Re: Big Brother and vested interests?

This post not CC'd by email
On Fri, 25 Nov 2005 12:20:52 -0800, Mary <imnotthere@xxxxxxxxx>
wrote:

>Having worked in a physician's office where studies were being
>conducted, I developed some strong opinions on the matter (I was NOT his
>study nurse). I'll try to be concise--
>
>1. All patients in the study CHOSE to participate and were paid for
>their participation.

G'day G'day Mary,

Thank you for replying. Over time I have come to put a lot of trust
in nurses in one particular respect. They often have to pick up the
bits as it were from medical misadventures so have a surprising amount
of knowledge that is frequently hidden from public view.

You raise the interesting point of "inducements". Often we had to
decide what was fair recompense for participation in a trial. If the
fee is excessive poor people especially are likely to be seduced into
participation in trials.

>2. MDs participating in studies often get their best profits from
>participating in studies, not in their day to day patient care (at least
>here in the US, esp. with the low cost of reimbusement w/HMOs).

Yes. There have been a few classic cases where this aspect has been
taken to the extreme. In one case a pharmaceutical company wanted to
increase it market share of about 15% for a blood pressure lowering
medication. They proposed a trial similar to the one that started
this thread. Doctors would prescribe for their patients one of three
drugs including the one marketed by the company. Some suspicions were
raised when the amounts to be paid to doctors came to light. These
suspicions were largely confirmed when it was discovered that the
company intended recruiting vastly more patients than were required to
statistically assess the relative merits of the three drugs. Put
simply it was an exercise in conditioning GPs to write increased
numbers of prescriptions for their brand. It didn't get ethical
approval.

>3. I saw evidence of the MD "cheating" in order to keep patients in the
>study. If too many patients drop out, he is not able to continue his
>participation, thus he loses income.

Sad but true.

>4. Because of what I saw occurring, I do not believe studies to be
>reliable.

And yet we need to be reliable.

>I really don't believe that the situation described in the quoted
>article will ever come to pass. But if it does, the patient's only
>choice is to find another physician no matter how difficult that may be.
> I wouldn't want to be the patient of an MD who required me to
>participate in studies.

Neither would I.

>Mary

Best wishes,

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin
.

Loading