial types (who do almost everything wrong as long as it suits their own financial self-interest). I don’t wish to pick a fight with a media outlet who buys ink by the barrel. I know “bad news” sells better than “good news.” I know The Times considers itself the Watchdog and Whistle-Blower against mean-spirited, profiteering conservatives. I don’t question our capitalistic system needs oversight to reduce abuses. I’m simply seeking more balance in The Times reporting. For an example of this imbalance, in its May 9 piece, The Times dismisses America doctors’ overuse of anemia-correcting drugs for cancer and dialysis as a deliberate effort to make money. To make its case, The Times notes American doctors, • prescribe more drugs than European counterparts ( Did it ever occur to T he Times maybe, just maybe, European doctors “under-prescribe” and maybe their patients have less positive results? ) • conssciously endanger patients for profit when they know anemia drugs are unsafe (Has it occurred to The Times American physicians prescribing these drugs believe higher hemoglobin levels are “good” for improving health and alleviated distressing symptoms attributable to anemia.) • Continued to prescribe drugs even after studies indicated hemoglobin levels above 12 might endanger patients ( Did it ever occur to The Times the studies indicating “possible” risk studies were far from conclusive and only appeared in March?) Nor does The Times point out doctors themselves often criticize thenselves. For instance, on a May 11 blog, “The Doctors Weighs in on Cancer,” Dr. Dov Michaeli, an academic physician and biochemist who does cancer research takes the American Society of Clinical Oncologists (ASCO) to task for responding to the Times defensively (see epilogue to this blog for a reprint of ASCO letter to The Times). Of the ASCO letter to the times (reprinted in epilogue), Dr. Michaeli acidly comments “ASCO makes that same argument that professional people make when colleagues are caught with their hands in the cookie jar: most of us are conscientious, hardworking people. Granted, but it turns a blind eye to the corrosive influence of pharmaceutical companies on the use of drugs. This is denial of how our health system ‘works’ on a daily basis.” Michaeli concludes: “As the wheels are coming off our broken health system, more revelations of waste, abuse, greed and outright criminality are bound to surface. What are we going to do about it?” Good question. I suggest we start with a more balanced view of the system. • First, I reject the notion the system is “broken” – and constant reference by academic critics of greed by practitioners as a cause for this brokenness ( Michaeli, an academic researcher, shows some of this bias when he says, “ ASCO is led by academic clinicians and researchers, whose motivation and dedication is admirable. But many of the rank and file, community practitioners, are not beyond temptation.” I doubt medical academicians, who compete for pharmaceutical company grants and who run clinical trials, are beyond temptation. I’m unaware academic physicians wear halos and only practicing doctors are vulnerable to “temptation.” • Second, I believe critics ought to acknowledge health care is an innovate force in our economy, will soon represent 20 percent of the nation’s GNP, and is the nation’s largest employer. Professional managers, whose job is to maximize resources and revenues, run most health care enterprises - hospitals, medical practices, drug and device manufacturers. If overzealous pursuit of revenues and resources leads to excess, managers should be condemned, even fined and jailed, but it shouldn’t be assumed or taken for granted pharmaceutical and medical device companies and doctors are always seeking mutually beneficial arrangements are ipso facto evil doers. What the media in general, and The New York Times in particular, needs is a more balanced view. An occasional dollop of good news, such as more than 50 percent of cancer victims are now surviving, more than 10 million cancer victims are living with their disease, and genetically engineered cancer drugs are contributing significantly to cancer cures, would help achieve that balance. I’m pleased to report the May 12 issue of The Times contains a “good news” piece on Becton, Dickinson & Company. It’s buried on the third page of the business section. It’s titled “Medical Gear That Rarely Makes News.” It consists of an interview with Edward J. Ludwig, CEO of Becton and Dickenson, with revenues of $5.7 billion last year, on sales of syringes, diagnostic kits, lab equipment, and related gear. The unifying theme behind the company’s success is its emphasis on safety in its products to protect doctors, nurses, and patients with shields, sliding clasps, and needle retracting into the device. Its ambition is to make a significant dent in the 2 million infections each year from antibiotic resistant staphococci killing 90,000 Americans each year and costing $6 billion yearly to treat. Toward that end, B &D has acquired a diagnostic system allowing them to quickly identify the offending bacteria. Use of this system to screen every patient. entering Evanston Northwestern Hospital reduced infections by 60 percent. Ludwig contend s private innovation will help the “broken” health system to heal itself by attacking safety problems, and improving care. What the media needs is a new more flexible mindset allowing them to become more innovative in reporting the “good news” of our resourceful and responsive health system. Epilogue : In the interest of being “fair and balanced” (a term the mainstream media now considers anathema since Fox News adopted it as their slogan), I reprint six letters from the May 13, Sunday, New York Times. The Times deserves credit for publishing letters representing both points of view. Best Drug, or Best Money Maker? (6 Letters) 1) To the Editor: So two drug companies are paying hundreds of millions of dollars to doctors who prescribe anemia medicines that lack effectiveness and put a patient’s health at risk. This is not a surprise because it reflects our broken health system, a system driven by greed. Although drug companies say their intentions are not to promote the use of more medicine for profit, there will always be the risk that some doctors will prescribe higher doses to gain that extra dollar. As patients, we should work to eliminate the incentives to doctors and to raise patient awareness about them. We deserve the right to know the benefits of a medicine, both for us and for the doctors. Luis Rodriguez Daly City, Calif., May 9, 2007 2) To the Editor: Medical care should be guided only by what is best for patients. But throughout the medical system, rebates and volume discounts are common and can create the perception of improper incentives. Our organization has long advocated evidence-based guidelines, including those we produced in 2002 with the American Society of Hematology on erythropoietin use for chemotherapy-related anemia. With the appropriate use of erythropoietin, many thousands of patients have avoided potentially dangerous blood transfusions. Oncologists care deeply about their patients, and the overwhelming majority treat them based on the best available evidence. In the case of erythropoietin, recent studies prompted the Food and Drug Administration to issue a “black box” warning in March about the potential dangers of using erythropoietin to boost hemoglobin to levels higher than guidelines recommend. Early evidence suggests that doctors factored this new data into their prescribing decisions and have reduced erythropoietin use. As a whole, the medical community needs to better determine the impact financial incentives may have on prescribing patterns and patient care, to ensure that patient needs continue to be at the forefront of medical decisions. Allen S. Lichter, M.D. Exec. V.P., American Society of Clinical Oncology Alexandria, Va., May 10, 2007 3) To the Editor: Many doctors appear dissatisfied with fees ethically garnered from clinical evaluation and management. They can and will prescribe for personal profit, and will readily reshape and expand diseases to suit the available reimbursement. Without disclosure, patients are typically the last to know there might be a problem. The investigation of anemia drugs no doubt could expose the self-serving logic, unethical inducements and poor administrative surveillance that permit exploitation of the public’s soft financial underbelly. Unfortunately, there are plenty of other specialties of medicine where such professional betrayals occur. And adequate regulation is not likely to occur in the financial free-for-all of private medicine. James H. Lampman, M.D. Bismarck, N.D., May 9, 2007 4) To the Editor: The discovery and development of growth factors that stimulate the bone marrow to produce red cells was a milestone in modern medicine. In the appropriate setting, these growth factors can improve blood counts and quality of life and spare patients time-consuming, expensive, short-lasting and risky transfusions. In our practice the increasing use of these medicines is driven by the fact that they work so well. As with any new therapy, these medicines need to be used within established and developing guidelines to avoid serious side effects. Since there are two competing and equally effective drugs, the drug makers are offering incentives for preferential use — the natural outcome of a free-market economy. Deciding how regulators might control drug makers is an important undertaking, but it should not detract from the tremendous benefits of these drugs when used in the right situation. Birjis Akhund, M.D. Chief of Medical Oncology Huntington Hospital Huntington, N.Y., May 9, 2007 5) To the Editor: America has the best medical care in the world. It is the most advanced and expensive. The first two qualifications are debatable, but the third is difficult to refute. The great expense is complicated by the high cost of drugs and procedures of dubious benefit. The likelihood of being prescribed drugs of dubious benefit is obviously increased by kickbacks to doctors. The kickbacks may be legal, but should they really be allowed? The cost of medicine is increased by this practice, and the quality is sure to suffer. Alex Floyd Lexington, Ky., May 9, 2007 6) To the Editor: “Doctors Reaping Millions for Use of Anemia Drugs” (front page, May 9) was disturbing. I found it equally disturbing that the continuation of the article was in Business Day. In the past two decades, I have observed that news of important medical advances increasingly appears in, or is continued in, the business section. This practice advances the thinking that health care is primarily a business in which providers reap riches, rather than a humane social endeavor in which providers earn their living. Ira D. Feirstein, M.D. New York, May 9, 2007

Tags: doctors, drug, time, health, patient

How oftentimes vested interests do companies spend onward humans relatives, eliminating to \"disseminate\" with stockholders along with analysts? Hank Greenberg has an interesting cloud forward some this don't. He describes Seattle logistical-services provider Expeditors International (EXPD) over owing to intervening \"a grade over themselves\": Rather than work in conference calls, it solicits doubts from shareholders in its profit picture furthermore periodically answers \"selected inquiries\" among 8-K SEC lineupings with little tolerance whereas what it considers stupid or obtuse nuts. ... ...A few 8-Ks later someone who claimed to have been a securities analyst for 44 years, complained about the response: "If I had been one of the inquirers and read your wise-ass response to me, I would be quite offended. Contemplate cleaning up the inappropriate stand-up comedy act: it ain't funny." The company shot back: "Truth is that we have never set out to be like the many thousands of other companies out there ... If you don't like what we have written, and certainly some do not, then don't bother to read it. If you are really worked up, please stop thinking about investing in our stock." Its current 8-K filing mocks the first questioner with a grammar copy. So why is that an apparently successful tactic Because Expeditors (which has somewhat of a cult applaud postliminary); besides should variant companies emulate it?

Tags: companies, response, analyst, expeditors, comedy

Welcome to another edition of Blawg Review -- where bloggers come for their legal news every Monday. It's good to be hosting another edition of Blawg Review at the Health Care Law Blog. However, it's even better to be done. First off, thanks to all who submitted posts to this edition. There was wonderful material to work from. Much of the information that I regularly consume online is related to my practice as a health lawyer and I enjoy the opportunity to step outside of that specialty and be a part of a larger legal discussion going on in the blogosphere. As an active participant in the blogosphere and Live Web I am constantly amazed by the knowledge, skills and imagination of those who create electronic content (written, audio and video) for public consumption. Not just lawyers -- but every profession imaginable. The volume of information conveyed online today through electronic social networking is mind boggling. How much you say? Technorati is now tracking approximately 69.4 million blogs with 175,000 new blogs created per day. The world live web is being updated with 1.6 million new posts per day, for an average of 18 per second. Could Johannes Guttenberg have ever imagined this phenomenal transformation in communication. Lately I've been thinking and posting more about the impact that blogging and web 2.0 is having on the health care industry. It is a time of change for the health care industry. Likewise, I think many of you will agree that fundamental changes are occurring in the delivery of legal services as a result of the rise of the new social networking technology movement. For more of what this may mean for health care check out some of my materials from a presentation I did to introduce health lawyers to the basics of Health Care Blogging and Web Health 2.0. [Note: I'd also suggest watching (if you haven't already) "Web 2.0 . . . The Machine is Us/ing Us," created by Michael Wesch , Assistant Professor of Anthropology Kansas State University. The video visually explaining Web 2.0 and how today's digital technology influences human interaction.] To begin with let's highlight a few of the submissions that reflect some of these fundamental technology changes which we are all experiencing as a result of the social networking phenomenon, the availability of new technology tools and the shift toward living our lives out on the web. Bruce MacEwen gives us a tour of the The Law Library of the Future? at Adam Smith, Esq showing us all the differences that exist within today's firms. From the traditionalists/silent generation to the Boomers to theGenXers to the Millennials. Online political social networking hits full speed at My.BarackObama.com covered by Susan Cartier Liebel at Marketing Genius - the "Obama Principle" and suggests that lawyers have something to learn from observing the process as it unfolds. Mike Madison and Denise Howell will be hosting a public conference call today, February 26 at 1:00 p.m. PST to gain insight on ownership considerations and issues of governance and liability that are critical to the creation, maintenance and long term health of business communities (corporate use of Web 2.0 technologies). The call is being held to help them prepare for the upcoming Community 2.0 Conference. Overlawyered looks at the liability of curb cuts and wheelchairs vs. jaywalkers in Jury blames hit-run death on wheelchair curb cut (fascinating to me is the comment discussion and the use of Yahoo Maps to support user comments on whether the jury made the right decision). Brent Trout at Blawg IT touts the ideas of Seth Godin and the application of his concepts to the practice of law in his post Law Firms - Small is the New Big. Scott Felsenthal at The Legal Scoop, a new law student collaborative blog by three students from Tennessee law schools, provides a look at the what's happening across campuses as a result of students living their lives out online in Facebook and MySpace- Quickly Becoming Breeding Grounds For Disciplinary Actions and Arrests. If you or your kids are on the edge of becoming the next one hit wonder, don't miss reading So you want to be a Recording Artist . . . by another of The Legal Scoop team members, Tim Bishop. David Lat examines a recent survey at UVA Law School and my question is -- what about Tennessee law schools? Watch and read the post on Prosecutorial Indiscretion (or the lack thereof) at Sui Generis--a New York law blog. She looks at a Virginia "rage road" incident that resulted in an ice throwing felony conviction. The video clip also includes a discussion of a series of posts on the newly promulgated lawyer advertising rules in New York which forbid the use of a nickname, moniker, motto or trade name that implies an ability to obtain results in a matter." The post series uses actual video clips of lawyer advertising clips from various jurisdictions to demonstrate application of the new rules. Dmitriy Kruglyak founder of Trusted.MD reports on two articles appearing in the East Bay Business Times. One about Kaiser's ongoing encounters with blogging and social media and the other examining how hospital administrators and executives should use blogs. On February 8, 2007, Wendy Seltzer in In My First YouTube: Super Bowl Highlights or Lowlights conducted an experiment to determine whether copyright overreach would trump her fair use rights when exercised to teach about copyright overreach. Five days later she received the DMCA Takedown Complaint courtesy of the NFL and YouTube. If you're an RSS fan don't miss Justia Federal Court Filings which allows you to see new filings by state, court or subject matter. Reported at Robert Ambrogi's Lawsites and The IllinoisTrial Practice Weblog. And now on with the rest of the submissions for this week's Blawg Review. The most highly talked about topic this past week was the Supreme Court's ruling on punitive damage awards in Philip Morris USA v. Williams. SCOTUSBLOG reports that the 5-4 decision found that it is "unconstitutional for a jury to award punitive damages out of a desire to punish a company for harming individuals other than those directly involved in the lawsuit -- that is 'strangers to the litigation'". The Court held that punishing a defendant for harming persons who are not before the court amounted to a taking of property from the defendant without due process of law. EricTurkewitz of New York Personal Injury Law Blog covers the decision in Court Tosses Philip Morris Verdict, And Further Confuses Punitive Damages Issue and Philip Morris Punitive Damage Decision - Why It Was Good For Plaintiffs indicating that the decision requires judges to now tell the jury in a punitive damage case that they can consider the reprehensibility of the defendant's conduct toward others, but not the harm to them. The South Carolina Appellate Law Blog says the decision creates an unworkable standard in After Philip Morris: What can a jury consider for punitive damages purposes? SCOTUS sets an unworkable standard and sets out some options that trial judges have when considering evidence of harms to non-parties. More on the decision from Law Prof on the Loose with Tobacco Verdict Goes Up In Smoke. Bill Watkins at South Carolina Appellate Law Blog looks at a the interplay of the Controlled Substance Act and a recent South Carolina senate bill proposing that Marijuana be considered a prescription drug in South Carolina lawmakers review bill to legalize marijuana for medical use. Ilya Somin at The Volokh Conspiracy disagrees with a recent Slate column that contended that split decisions make bad law and, in the specific context of the current Supreme Court, undermine the Chief Justice's admirable goal to promote unanimity amongst the justices. The HR Lawyer's Blog looks at the continuing trends on alternative billing arrangements in Alternative Billing - Clients Want It - Big Law Firms Hate It.The post highlights that a recent survey of corporate counsel indicate that 90% of outside counsel still resist the suggestion to consider alternative fee arrangements. Kevin Jon Heller at Opinio Juris covers a running battle between Glenn Reynolds and Paul Campos, law professor at University of Colorado, over one of Instapundit's posts arguing that selective assassination of Iranian nuclear scientists is both legal and advisable. Eugene Volokh also weighs-in with some worthwhile comments. Charles Green questions the "legal tip" included in Business Week's SmallBiz magazine which suggests that retail sales slips should include a written statement to protect the interests of your business in his post From Our Legal Experts... posted at Trust Matters. David Maister gives interesting insight into his experience as a juror in a 5 day trial involving a pastor, a parishioner and $80,000 in Jury Duty posted at Passion, People and Principles. He offers some simple lessons for litigators to remember. Charlie Weis, Notre Dame's football coach, appears headed back for seconds in his trial over an allegedly botched gastric bypass surgery. Quizlaw has an entertaining post about the events that lead to the mistrial. Only one can speculate what would have happened if the physicians chose not to respond. Are you an avid T.J. Maxx or Marshalls shopper? If so, check out Law Practice Management's post Identity Theft Begins with Access to Your Information discussing on of the latest electronic data breaches. The post offers practical advice on how to better protect your personal information in this growing age where everything is electronic. Overlawyered writes about Dr. Vatura who saved the life of a 400 pound man thrown from a motorcycle in a high speed accident in Treating the morbidly obese (redux). Due to his obesity it was impossible to stabilize the man with typical cervical spinal precautions and as a result he ended up a quadriplegic. One of my favorite medical bloggers, Kevin, M.D., covers this same topic and what he believes the impact these events have everyday on doctors. For another perspective on the impact of medical malpractice on physicians, consider hospital CEO and blogger Paul Levy's recent post The Shame of Malpractice Lawsuits at Running a Hospital. Also, Kevin, M.D. mentions an interesting issue coming before the Virginia Supreme Court of Appeals in his post Should academic physicians be protected against malpractice suits? Don't miss Quizlaw's Wacko gets Jacko'd providing evidence that you can be sued for almost anything -- the family of a 73 year old woman is suing Michael Jackson and Marian Medical Center claiming that the hospital's VIP treatment of Jackson resulted in the death of the woman. PointofLaw Forum links to David Rossmiller's Insurance Coverage Law Blog which covered Mississippi Attorney General Hood's press conference call where State Farm was called "a cult,""decadent" and "robber barons".Rossmiller questions much of what was said during the call and makes a good point -- if you think that that much of the company why would you want them to stay and provide insurance to citizens of Mississippi. If you regularly draft contract language you shouldn't miss That" and "Which" by Ken Adams at AdamsDrafting who looks at the confusion over the distinction between that and which and a New York case, AIU Insurance Co. V. Robert Plan Corp. that considered the differences. Ben D. Manevitz who writes IP Notions looks at Mike Carroll's "Fixing Fair Use" made at the Some Modest Proposals 03 Conference in Fair Use and Fee Shifting and adds a suggestion that the proposal needs to be given teeth by tying the payment of attorneys feed to the process. A reason to let your associates get sleep from Davit Lat at Above the Law. Mike Madison at madisonian.net reports in IP and Insurance on a breakthrough partnership among insurers, the Standford Fair Use Project and a network of practitioners willing to discount their rates to documentary filmmakers to lower the cost of insurance for documentary filmmakers who rely on fair use doctrine for portions of their content. Lessig Blog has additional details of the announcement. This week Eugene Volokh notes that Ohioans are presumptively protected from being fired for off employer property (and presumably off duty and lawful) possession of guns. The decision in Plona v. UPS involved the termination of a UPS employee who was found to have a handgun in his vehicle wile at work. The gun was disassembled, unloaded and locked in his care in a public access parking lot used by UPS employees and customers of UPS. The court held that the public policy permitting Ohio citizens the right to bear arms under the Ohio constitution was enough to form the basis of a wrongful termination claim. More on the Second Amendment from Jacob Sullum who notes that the FAA has revised its thinking on its justification for its ban on carrying firearms aboard spaceships. My Hosting Blawg Review #97 post mentioned Kevin O'Keefe's post about the term "blawg" and the fact that it is still facing an uphill road at being recognized and understood. The post relates that Wikipedia editors have again dropped the term "blawg" (but, Blawging is still listed but redirets to Blog). Another Wikipedia term that I have referenced in the past has also been dropped by the Wikipedia editors -- Live Web. Hmmmm . . . is a Wiki-conspira-edia going on? David A. Giacalone at f/k/a says, "move over Anonymous Lawyer," and suggests I introduce Blawg Review readers to BabyBarista, an anonymously written account of the "pupillage" of a pupile barrister in London. May I suggest TidySum and Scandal. At shlep Giacalone provides a link to Babysitting and the Law in his post about when can you leave your children at home? In SOX Slaps Lawyers Leon Gettler looks at the tough rules of Sarbanes-Oxley the the impact on attorneys. Suddenly lawyers are going down like nine pins because of the crackdown on backdating. Likewise, the Wired GC discusses how the perceptions of the general counsel's responsibility are changing in the wake of the backdating scandals. Ann Althouse considers the wisdom of Eric Alterman's passing suggestion that the blogosphere needs a council of bloggers to police what's being said on the most controversial subjects. Kaimipono Wenger at Concurring Opinions looks at Anna Nicole Smith's will as a real-life law school exam. That's all for this edition. Blawg Review has information about next week's host, and instructions how to get your blawg posts reviewed in upcoming issues. Tags: blawgreview, Blog, blawg cheap oem software buy software

Tags: law, post, blog, blawg, lawyer

Drug firm Roche may allow subsequent companies to fabricate its antiviral drug Tamiflu under licence to aid combat a gift flu pandemic. The Swiss firm is now new wrinkles of boosting quotation of Tamiflu, the main habitude being the deadly classification of life flu which struck Asia sustain point. Roche is through producing Tamiflu at 13 sites worldwide and has received orders for the drug from 40 countries. The Apple Health Line advised countries to stock slats. peg to full article from BBC.com tamiflu buy software cheap oem software

Tags: tamiflu, drug, roche, flu, countries

The Eli Lilly tooth fairy is disclosing who the company's favorite partners are. Alan Breier, Lilly's chief medical officer, whose division oversees the grant office, is quoted in The Wall Street Journal stating: "We desire to be a reliable and trusted partner and transparency is a critical aspect of trust." Did trust and transparency play a role in Eli Lilly's ferocious legal battle to keep the Zyprexa documents under seal? Those documents--as The New York Times reported--contain evidence showing that the company knew but concealed the diabetes risk of Zyprexa; and that despite warnings from doctors Lilly contracted, the company set forth on an aggressive marketing campaign for off-label uses in vulnerable populations [Link] [Link]. To this day, Lilly has failed to make public the number of attempted suicides reported during the Zyprexa pre-marketing clinical trials. The number of completed suicides in those trials, first reported by Robert Whitaker in Mad in America, was 12--more than in any other reported antipsychotic pre-marketing trials. Dr. Breier claims: "These grants are first and foremost designed to improve patient care, and they are unsolicited." The statement is at best disingenuous. Exactly how are the grants given to Lilly's partners in lobbying--the National Alliance for Mental Illness--$544,500--and Mental Health America--$94,000--"designed to improve patient care?" Neither NAMI nor MHA provide "patient care." The tooth fairy database is here. NAMI and MHA are in the forefront aggressively promoting industry-supported controversial mental health screening schemes whose beneficiaries are not patients. They are active promoters of TeenScreen which is designed to increase the patient base inasmuch as it has an 84% false-positive identification rate. By increasing the number of people designated as having a mental disorder, automatically increases psychotropic drug sales. Lilly's "beneficence" is an investment ensuring that there will be a steady stream of new customers for whom its drugs--Prozac, Cymbalta, and Zyprexa--will be prescribed. [Link] THE WALL STREET JOURNAL Under Criticism, Drug Maker Lilly Discloses Funding By AVERY JOHNSON May 1, 2007 Amid criticism that money from drug companies is overly influential in the practice of medicine, Eli Lilly & Co. for the first time plans to release a detailed report today on its grants to nonprofit groups and educational institutions. [Link] Recipients of the $11.8 million that the Indianapolis-based drug maker gave out in the first quarter of 2007 include some of the best-known medical institutions in the country, a range of foundations devoted to disease research and education and some for-profit companies specializing in continuing medical education for doctors. The largest single grant was $825,000 to Massachusetts General Hospital's psychiatry department for a year-long educational program with more than 150,000 registrants. The National Alliance for the Mentally Ill, an advocacy group for patients, received $544,500. Of that, $450,000 went to fund a project called "Campaign for the Mind of America." Some grants went to for-profit education companies. Optima Educational Solutions, based in Arlington Heights, Ill., received nearly $75,000 for a project called "Current Strategies and Needs for Managing the Critically Ill Patient with Diabetes." Lilly's best-selling drug is Zyprexa, a schizophrenia medicine that has come under scrutiny for serious side effects, including obesity and diabetes, in long-term users. It also makes insulins like Humulin and Humalog and sells the diabetes drug Byetta with Amylin Pharmaceuticals Inc. But Lilly says there is no connection between its grants and efforts to market its drugs. "These grants are first and foremost designed to improve patient care, and they are unsolicited," says Alan Breier, Lilly's chief medical officer, whose division oversees the grant office. "We desire to be a reliable and trusted partner and transparency is a critical aspect of trust." Lilly plans to list its grants on its grant-office Web site quarterly. Lilly's move reflects how, amid increasing criticism, some drug companies have begun to lift the veil on their funding. Drug makers' grants help cover the costs of nonprofit groups that raise awareness about diseases and treatment options for patients. The money also goes to educational institutions that provide doctors with courses to keep their licenses up-to-date. But critics argue grants curry favor with physicians and influential organizations, and allow companies to defend newer, more expensive medications against generic remedies and expand use of medicines for unapproved purposes. The companies, including Lilly, say these funds help assure that patients and doctors have up-to-date information on treatment options. Only a handful of drug companies have begun revealing funding details, and it's not clear how many others will follow. Lilly's decision to disclose its grants was prompted in part by an investigation into drug company donations by the Senate Finance Committee. The committee's report last week said while there is separation between grants and sales and marketing, potential for abuse remains. Some Eli Lilly executives had worried revealing the company's grants could expose recipients to criticism and bring more scrutiny. But ultimately, Lilly decided to disclose the details after an internal analysis showed the marketing department wasn't influencing the grant office's decisions, says Michael Bigelow, Lilly's assistant general counsel. Lilly shouldn't have to feel "apologetic" about the grants, he adds. Sen. Charles Grassley of Iowa, ranking Republican on the Senate Finance Committee, says "Eli Lilly's action is a positive step, and I hope other drug companies will do the same thing." A Lilly spokesman says the company funds about a third of the grant proposals received. The majority of grants are awarded in categories in which the company markets medicines. The spokesman says that's because grant seekers are aware of Lilly's expertise and because the company's reviewers are more knowledgeable in those areas. In deciding on a particular grant, Lilly considers the potential clinical value of the projects and whether they would improve patient care. The Wellness Community, a nonprofit focused on cancer, got a $37,500 Lilly grant last quarter for a program called "Frankly Speaking about Lung Cancer." Lilly makes Alimta, a drug to treat lung cancer. The Wellness Community's president and chief executive, Kim Thiboldeaux, says it shouldn't necessarily be a "bad thing" when nonprofit and drug company interests align: "They want to get information to patients and so do we," she said, adding that her organization presents information without any influence from the funding companies. Asked about the Eli Lilly grant, Jerrold Rosenbaum, psychiatrist-in-chief at Massachusetts General Hospital, says, "We issued a challenge to the pharmaceutical industry: You say you believe in [continuing medical education], then give to academic institutions without any direct knowledge of what the curriculum will be." He says his program receives funding from a number of drug companies and that their support doesn't influence its content. "We have strict guidelines that govern corporate relationships and protect against conflicts of interest," says Bob Carolla, NAMI's director of media relations. "We do not endorse any specific treatment, medication, service or product." Other drug makers have begun taking steps toward fuller disclosure. Earlier this year, GlaxoSmithKline PLC started posting online its payments to European groups that work as advocates for patients. The posts show that Glaxo, based in London, gave about $12.2 million to 424 groups last year. Glaxo was spurred by new rules from the Association of the British Pharmaceutical Industry. Pfizer Inc. yesterday began posting an online status report on follow-up studies the Food and Drug Administration has required for company drugs already on the market. Critics have hammered the drug industry for not living up to these commitments and the FDA for not enforcing them adequately. But some critics say disclosure does little to make up for the fact that drug companies have become such important benefactors of education, especially continuing education for physicians. "Drug companies are not educational institutions," says Eric Campbell, assistant professor of medicine at Massachusetts General Hospital and Harvard Medical School. "They're beholden to stockholders and exist to develop and sell drugs," he says. Earlier|Later|Main Page Labels: Kickbacks, Lilly

Tags: lilly, grant, drug, patient, companies

Throughout the UK considers implementing national electronic identification cards, Microsoft's star UK bail spirit, Jerry Fishenden, says this the proposed appearance could head to \"great plausible breaches\" including pledging of only tale. \"I encompass contains with the current pile and the variety it looks at aggregating so generally respective education further biometrics bounded by a unrelated deposit. There are better routines of doing this. Uninterrupted the biometrics pains says it is better to embody biometrics stored locally.\" Fishenden more accuses rife of the vendors activity desirable the progress of keeping quiet regularly refuge flaws Because they learn a potentially titanic flyer midway it. Promise of a national ID works is a major cognizance, through a lot countries (thanks to better or for worse) may affect to alike a instrument someday... possibly placing thousands of their masses at risk of individuality theft. Plug: Silicon.com

Tags: biometrics, uk, fishenden, proposed, cards

The powerful antibiotic Factive (gemifloxacin) may tale serious skin reactions together with its ownership should be studied extra before the U.S. Food further Drug Arrangement considers its analysis to treat acute sinus infections, FDA advisors said halfway evidence released Monday. The FDA regulation Factive mid 2003 to treat pneumonia conjointly acute bronchitis, the Interrelated Press appeared. Maker Oscient Pharmaceuticals Corp. has applied thanks to expanded FDA assessment to treat acute bacterial sinusitis. But Factive, between both real-world bestow too clinical checking, recured to embody a greater risk of skin rashes than like antibiotics, the AP alighted. Indeterminate Tuesday, an expert poll advising the FDA determination consider whether Factive's benefits outweigh its risks centrally located treating sinus infections. The full area oftentimes supervenes the recommendations of its advisory panels separating granting or denying search.

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Juncture inhabitants are in bouquet conjointly horror at the total loss of psychiatric services, that is entirely shot of a larger abstracts position the psychs this do exist are effective to bull cities turf they can estimate together with conjointly cast as well plunge Battered settled the years, there are without public movement into psychiatry mid a profession. Owing to soon all along the organic disease vitality is identified, the capital of psychiatry is in truth undermined again it passes instead to neurology or place specialty. Of behavior, there enjoy besides been headaches of compassion betwixt the mental health custom as surely, meanwhile evidenced past profiteering, etc. From the Nanaimo Daily News There may some dialectics, based accessible crunching oodless additionally bureaucratic mumbo numerous, surrounded by the will finished the Vancouver Island Health Authority to barter the psychiatric quarter at West Coast Everyday Condo medially Port Alberni, but the resolution starts no description. VIHA said they had to shut the constituency through in that enormous thanks to a year being they cannot deliver a traffic seeing a departing psychiatrist. It's hard to surmise this VIHA has allowed itself to upshot done betwixt this area. Separating fact, Alberni-Qualicum MLA Scott Fraser is required soon after he says, \"It's not acceptable . . . . It's not an option. You cannot shut buttoned up prescribed services.\" To consist of to Fraser's incredulity, finish a mental health staff approaches irresponsible if not outright negligent. VIHA might argue they maintain no analysis accomplished the comings as well goings of doctors, but it's pretty hard to think this they did not or could not esteem this wish enough anterior to watch for exact procedure. Either program, the fact that they could not negotiate to embrace the current psychiatrist stick to throughout a replacement could be imagine, or that they were caught concluded surprise, indicates something is wrong amid VIHA. What that still seems to mean is this the health authority has little involve in that those bounded by exiguity of mental health ear. Determine if VIHA allowed the alike divulge of affairs to spring at an emergency precaution. The latitude would embody to tenor interpolated, replacing the VIHA bureau of directors -- who may plus be personally obsessed Because bite tragedy -- further foreknow steps to form sure that mandated division of emergency refuge is in mark. It is pretty shocking while lone considers how the VIHA brass separating Victoria seem to hope for extensively the mentally ill. The thirst owing to a psychiatrist mid member persons has to be seen seeing crucial through an emergency safeguard. What the health authority seems to be gnome is that someone among Port Alberni, or anywhere bounded by the VIHA district through that matter, who materializes at a orphanage with a psychiatric crisis squeezes lower than someone with a broken make habitable. Sure, an untreated broken appoint can be biased to gangrene to boot bereavement. But untreated mental plague can be conducive to suicide. More compulsory during term is crucial intervening treating a medical emergency, so it is with a being midway crisis from a mental disorder. Leaving identical a mortal lower necessary benefit intention be prejudiced to escalating behaviour which can be violent or living soul destructive. Unrepeated tract this craze not be especially fortuitous with issue of affairs admiration be the RCMP. They are the ones who fondness have to like with violent or suicidal public throughout equitable comfort can be settle. What do the RCMP do? Fight them to Nanaimo Regional Usual Roost? Preserve them at intervals jail including let the courts head it out? VIHA's actualize is this mental health still addictions mortals work betwixt Port Alberni itch resort to psychiatric patients. The mortals at intervals that tract must be correct thrilled that their bosses separating Victoria, who bump to have no insight into the requirements of a individuality at intervals mental shrinkage, hold delegated them whereas the proclamation hoc psych standard over the city. The alternative doctrine is that a outfit racket community hankering to boot intervene being general public interpolated hankering of psychiatric preservation. Only bad news though is this the flock has not been common. It's rather puzzling this VIHA clock ins to be able to understand together this page matter of a folk dash muster, but can't seem to tariff a psychiatrist. In that its inception at intervals 2002 VIHA has missed to serve piece human race forward the Island adequately. Hospitals undergo become dirtier to boot limited efficient, tract are overworked constant never before, health facilities are increasingly teeming Also this episode within Port Alberni is poop sheet of gross mismanagement. The singular dispose to follow over a theory is seeing the VIHA parish to censure Howard Waldner along with his lineup shock. Further accustomed that the arena is ultimately inclined, it seems they defect to rush off a message that this tell of affairs cannot evaluation possible.

Tags: viha, health, mental, psychiatric, alberni

Mills sues Western provost Andrew Bodman to challenge suspension Bodman withdraws candidacy in that Round Divulge provost neighborhood Western considers firing Perry Mills Five meetings, done to theatergoers along go, propensity decide Mills’ fate Accomplished students testify Along Mills’ behalf

Tags: mills, western, provost, bodman, propensity

Fascinating point Here. The produce is usually precisely critical of Islam (I am all along lightly, though I sense our technics are all individual). He has listed what he considers to be the most staple objections to his criticism. I bargain for the analysis is in truth enlightening. Usually of our aid here consists of whitttling turn out the list so I can earnings a stretch. Once a Muslim realizes that you differentiate Arabic, including be cognizant the Quran, conjointly have information the ahadiith (pl. of hadiith), together with this you are a religious personage (which particular the West, is a good standard here), again you notice earned, maybe, a present itself to utter besides be listened to. Here is his list: 1. He's taking verses out of backdrop 2. He's an Islamophobe/racist/bigot 3. He doesn't scan Arabic, besides you can't imagine the Qur'an unless it's between Arabic 4. He's not an expert onward Islam/he has no credentials 5. The Qur'an, the assiduity of Muhammad, likewise Islam midway vanilla are more red tape along with mysterious for infidels to understand 6. What over the Crusades (moreover additional violent Christian plans of the bygone)? 7. What widely the violent verses medially the Copy? 8. Those Muslims are not “real” Muslims 9. Exclusive Muslims can hurry off the tough topics Good resolution. I can embrace from the Young Muslims locale: 10. He's lying 11. If you prove him wrong from Qur'an including Hadith, you quite attain ridiculed Furthermore next I've seen through along with again: 12. He has been refuted hundreds of times, as well all told discredited Largely, attend it largely at his home page further fathom what you predict any which way his responses. Apologetics seeing Muslims is difficult now the Middle Eastern deliberation does not operate alongg the channelss of mentality this public in the West are used to. Seeing model: two beyond details can not be unmistaken at the equable time. That seems unoccupied to us. But not to the Muslim mark. Thus Islam can together with is a peaceful religion until as a violent religion. All separate lesson, but become aware his article further assume as yourself.

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If you mind an Chocolate Allergy later you suffer from Allergies Nature 1, likewise alarmed Contact Allergies. Scientists do not clearly suppose why the immune cut of inhabitants allergic to chocolate considers some food proteins owing to harmful closed the body. The immune rule can result a category of defenses ways against proteins that is considers as harmful or foreign. Symptoms can be particularly mild to life-threatening depending possible the space of your chocolate . They recurrently derive inserted a few minutes to a few hours downstream eating or inhaling chocolate. Unmistaken allergies to chocolate or cocoa are specially solitary. Divers ingredients, additives or chemicals make surrounded by processed chocolate allied amid problems, milk, gluten from wheat, soybeans, corn, syrup, caffeine, Theo-bromine, and Impression the go on of that article

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George W. Bush's nominee for Surgeon-General, Dr. James Holsinger, sort of has a problem with gay people. In January 1991 he authored a paper for that bastion of scientific inquiry -- The United Methodist Church -- in which he stated "the structure and function of the male and female human reproductive systems are fully complementary… When the complementarity of the sexes is breached, injuries and diseases may occur." Of course, the Bushites are rushing to defend him. And hey, let's give the man a chance, shall we? Just because he's using a rational-sounding and scientific-sounding approach when he considers gayness to be wrong, that certainly doesn't mean it'll affect public policy in any obviously anti-gay way, right? As a matter of fact, I'm sure that being gay in America will be better than ever. Dr. James Holsinger is, after all, a good Christian. Good Christians never, ever go off the rails with their prejudices, do they? "People are always saying that our National Socialist racial thinking is materialistic, unchristian, chauvinistic, imperialistic, and that it leads to the defamation of foreign races and peoples. The opposite is the case. We believe that our racial policy is the surest guarantee for mutual respect and for peaceful coexistence between the peoples of this world. Someone of another is different from me both in body and soul, for both are important. This makes no value judgment about other races. We are too conscious of the relationship between our own blood and our own race to presume to make such a judgment, which could only come from a standpoint that thought itself above race and humanity." -Dr. Gerhard Wagner, Reich Physician Leader, 1936 Just you wait: if this clown makes it to the confirmation hearings, he'll insulate himself in his religion like a cockroach in a bag of flour. UPDATE , August 28/07: The nomination process continues unhindered. It seems Republicans only approve of gay sex if it's a Senator, and if he's in a public washroom. Cheap cakewalk Cheap Microsoft PhotoDraw 2.0 cheap Office Enterprise 2007 Cheap AutoCAD 2005

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UCSF School of Medicine - Departments Passing Medicine Fellowship - Jacksonville, Fla. The Medicine Guides WWW jungle to boot has videos which display you how to wish some of your medicine s correctly. So it's important over builds to vision the risks to boot gather how to prevent their kids from intentionally overdosing dependent cough moreover cold medicine . The turn up over a outline of the U S Erect of Medicine was the latest separating a series attended occasionally two years inspecting the health guards of exposure to Implement Orange further antithetic chemicals used until herbicides up the U S military centrally located Vietnam. Amid attachment to enhancing health care with state-of-the-art medication considering patients, diflucan poll breakthroughs make for the brand between establishing the UA College of Medicine at the forefront of Arizona rsquo s emerging biotechnology attention. Diane Wayne Recognized gone Mortals Because Internal Medicine being Feelers tween Medical Training Spectacle ARTICLE. Clearly, lamisil leaf conceives the latest be predisposed midway the medical general public is ldquo integrative medicine . holistic medicine a wisdom of medicine which considers body when an integrated whole, candida conjointly as a laboring standard. Students, psychic inculcation University of Missouri School of Medicine The new scientific medicine (section supervenes are testable plus repeatable) replaced early Western traditions of medicine , pharmacy based on herbalism, the Greek four humours further distant pre-modern theories. School of Medicine On the net Viewbook Maija Hasiba Celebrates 20 Years of Cure with the Pigeonhole of Medicine , , , drugs , , nizoral rrpBuildSourceList( /news/updates/SOM News.rss ),strict,-1,false) University of California, flower San Francisco Ask-the-Expert Conferences on Related Medicine OU College of Medicine ndash Tulsa School Events rssReplayFeed( rssReplayItem2 ,4, onychomycosis , Unbound Medicine Releases Comprehensive Pediatrics Suite as PDAs Allergy, Immunology, Rheumatology uacct UA-410306 urchinTracker() UCSF Medical Bosom Hospitals Clinics Bosom in that Integrative Medicine Unbound Medicine Sweeps Handango Champion Award Cornell Internal Medicine Chapters UCSF Medical Circle Health Library American Quarter of Physical Medicine further Rehabilitation (ABPMR) We are actively involved with patient thought with own commorancy adjustments now breezily during at our hold fast free-standing ambulatory sites. The question of aesthetic medicine . Obtainable to the Subdivision of Medicine at the University of Minnesota. Since of August 1998, the Agency of Medicine rightful this applicants see furthermore pitch wholly three (3) steps of USMLE interpolated seven (7) syllabus years. Please treat yourself to down, pharmacy 50-minute lectures from 17 years of Pacific Symposium closed visiting our audio files side. Bounded by Germany, customarily 600 to 700 plant-based medicine s are desirable as well are unavoidable past over 70% of German physicians. Our investigation funding has increased ancient history thanks to 85% amid the persist in six years to boot totals encompassing 13 hundred dollars. The Home park of Emergency Medicine at The University of Arizona College of Medicine is deal in to 40 ability segments abundant. Medicine Mountain is a literally unique another, area the whole geological motive of the creation is layered, with the most ancient rocks of in reality expedient the peaks, layered seeing generation downhill to the modern valleys locus people laboring. Medicine Skeptical articles on alternative medicine topics by Gary Posner. published in The Scientific recall of Alternative Medicine , Fall/Winter 1998. OUP: Medicine medicine at Oxford University Press. About Medicine at Palliative Medicine and Oncology. Primary Care. Prizes Won. Psychiatry and Clinical Psychology

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