I signed up for the comcast bundle and was given an install date. The sign up was this online chat thing that took two hours as the rep was obviously “chatting” with ten people at once. I took the day off and stayed at home and waited. Noone showed. I called comcast and the automated line said the install was a week later. I thought maybe I made a mistake. Next week, again no show. I called and the date is now a week later. I stayed on the line and talked to a rep. They said that it took 5-7 days to “port” my old phone number from At&t to comcast. But it was now almost a month later. I asked why noone had bothered to notify me about the change in appointment. They said that an “automated call” was sent out, but I received no call. And the fact that this happened twice indicates to me that in fact no call was generated. They said they would try and get someone to come out that day. At the end of the day they called and said someone would come the next day. I again stayed home the next day. I called the automated service and the message said that the appointment was a week away. I got a rep on the line who assured me that they were coming between 11-2 that day. At 2, noone had showed up. I called back and they said my appointment was for a week later. I explained that I had been assured they were coming that day. They said someone would call back within the hour. No call. I called to cancel my subscription and was asked why? I explained the situation and they said they would get someone out there that day. I also asked if they would connect my Tivo or if they had DVR. and they said I would have to hook that up myself and they didn’t know if the techs had a “Tivo card”. Noone showed up anyway. At the end of the day someone called back and said they would cancel my subscription. Then I got another call asking why I was canceling? So frustrating. I went online and got an appointment for At&T U-verse with an email confirmation with no problems.

Pete Correll, who heads up the Board of Directors of the Grady Memorial Hospital, which provides care for the indigent in Atlanta, GA, was behind the heartless decision to pull the plug on patients receiving dialysis, which is a life saving treatment. When confronted with this at a medical board meeting, when all of the patients were present, he took out a full page ad in the Atlanta Journal Constitution defending himself. Do we detect a note of bad consciouss? You see, he had been tasked with helping Grady “make money”. But Grady is a hospital for the poor. It used to be that doctors saw their role as helping people. But now the hospital and insurance administrators are teaching them to think about making money, and not thinking about the welfare of their patients.

You can see Correll whining about being called a murderer. But what else is he if he pulls the plug on a treatment required for survival. And his comments about making money for a hospital that was established to provide treatment for the poor and indigent are ridiculous.

Let’s get doctors in charge of these boards and organizations. Not heartless former CEOs of organizations.

 

read for yourself and decide based on this ad taken out in AJC after the board meeting.

Neil Shulman MD gave a talk at a recent Emory Cardiology Research Conference about the plight of the Grady Hospital dialysis patients. (Read all of the posts about Grady dialysis here). A year ago, we the Grady patients received a death sentence after the board of directors decided to close the dialysis clinic and told the patients to go back to their countries or bugger off in general. In conjunction with the Advocates for Responsible Care we filed the patients into the board rooms and subsequent court hearings filed by Lindsay Jones on behalf of the patients. With some effort we got them to provide a year of treatment through the private clinic Fresenius, but now their time is up on August 31. At the conference one of the doctors said that the power of doctors is eroding, and increasingly it is the situation where administrators tell the doctors what to do with their patients. Funny, I didn’t think they should have the power to do that, but what the hey…

Meanwhile, at least one woman went back to Mexico, where she died because she couldn’t get dialysis, another went to Florida and almost died, then came back to Georgia, and there are several other stories like that. There still are 33 patients who need dialysis who are still alive who will be affected.

Meanwhile, the CEO of Grady, Michael Young, got a $300,000 bonus for saving money at Grady, which is the priority these days.

Pete Correll is former CEO of Georgia Pacific who runs the board of Grady. 

Baxter sells supplies for dialysis and charges twice as much for the dialysis supplies here as it does in Mexico. Maybe we should smuggle some over the border. We are asking Fresenius, DaVita, and Emory to provide compassionate care for these patients.  Robert J Parkinson, Jr, is president and CEO of Baxter.

 Kent J Thiry is CEO of DaVita, a dialysis company which has recently come under scrutiny for milking the use of the drug Epogen in dialysis patients for treatment of anemia.

Thomas Lawley MD is the Dean of the Emory Schoo of Medicine and is on the Grady Board. I have gone to the meetings but he usually just sits there and doesn’t say anything. Emory supposedly has picked up a few patients but they could do more to get these other harbingers of corporate greed to do something.

 

Ben J. Lipps, PhD, is the CEO of Fresenius who is the largest provider of dialysis in the US. They pay Lipps $4,310,000 a year in salary and compensation each year. (Maybe he could donate some to dialysis patients) Although Fresenius is a German company, they have adopted well to the American system of putting profits over people when it comes to healthcare. If a situation like the Atlanta dialysis situation occured in their home country, the local population wouldn’t stand for it.

The problem is that medical decision making is slowly being taken away from the doctors and put into the hands of people who don’t have the experience of connecting with people about their healthcare. Witness how administrators at Grady asked the doctors there to sign a statement saying that it would be fine for dialysis patients to get their dialysis only through the ER and on an as needed basis. They refused.

If each of these entitities would take on a few charity cases, like they used to in the old days, the problem would be solved.

Note: the post was updated one day after the initial posting.

See this article by UW-Seattle nephrologist Rudolph Rodriguez MD arguing that physicians have an ethical imperative to help these patients.

Dan Carlat MD has just come out with a book on American psychiatry that has got a lot of people talking. In Unhinged: The Trouble With Psychiatry – A Doctor’s Revelations About a Profession in Crisis Dr. Carlat describes the practices of the typical psychiatrist. In order to generate the most income, most of the appointments are 15 minute “med checks,” and the treatments are based on psychopharmacology and the biological psychiatry model. Patients are fed the pharma marketing explanations of how psychotropic medications work, providing solace for all involved, although there really isn’t good evidence for the explanations. Meanwhile, psychiatrists have farmed out therapy to the other professions, and have adopted a herd em through mentality toward their patients.

A July 13, 2010 interview about the book with Dr. Carlat on NPR’s “Fresh Air” show (which you can listen to here) has evoked some controversy. Giovanna Pompele wrote a critique on the Beyond Meds blog that takes him to task for his comments. She feels that by describing these practices and not apologizing for them, or implying that they still go on, that he is committing an offense. He also had some people throw some rocks about the implication that psychiatric training did not place a high value on therapy training.

I’m not sure I really see it that way. I think it is good that he is bringing this stuff out into a public discussion. I too used to give “drug talks” (see “Confessions of a Psychnetter“) but at the time I deluded myself into thinking that I was providing a useful “education”. However when they wouldn’t let me pick my own slides I realized I was doing nothing more than paid ads for the drug companies, and they dropped me for being difficult. I didn’t like it anyway, because the conversations with the psychiatrist attendees were like “I gave her Zoloft, and she got sleepy, so I gave amphetamines, and she developed… what should I do now?” Years later, the situation has degenerated to the point where my academic physican colleagues openly bemoan the fact that they can’t give “promotional talks” (yes, they actively call them that now). As for clinical work, I refuse to do the 15 minute med check thing, and restrict my clinical work to doing one hour evaluations. The part about telling patients that antidepressants increase serotonin in the brain is kind of a joke, because that is just marketing PR, and researchers like myself who have spent a lot of time reading the primary literature know it is a joke. However I’n not sure how much psychiatrists in the community have read that literature.

The idea of prescription medications like psychotropics being used to treat chemical imbalances has been burned into the public consciousness. Just take the example of Lindsay Lohan, who is on trazodone, Zoloft, Adderall and dilaudid, mixed with alcohol and cocaine, just one in a string of celebrity disasters to bite the dust on these lethal combinations. And when I pointed that out on TV last night, a caller practically took my head off, and there was a general discussion about her “depression” and how she needs to keep her meds in jail. How do we know she has real depression until all those drugs get out of her system? You don’t throw prescription meds at people who are actively abusing drugs (oopes, unless they are a Hollywood celebrity, of course).

I also see a little bit of the reaction to the acadmic psychiatist speaking the truth syndrome which is like “get him!” The whole psychiatry field has been perpetuated by myths and disttortions for so long that when someone talks frankly everyone freaks out.

By way of disclosure Danny wrote thispost in my support last year. I mention this as as a disclosure of my potential bias.

A couple of months ago I wrote in my post “Another One Bites the Dust” about Hollywood actress Brittany Murphy dying at 33 from a combination of different prescription medications, including hydrocodone, acetominophen, methamphetamine, and chlorpheniramal. That was just one more to drop, after the death of socialite and Johnson & Johnson family heiress Casey Johnson (”wifey of Tela Tequila, who is now in rehab herself with Dr Dr on the Celebrity Rehab TV show. Casey was taking a string of prescription medications, including Oxycontin, Klonopin, Valium, Xanax, and Ativan. She was also using marijuana, cocaine and ecstasy, and had diabetes. She died at the age of 31. Actor Heath Ledger died from prescription medications including OxyContin, Hydrocodone, Valium and Xanax, and the sleep aids Restoril and Unisom. Anna Nicole Smith died at 39 while on choral hydrate, Klonepin, Ativan, Benadryl and Topamax. This occurred just a few months after her son Daniel died from a combination of Zoloft, Lexapro, Serax, Valium, and methadone. And last year I wrote about the death of Michael Jackson, another victim of prescription medications.
These drugs include pain medications (Hydrocodone, Oxycontin), benzodiazepine sedatives used for anxiety or insomnia (Valium, Klonepin, Ativan, Serax, Restoril).

Tonight at 8 pm EST I will be on the Nancy grace show (Headline News) and the topic will include Lindsay Lohan.
Now Lindsay is off to jail, and the worst part of it for her will be that she can’t take her drugs with her. She apparently has been doctor shopping, and is on Zoloft, trazodone, Nexium, Adderall, and dilaudid.

Taking opiates, amphetamine stimulants, and psychotropics, and mixing them with alcohol and cocaine, is potentially a very lethal combination. When you put so many mind altering substances into your system, who nows what will happen. But unfortunately the end result is that these young starlets eventually stop breathing.

Interview of me by Neil Shulman MD about my experiences with the pharmaceutical industry. Exclusive footage you won’t see on the mainstream media.

Part 1

Part 2

Part 3

Part 4

Part 5

This is a repost from February 6, 2008, relevant in light of the fact that news now tells us that the manufacturer of Avandia has been covering up the risks of heart complications with their diabetes drug since it arrived on the market in 1999 and made several billion dollars on it in the meantime.

Today the NHLBI announced that the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study would be stopped because of an increased risk of death in patients on intensive glucose lowering treatment regimens. 10,251 patients with Type 2 diabetes were being treated with a range of medications for glucose control and were divided into intensive versus standard glucose
lowering groups. There were 257 deaths in the group receiving intensive treatment to lower HbA1C (a marker of elevated blood glucose levels) to below 6% compared to 203 deaths in the standard treatment group (HbA1C 7-7.9%). Deaths included sudden death and cardiovascular causes.

Reactions from medical experts included “surprise” and “shock”, and yet this should not have come as any surprise since the fact that glitazone medications used for diabetes, including Avandia (rosiglitazone) and Actos (pioglitazone) carry a cardiovascular risk was previously known. For example, last year an article in the New England Journal of Medicine showed that Avandia (rosiglitazone) increased heart attack risk by 43%. These drugs also cause fluid retention which increases the risk of heart failur. For instance, in the A Diabetes Outcome Progression Trial (ADOPT) 4360 patients with poorly controlled Type-2 diabetes were randomly assigned to four years of treatment with rosiglitazone, metformin, or glyburide. Rosiglitazone caused more heart failure than glyburide, and was associated with more weight gain (+4.8 kg—convert to pounds, v -2.9 kg for metformin) and fluid build up or edema (probable cause of the heart failure). 22 rosiglitazone patients developed heart failure, compared to 19 with metformin and 9 with glyburide.

In the PROspective pioglitAzone Clinical Trial in macroVascular Events (PROactive) Study, 5238 patients with Type-2 diabetes and evidence of vascular disease were randomly assigned to treatment with pioglitazone or placebo to be taken with their typical treatment regimen. There was no signficant difference in the primary outcome of any vascular event; 281 patients on pioglitazone developed heart failure compared to 198 on placebo, a 42% increase which was highly statistically significant. Most people don’t know that glitazones cause weight gain and actually create new fat cells, making you more “fatty’. So in other words, they are promoting the thing that causes Type 2 diabetes in most people (i.e. weight gain),
and causing the thing that we are trying to prevent by treating diabetes (i.e. heart attacks and heart failure). Not a very good deal.

Go here to listen to an archived interview on the Sasha Show about stress, depression, the media, and modern times. It is WGCU SW Florida public radio. Friend the show on fb by looking for ‘Sasha Show’ or friend me here ‘Doug Bremner’.

NYU has acquired the archives of so-called “artist” Larry Rivers who filmed his daughters naked while they were growing up, including the time when they developed breasts. When they complained he told them that they were bad daughters and uptight. This douchebag was apparently big on the beat artist and NYC circuit. Her mother said it “wasn’t a big deal at the time, but now NYU was making it a big deal by not giving up the films.” Now New York University (NYU) has acquired his archives, including the films, which are essentially child pornography. His daughter, Emma, states that the filming caused her to have anorexia, and drove her into therapy. She wants the films back.
But a spokesperson for the archive said he didn’t have the “authority” to go back and figure out which parts of the archive are innappropriate. I say someone from NYU should use a little bit of f-ing sense and get rid of their child porn collection. What do you think?

href=”http://www.beforeyoutakethatpill.com/index.php/2009/05/28/pharma-giles-writes-the-australasian-journal-of-boneheads-joints/ozziebones_jpg2/”>
A furore has erupted following The Scientist magazine’s revelations that Phoni Pharmaceuticals paid an undisclosed sum to scientific vanity publisher Elsleazier to produce several volumes of a publication that had the look of a peer-reviewed medical journal but which contained only reprinted or summarized articles, most of which presented data favourable to Phoni products. The journal appeared to act solely as a marketing tool with no disclosure of company sponsorship.

The Australian Journal of Boneheads and Joint Medicine, which was published by Extracta Moneya, a division of Dutch scientific publishing juggernaut Greed-Elsleazier, also contained little in the way of advertisements apart from ads for Formonimax, a Phoni drug for osteoporosis, and Viletoxx, Phoni’s controversial pain-killer.

In a statement provided last week to The Scientist, an eminent Australian physician and long-time member of the World Association of Medical Editors reviewed four issues of the journal that were published from 2003-2004.

“An average reader, such as a doctor, could easily mistake the publication for a genuine peer reviewed medical journal”, he said. “Only close inspection of the journals, along with knowledge of medical journals and publishing conventions, enabled me to determine that the Journal was not, in fact, a peer reviewed medical journal, but instead a marketing publication for Phoni.”

“They’ve done a heck of good job, and it was only when I noticed that some of the names of the so-called “honorary editorial board” appeared to be made up that I became suspicious,” the reviewer admitted.

“Professor Phil. I. Daftwhoofing appears to be an anagram of “Ripping Off Fools Who Read This,” for example. Similarly, Dr. Leon Theophuleet is an anagram of “Pulled The Other One”. And “Gill Ripcheap” seems to be an anagram of Rich Pillager, who I believe is Phoni’s Head of Global Marketing…”

A spokesperson for Elsleazier, however, told The Scientist, “All of our journals are thoroughly peer-reviewed prior to publication, by our accountants. Our company would never publish a journal unless it was guaranteed to make us lots of money. After all, our publications are well-known for the standards they deliver – standards of living for our publishing executives, that is…”

Disclosure of Phoni’s funding of the journal was not mentioned anywhere in the copies of issues obtained by The Scientist. Elsleazier acknowledged that Phoni had sponsored the publication, but did not disclose the amount the drug company paid.

The spokesperson added that Elsleazier had no plans to look further into the matter. “The high prices of subscriptions to our journals are a guarantee of their quality,” he said. “After all, everyone recognises the quality of Australian scientific publications, in the same way that American diplomacy journals or Nigerian accountancy and banking magazines are regarded…”

One of the genuine members of the Australian Journal of Boneheads and Joint Medicine’s “Honorary Editorial Board,” Dr. Táké Bakhandar, a rheumatologist in Australia, said he was delighted to serve on the board, however. Dr. Bakhandar has been on Phoni’s Asian Pacific and international advisory boards since the mid 1990s, as well as the advisory boards of other pharmaceutical companies, including Pfizer and Amgen.

“You get involved in a whole bunch of things at this level,” he said, adding that he had put his name on “quite a few advertorials” for pharmaceutical companies in the past 10 years. “I’m delighted to be able to promote the life-enhancing products of the pharmaceutical industry,” Dr. Bakhandar said.

His colleague and fellow member of the Australian Journal of Boneheads and Joint Medicine’s Honorary Editorial Board, Dr. Pádme Baksheesh, agreed. “My own observations conclusively show that there is a direct relationship between the number of products I plug for pharmaceutical companies, and the degree to which my life is enhanced,” he said.

Rich Pillager, Head of Global Marketing for Phoni Pharm. Inc. was also unrepentant.

“The Australian Journal of Boneheads and Joint Medicine” is an important tool in Phoni’s CME (Continuing Medical Education) programme,” he said.

“After all, we’ve been putting out advertorials for years. Everyone remembers our series of children’s books that were designed to promote the use of Phoni’s SSRI Saloadatat in children, for example,” Pillager notes, referring to the controversial “Mr. Bipolar” book based on the UK “Mr. Men” franchise.

“Our competitors have been doing exactly the same thing, only we’re aiming our latest fairy tales at the adult market. I can’t see what the problem is,” he frothed rabidly.

[this was a spoof piece but unfortunately the quote
"You get involved in a whole bunch of things at this level,"
was real, and the fake journal was real as well]

For more of Pharma Giles work see his hilarious children’s book ‘The Story of Modern Medicine’.

originally posted here on May 28 2009