Nurses and physicians learning from each other

I enjoyed the article yesterday from Registered Nurse Theresa Brown in The New York Times Well column. She examines the relationship between nurses and physicians, and how both learn from each other. Nurses learn from doctors and younger doctors often learn from the experience and guidance of nurses. I thought the final quote was particularly pointed: "There’s always more to learn, and no matter how hard any of us try, there’s rarely enough time for one person to learn it all."

More on pharmaceutical companies and physicians

The New York Times had an article today about an Institute of Medicine report that advises stopping the flow of gifts from pharmaceutical companies to physicians. While pharmaceutical companies have voluntarily stopped giving small gifts, such as pens and notepads, earlier this year, but the IOM report goes even further, recommending the end of industry-sponsored medical education courses. The recommendation to end industry-sponsored education courses is the most controversial, because many physicians and the companies argue that the courses provide a valuable and necessary service, to educate physicians about rapidly changing medical advances. But others warn about the dangers of bias and influence that pharmaceutical companies wield.

bad advice

Dr. Peter Ubel offers a physician's perspective on giving patient's the information they need to make a decision, even if it means giving bad advice. The article examines the complications of the physician-patient relationship when it is not simply a directive relationship, but one in which a physicians acts as a patient's guide.

You can find the article here.

Review board steps aside approving a fake study

The Wall Street Journal Health blog had an article today about Coast IRB, a for-profit Institutional Review Board that approved a fake study posed by the Government Accountability Office. The GAO conducted the sting operation to see if for-profit IRBs adequately review and supervise medical trials and the interest of research subjects. The approved study had a fake company, falsified records and an unapproved product. The company failed to ensure that risks to subjects were minimized and whether the research would be conducted under acceptable legal and professional guidelines. As such, the company has agreed to stop reviewing new FDA-regulated studies and halt enrollment to previously approved studies. The company itself will undergo complete restructuring, with a new board, new standards of practice and frequent internal audits.

The case shows the importance of institutional review of clinical research studies and the importance of knowing that the reviewers are capable of doing their jobs.

lessons from pharmaceutical sales

The New York Times had an article today about how the New York City health department is taking a lesson from pharmaceutical sales forces. The health department sends health educators to clinics in under served areas to detail city health resources and educate physicians about health interventions. The educators come armed with posters, condoms, and yes, even pens, to reinforce their message. They also work to build on-going relationships with the physicians and clinics they serve.

What do you think? What other strategies can public health workers learn from other industries to make their message stick?

The science behind health policy

John Tierney wrote an article in today's New York Times science section about the science behind political health policy decisions, citing New York mayor Michael Bloomberg's initiative to cut the nation's salt consumption in half. Tierney expressed concern about the lack of randomized control trials as evidence that cutting salt so drastically will have a health benefit. He also expressed concern about what happens to science when a health policy seems to declare a matter closed. See what others have to say here.

What do you think?

health literacy and the responsabilities of health and communication

Dr. Pauline Chen's column in the New York Times last week examined patients with limited health literacy and the effect that has on their health. Doctors talk and patients don't always listen and doctors get blamed for talking over patients heads. But as some of the commenters on Dr. Chen's column pointed out, communication is always a two-way street. If patients don't understand, shouldn't they ask more questions? Shouldn't patients be proactive participants in their own care? But how can the patients ask questions if they don't have a relationship with their doctor, don't trust their doctor, are intimidated by their doctor?

There are no easy answers in human communication.

How far should a smoking ad go?

The Today Show aired an interesting story this morning about an anti-smoking ad running in New York. The ad shows a very upset little boy, lost in a train station, and asks the audience to imagine if he was this upset to lose you for a minute, how upset would he be to lose you for a lifetime?

Some are concerned about the little boy in the ad, asking if those tears are a little too real to be acting. But it also raises the question of how far is too far to go in a health ad.

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What do you think? Does it go to far? Or is it effective?