A Commentary By Antonella Surbone MD PhD FACP, Ethics Editor on the Article Bidil: The Future of Medicine or A Return to the Dark Past?
On April 18, 2012, President Barack Obama during his campaign was photographed on the bus that Rosa Park was riding on December 1, 1955 when she refused to give up her seat for a white passenger.
“I just sat there for a moment, President Obama said, and pondered the courage and tenacity that is part of our very recent…
By Brian D. Clark
Faculty Peer Reviewed
The ability to critically assess the validity of a clinical trial is one of many important skills that a physician strives to develop. This skill helps guide clinical decision-making, and there are a number of things that we are trained to look for to help determine the validity of any given study. Right at the top of the list of factors that go into this appraisal is that of study design, with the randomized, placebo-controlled trial serving…
By Xiao Jing Wang
Faculty Peer Reviewed
ML is from Fu Zhou, China. She doesn’t speak much English and works in her family’s clothing store as a sales girl. ML is only one year older than I am. When ML was first diagnosed with lupus, about when I started my first year of college, she spent two months in the ICU with renal failure. ML had most of her bowel resected after developing mesenteric vasculitis. With a combination of lupus cerebritis, high dose steroids, and…
By Ishmeal Bradley, MD
Faculty Peer Reviewed
The goal of public health is to prevent or minimize disease and injury on a population level. How to achieve this end has changed over time, though. In previous decades, communicable diseases posed the greatest health risks. Consequently, public health officials used the tools of isolation, quarantine, and (forced) vaccination to combat these threats. Today, however, the major causes of morbidity and mortality are chronic conditions, many of which are thought to be due to lifestyle behaviors. Consider obesity,…
By Ishmael Bradley, MD
In March 2010 President Barack Obama and the Democratic-led Congress passed the single largest change in the American health care industry since the introduction of Medicare and Medicaid in 1965. The Patient Protection and Affordable Care Act (PPACA) aims to drastically change the way that health care is delivered and financed. It partially draws upon the idea of personal responsibility and its role in promoting individual health. Some states, notably Tennessee and Florida, had already tried similar approaches. Expanding upon these…
By Antonella Surbone MD PhD and Jerome Lowenstein MD
The recent hearings at the Food and Drug Administration regarding the revocation of approval for the use of Avastin in the treatment of breast cancer bring into sharp focus several very important issues in medicine today.
The pharmaceutical industry, armed with powerful new tools for deciphering the signaling mechanisms and mutations responsible for the development and progression of malignancies, has developed new therapies for treating cancer and other malignancies. The cost of development of each new…
By John J. Mercuri
Faculty Peer Reviewed
Noon: Alarms rang. The residents arrived. Equipment filled the room. The nurse manager called legal. Attending physicians hurried in and out. The family insisted that everything be done. The code lasted five hours and fifteen minutes. The room fell eerily silent when the patient died.
For weeks, the medical personnel who cared for this ninety-two year-old patient knew that she would never leave the hospital. Yet, for weeks, the patient…
By Synphen H. Wu, PhD
Faculty Peer Reviewed
Mr. C is a 46-year-old Chinese immigrant restaurant worker who came to Bellevue Hospital after two weeks of fatigue, malaise, right upper quandrant (RUQ) abdominal pain, and progressive jaundice. He was referred from a Chinatown clinic, where his blood tests showed hepatitis B surface antigen, a hepatitis B viral load of 133 million copies, and elevated liver transaminases and bilirubin levels, consistent with acute hepatitis B reactivation and fulminant hepatic failure.…
By Ishmeal Bradley
Faculty Peer Reviewed
In the first two parts of this article, we explored the historical and legal contexts of direct-to-consumer (DTC) advertising, the effects of these ads on prescribing behavior, and the economic incentives to advertise. In this final installment, we will examine what patients and physicians really think about these ads and offer one possible way to minimize the potentially harmful effects of DTC advertising.
Perceptions about DTC Advertising
Patient perceptions…
By Ishmeal Bradley
Faculty Peer Reviewed
In the first installment, we looked at the history behind consumer advertising of prescription drugs. We also explored the concept of commercial free speech and why this form of advertising is legal. To fully appreciate the controversy about direct-to-consumer (DTC) advertising, we must now examine the commercial effects of these ad campaigns. Do these ads really increase prescription volume and drug costs? Are both physicians and patients affected by the commercials they see…
By Ishmeal Bradley, MD
Faculty Peer Reviewed
Advertising is everywhere. That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these ads…
David Shabtai
Faculty Peer Reviewed
In a bold move, the U.S. Preventive Services Task Force recently changed their breast cancer screening guidelines – recommending beginning screening at age 50 and even then only every other year until age 75. Bold, because the Task Force members are certainly aware of the media circus that ensued when in 1997, an NIH group issued similar guidelines, prompting comparisons to Alice in Wonderland. The new guidelines, recommend “against routine screening mammography in women…
