bullshit diagnoses, through recent decades

[Anonymous]

I am not insinuating, I have stated that there are incentives to prescribe one competing medication over another. You may call it bribes if you like. In post soviet eastern bloc countries they call it "Gifts" so you choose.

I call total bullshit. Some (very few) docs do go to the expensive dinners. Pdocs are discouraged within the APA etc from accepting anything from anyone.

Look , My daughter saw several therapists who were in private practice.

Therapists are not psychiatrists. Do you even know the finer distinction between someone who has an MSW versus someone who has an MD?

Thought not.

[TheWho]

This is an open forum, you are free to post a link which proves or supports your position. I am posting from first hand experience and second hand knowledge, as my brother-in-law is in private practice.

Really, your brother-in-law is a private practice pdoc?

A yes or no will suffice.

Yes

[Anonymous]

I doubt it - we are talking about pdoc's and you bring up your daughter's therapists - it's comparing apples to oranges.

Pay attention, TW.

You are confusing a complicated argument, try to keep up.

So, you're *first-hand info* about your daughter's therapist doesn't count here. Try again.

[Anonymous]

APA's position on drug rep dinner's  -

Section 5–L
Question: It seems inappropriate for me to attend a presentation by a
drug company at a nice hotel with a free dinner buffet and then be paid
$100. Do you agree?
Answer: Yes we do and so does the AMA. Acceptable would be a modest
meal and no fee plus a squinty-eyed attitude toward what is presented.
See Opinion 8.061, AMA Council Opinions, 2000–2001. (April 1990)

I'm sure your brother-in-law has no clue about ethics guidelines, either - if you are spouting all this crap - if he's even a psychiatrist, as in an MD.

There are loads of info out there about ethics. You know, TheWho, as in a conscience - something you probably know nothing about.

[TheWho]

I doubt it - we are talking about pdoc's and you bring up your daughter's therapists - it's comparing apples to oranges.

Pay attention, TW.

You are confusing a complicated argument, try to keep up.

So, you're *first-hand info* about your daughter's therapist doesn't count here. Try again.

You are welcome to back up your position anytime.  So far you havent shown us anything.  Do you have a link?  Knowledge of the profession?  You dont support any of your arguments

[Anonymous]

TheWho anonymously said

You are welcome to back up your position anytime. So far you havent shown us anything. Do you have a link? Knowledge of the profession? You dont support any of your arguments

I said -

APA's position on drug rep dinner's -

Quote:
Section 5–L
Question: It seems inappropriate for me to attend a presentation by a
drug company at a nice hotel with a free dinner buffet and then be paid
$100. Do you agree?
Answer: Yes we do and so does the AMA. Acceptable would be a modest
meal and no fee plus a squinty-eyed attitude toward what is presented.
See Opinion 8.061, AMA Council Opinions, 2000–2001. (April 1990)

I just did - can you back up your claims? - I thought not.

Until then, this discussion is over.

[Anonymous]

http://pn.psychiatryonline.org/cgi/content/full/40/16/3

I highlighted the pertinent facts from the APA president - so ThePoo - put up or shut up.

From the President
 

Big Pharma and American Psychiatry: The Good, the Bad, and the Ugly
Steven S. Sharfstein, M.D.

 
 
 

APA's annual meeting is one of the largest medical meetings in the United States and the largest psychiatric meeting in the world. There is something for everyone at our wonderful meeting, but many have commented to me on the extraordinary presence of the pharmaceutical industry throughout the scientific programs and on the exhibit floor.

The U.S. pharmaceutical industry is one of the most profitable industries in the history of the world, averaging a return of 17 percent on revenue over the last quarter century. Drug costs have been the most rapidly rising element in health care spending in recent years. Antidepressant medications rank third in pharmaceutical sales worldwide, with $13.4 billion in sales last year alone. This represents 4.2 percent of all pharmaceutical sales globally. Antipsychotic medications generated $6.5 billion in revenue.

When the profit motive and human good are aligned, it is a "win-win" situation. Pharmaceutical companies have developed and brought to market medications that have transformed the lives of millions of psychiatric patients. The proven effectiveness of antidepressant, mood-stabilizing, and antipsychotic medications has helped sensitize the public to the reality of mental illness and taught them that treatment works. In this way, Big Pharma has helped reduce stigma associated with psychiatric treatment and with psychiatrists. My comments that follow on the pharmaceutical industry and its relationship to psychiatry bear this in mind.

The interests of Big Pharma and psychiatry, however, are often not aligned. The practice of psychiatry and the pharmaceutical industry have different goals and abide by different ethics. Big Pharma is a business, governed by the motive of selling products and making money. The profession of psychiatry aims to provide the highest quality of psychiatric care to persons who suffer from psychiatric conditions. There is widespread concern of the over-medicalization of mental disorders and the overuse of medications. Financial incentives and managed care have contributed to the notion of a "quick fix" by taking a pill and reducing the emphasis on psychotherapy and psychosocial treatments. There is much evidence that there is less psychotherapy provided by psychiatrists than 10 years ago. This is true despite the strong evidence base that many psychotherapies are effective used alone or in combination with medications.

In my last column, I shared with you my experience, and APA's, in responding to the antipsychiatry remarks that Tom Cruise made earlier this summer as he publicized his new movie in a succession of media interviews. One of the charges against psychiatry that was discussed in the resultant media coverage is that many patients are being prescribed the wrong drugs or drugs they don't need. These charges are true, but it is not psychiatry's fault—it is the fault of the broken health care system that the United States appears to be willing to endure. As we address these Big Pharma issues, we must examine the fact that as a profession, we have allowed the biopsychosocial model to become the bio-bio-bio model. In a time of economic constraint, a "pill and an appointment" has dominated treatment. We must work hard to end this situation and get involved in advocacy to reform our health care system from the bottom up.

Furthermore, continuing medical education opportunities sponsored by pharmaceutical companies are often biased toward one product or another, and they are more akin to marketing than CME. APA has strict guidelines for the industry-sponsored symposia presented at our annual meetings; sanctions are applied when our rules are broken. Our guidelines have been held up as a standard for medical meetings in other specialties throughout the country. But there are many grand rounds, evening dinners, and lectures where such standards do not prevail.

Direct marketing to consumers also leads to increased demand for medications and inflates expectations about the benefits of medications. As a profession, we need to be concerned about advertising and the impact it has on the over-medicalization of our field. Of course, what is marketed to consumers are the highest-cost, on-patent products, and the cost of medications is something rarely considered by prescribing clinicians. When doctors don't prescribe cheaper but equally effective drugs, it consumes money that could have been used to provide other psychiatric or medical services.

There are examples of the "ugly" practices that undermine the credibility of our profession. Drug company representatives will be the first to say that it is the doctors who request the fancy dinners, cruises, tickets to athletic events, and so on. But can we really be surprised that several states have passed laws to force disclosure of these gifts? So-called "preceptorships" are another example of the "ugly"; that is, drug companies who pay physicians to allow company reps to sit in on patient sessions allegedly to learn more about care for patients and then advise the doctor on appropriate prescribing.

Drug company representatives bearing gifts are frequent visitors to psychiatrists' offices and consulting rooms. We should have the wisdom and distance to call these gifts what they are—kickbacks and bribes. (For more thoughts on this topic, see Viewpoints on page 33.) If we are seen as mere pill pushers and employees of the pharmaceutical industry, our credibility as a profession is compromised.

Here are several suggestions for remedies in our relationship with the industry.


We need to embrace a new professional ethic. The doctor-patient relationship should not be a market-driven phenomenon.

Preceptorships should be considered unethical.

Enticements, gifts, parties, and so on should be reined in because patients must believe that their doctor has their best interests in mind when a prescription is handed to them.

We must re-evaluate single-sponsored medical education events and phase them out in favor of more general support for CME along with a careful policing of these events for bias.

The amount and support received by individual clinicians and researchers from industry should be transparent and the information readily available.

When we attend lectures at annual meetings and other educational events, and read journals and textbooks, we should know very clearly about the industry support given to presenters and authors.

As psychiatrists, we should all be grateful for the modern pharmacopia and the promise of even more improvements in the future. At the same time, however, we must be very mindful that we cannot accept gratuities in the new medical marketplace.  

[TheWho]

Here is something more recent:

Pharmaceutical companies fail to publicly reveal all of the money and gifts they give to physicians and health care workers—making it hard to know what the money is for …


What they were doing," Ross says, "is saying that all of their payments were trade secrets … It's improbable that all of a company's payments were truly proprietary." Moreover, in 75 percent of the reports handed over to the researchers, the companies failed to identify the gift recipients despite a legal requirement to do so, Ross says.

In Vermont, companies made 2416 such payments, which totaled $1 million. Half of all payments exceeded $177, up to a maximum of $20,000, and 68 percent were listed as food. In Minnesota, of 6238 payments totaling $22.4 million, half of the payments topped $1,000, and the largest was $922,239.…..

....Pharmaceutical companies' "marketing techniques and their reluctance to disclose them invite further misgivings about the industry.

Link to article



...

[Anonymous]

That article was in Scientific American and about the AMA - how is pertinent to psychiatry (duh, try somethign about *APA*) Seriously, are you that dense? There is a huge difference between the two - but you can tell your total ignorance is showing.

Dude, you cannot even cite academic articles - iIgave you the presidents address and you give me some shit you can get off a newstand?   :rofl:  :rofl:  :rofl:  :rofl:  :rofl:

[Anonymous]

Plus, please read the aforementioned things I already posted - so far you have showed me nothing about *PSYCHIATRISTS* (you don't know the difference between a therapist and an MD!!!! :rofl:  :rofl: )

Nothing, i keep offering more proof and show zero results as they pertain to the argument of PSYCHIATRY!!!!

 :rofl:  :rofl:  :rofl:  :rofl:

[Anonymous]

The interests of Big Pharma and psychiatry, however, are often not aligned. The practice of psychiatry and the pharmaceutical industry have different goals and abide by different ethics. Big Pharma is a business, governed by the motive of selling products and making money. The profession of psychiatry aims to provide the highest quality of psychiatric care to persons who suffer from psychiatric conditions.  

[TheWho]

Sorry to upset you so much and burst your bubble.  But did you really think that doctors and psychologists were immune to receiving gifts and bribes?  What country are you from...wake up!!    The article is clear and JAMA has also jumped in and are concerned.

Michelle Mello of the Harvard School of Public Health write in an editorial accompanying the study in this week's JAMA The Journal of the American Medical Association. "Drug companies' attempt to evade regulations may backfire," they conclude, if "public resentment over noncompliance with existing laws sparks demand for additional regulation."



...

[Anonymous]

Aw poor who, you are all over the place - too bad you can't put an argument together without the spin. I'm not upset, but I do think you are projecting.

You still haven't answered the questions - you made these grand claims about psychiatry and now you are falling back on the AMA.

Too bad for you. I can see you for the blowhard phony who is full of shit for exactly what you are - full of shit.

& remember you're extravagant claims have been saved for all of posterity

I am not insinuating, I have stated that there are incentives to prescribe one competing medication over another. You may call it bribes if you like. In post soviet eastern bloc countries they call it "Gifts" so you choose.

Mathematics Disorder (cant wait to read the details)
Caffeine Disorder
Disorder of Written Expression
Telephone Scatalogia (making obscene calls) and believe it or not you will be able to get reimbursed for having Malingering, because this will become a disorder that needs treatment…Woah!!!! ………. to name a very few.

After 2011 a diagnosis (for the above, as well as many others) will qualify for payment by health insurance agencies.

One of the challenges for psychiatrists and/ or psychologists is to constantly bridge the gap between diagnosis and insurance reimbursement. They also need to keep their thumb on the pulse of what the pharmaceutical industry is testing or presently has in clinical trials so they can reduce couch time (which insurance companies hate) and prescribe more drugs.

personally, I can't wait for the APA lawyers to get a hold of you.


 :rofl:  :rofl:  :rofl:  :rofl:

[Anonymous]

Mathematics Disorder (cant wait to read the details)
Caffeine Disorder
Disorder of Written Expression
Telephone Scatalogia (making obscene calls) and believe it or not you will be able to get reimbursed for having Malingering, because this will become a disorder that needs treatment…Woah!!!! ………. to name a very few.

After 2011 a diagnosis (for the above, as well as many others) will qualify for payment by health insurance agencies.  

Also, care to back any of this up?? Mathematics disorder is dyscalculia - and is already in the DSM-IV - it's for site specific brain injuires an/or learning disorders. So again, you're wrong!

I could go through the whole list and make you look truly stupid  but you are on well on your way to doing that all by yourself.

As i said, you didn't even know the difference between an MSW vs MD - or even the difference bewteen the APA president and scientific american. So, when you get a clue or some evidence - let me know. Until, ciao!

 :rofl:  :rofl:  :rofl:  :rofl:

[Anonymous]

Sorry to upset you so much and burst your bubble.  But did you really think that doctors and psychologists were immune to receiving gifts and bribes?  What country are you from...wake up!!    The article is clear and JAMA has also jumped in and are concerned.

Michelle Mello of the Harvard School of Public Health write in an editorial accompanying the study in this week's JAMA The Journal of the American Medical Association. "Drug companies' attempt to evade regulations may backfire," they conclude, if "public resentment over noncompliance with existing laws sparks demand for additional regulation."



...

Hey Who,
A little of your own advice back to you. If you calm down and listen up, you just might learn something.