From physician to felon: A doctor warns how easy it is to be bribed

Washington Post, 12 April 2017
Author: Lenny Bernstein
“In 2014, an internist pleaded guilty to one count of accepting a bribe. She accepted monthly payments of $5,000 to refer patients to Biodiagnostic Laboratory Services, for blood tests and other screenings. Such referrals are illegal in medicine because of the potential that doctors will put their financial interests ahead of the needs of their patients. To date, 29 doctors have been convicted in the multiyear investigation. The U.S. attorney’s office in New Jersey said the case involves more than $100 million paid to the testing lab by Medicare and private insurance companies.”
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Yes, your doctor might Google you

The Conversation, 30 March 2017
Author: Merle Spriggs
“An Australian survey of how doctors use social media found about 16% (about one in six) had searched for online information about a patient, with roughly similar results from studies in the US and Canada. This raises several ethical concerns. For instance, what if your doctor’s search through your Facebook, blog or Twitter feeds revealed aspects about your lifestyle, like drug or alcohol use, you didn’t tell your doctor directly? What if that information influenced your access to surgery?”
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Many Doctors Get Payments From Drug Companies

MedicineNet, 21 March 2017
Source: HealthDay News
“Many American doctors receive payments from drug companies, but few patients know about those financial ties, a new study finds. The study found that within the previous year, 65 percent of patients visited doctors who got payments or gifts from drug or medical device companies, but only 5 percent of the patients were aware of those doctor-industry links.”
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‘Do no harm’ vs. ‘legitimate use of force’

EurekAlert, 16 March 2017
Source: University of Montreal
“Should a military doctor obey an order to not treat an enemy combatant? Or certify a sick soldier as fit to fight? Should a nurse take part in interrogations? Ride along on medical caravans to build trust with locals? Violate patient privacy for military ends? These and other questions are being studied by Canadian researchers with the Ethics in Military Medicine Research Group. Their latest paper, published in December in the winter issue of the Journal of Law, Medicine & Ethics, compares the ethics codes of the Canadian Medical Association and the Department of National Defence and the Canadian Armed Forces. ”
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(Re)disclosing physician financial interests: rebuilding trust or making unreasonable burdens on physicians?

Med Health Care and Philos (2017).
Author: Daniel Sperling
“Recent professional guidelines published by the General Medical Council instruct physicians in the UK to be honest and open in any financial agreements they have with their patients and third parties. These guidelines are in addition to a European policy addressing disclosure of physician financial interests in the industry. Similarly, In the US, a national open payments program as well as Federal regulations under the Affordable Care Act re-address the issue of disclosure of physician financial interests in America. These new professional and legal changes make us rethink the fiduciary duties of providers working under new organizational and financial schemes, specifically their clinical fidelity and their moral and professional obligations to act in the best interests of patients.”
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As biosimilars hit, EU pharma warns against blanket prescribing

Reuters, 9 March 2017
Authors: Ben Hirschlerand Edmund Blair
“European drugmakers, faced with increasing competition from cut-price copies of complex biotech drugs, cautioned doctors on Thursday to take care when switching patients from an established product to a so-called biosimilar version. The European Medicines Agency has to date approved two dozen biosimilars against just four in the United States.”
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Surgery or Drugs? Doctors’ Pay May Influence Choice

NYT, 8 March 2017
Author: Nicholas Bakalar
“Sometimes doctors choose to do surgery not because it is absolutely preferable to other treatments but because they get reimbursed for it, a new study suggests. What we need is a system that incentivizes doctors to be aggressive in treating patients in a timely fashion, but not to create procedures for reimbursement.””
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Conflict of Interest in Seminal Hepatitis C Virus and Cholesterol Management Guidelines

JAMA Intern Med. 2017;177(3):352-357.
Authors: Akilah A. Jefferson, Steven D. Pearson
“Neither the cholesterol guideline nor the hepatitis C virus guideline fully met the IOM standards for commercial COI management, and discordance between committee leader guideline disclosures and those in contemporaneous articles was common. Adherence to additional IOM standards for guideline development and evidence review was mixed. Adoption of consistent COI frameworks across specialty societies may help ensure that clinical guidelines are developed in a transparent and trustworthy manner.”
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Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest

JAMA Intern Med. 2017;177(3):344-350.
Authors: Susannah L. Rose, Janelle Highland, Matthew T. Karafa
“Patient advocacy organizations engage in wide-ranging health activities. Although most PAOs receive modest funding from industry, a minority receive substantial industry support, raising added concerns about independence. Many respondents report a need to improve their conflict of interest policies to help maintain public trust.”
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