I suppose I should not be surprised that Vermont is doing so much to combat inappropriate drug company influence. After all, the state is famous for liberal physicians, including, most prominently, the current chairman of the Democratic National Committee, Howard Dean.I recently gave a talk (as part of my “Dirty Thirty” tour) to the Vermont Psychiatric Association. What an impressive group. These are psychiatrists who are in the profession to help their patients, no matter what it takes, and are refreshingly unwedded to the medication solution. For example, Alice Silverman, one of the association's representatives to the APA, no longer starts with antidepressants when treating mild depression, because she has found therapy to be just as helpful. Her patients are happy because they don't have to deal with either sexual dysfunction or a higher risk of osteoporosis.
Also present was David Fassler, the incoming secretary-treasurer of the APA. I look forward to working with him on the newly formed APA Work Group to figure out who to wean ourselves off of industry money.
Vermont is absolutely at the forefront of the growing movement to wrest control of medicine away from the pharmaceutical industry. The legislature has passed a law restricting prescription data-mining; the University of Vermont Medical School has banned drug company gifts or meals; and the Vermont Association of Mental Health has just said "no" to industry support. To read more about what Vermont is doing, read this excellent overview article in the Barre Montpellier Times Argus.
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6 comments:
i wish i could move to Vermont, but my family would not be happy:
eskimos they are not!
You see, the mind set is out there, it's just the mob mentality of colleagues in urban settings that ruins it for the minority of us who embrace, in my opinion, the right mind set to treatment.
your tour is enlightening, eh?
Dan: That law restricting data mining violates the First Amendment Free Speech Clause. So said the First Cuircuit. It has a lesser known obverse side, the freedom to receive speech. Vermont is in the Second Circuit.
http://imshealth.com/vgn/images/portal/cit_40000873/51/6/81014397Final%20Order.pdf
"Vermont is doing so much to combat inappropriate drug company influence. After all, the state is famous for liberal physicians"
Umm, the former does not follow from the latter. Are you seriously saying that conservative physicians are more likely to be on the take from Pharma?
As my last posting here, I just want to go on record as saying this posting speaks volumes to what potential is out there when physicians rise up and speak out for what is right for patient care.
To risk alienating many colleagues, until proven otherwise, psychiatry has too many whores and cowards. If you're in it for a buck and won't speak out when the behaviors are wrong, you only validate those who bash our profession. To those of you who feel and act as I do, thank you for your efforts and desires. Patients count on us to do what is right and clinically appropriate.
It is time to take a stand nationally. Don't wait for the APA to do it for you. The Dr Carlats of our field can't do it alone, so if you give a damn, speak out or accept what your silence offers.
Strength in numbers, people!
TF: Question. Do you know the interest of patients you have never seen better than they and their doctors do? You imply that patients and doctors must be protected from irresistible drug company promotion. Where are the data that support such an extreme view? None exist. This movement is a pretext to divert the $1.5 bil that goes into CME and promotion through base left wing organizations. What arrogance the left has.
I wish this were universally true in Vermont. I had a pediatric doctor push focalin for my son in St. Johnsbury VT... the office of course loaded with focalin gadgets, pens, notepads etc. He had been on dexedrine and it was working, I merely went in to get a prescription refill and almost let her switch him.
His regular doctor was out of town for an extended period.
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