July 2nd, 2007


I can't resist an occasional note on one of my favorite subjects.


Is Your Doctor Tied to Drug Makers?

It’s no surprise that the pharmaceutical industry is appalled at proposals to set up a national registry of its gifts and payments to doctors. Too much information might lead patients to suspect that their doctors are choosing costly medicines out of gratitude to the manufacturers rather than for the best medical or economic interests of their patients.

The drug companies ply doctors with a wide range of gifts, everything from free lunches for busy doctors and their staffs while sales representatives extol the virtues of their latest drugs to subsidized trips to vacation spots for conferences billed as educational events. The companies also pay large sums to doctors for consulting or for conducting research. These payments, which can mount into the hundreds of thousands of dollars over a period of years, look suspiciously like inducements to promote or prescribe the companies’ drugs.

Although medical societies and the industry’s trade association have adopted voluntary guidelines that are supposed to limit payments and gifts to modest proportions, they typically still allow doctors to be paid as consultants or speakers, leaving plenty of room to lavish favors upon them. As Gardiner Harris reported in The Times last week, one drug company invited doctors to a weekend training session in Orlando, Fla., to learn how to give marketing lectures to other doctors for an asthma medicine. The enticement was free airfare, a rental car and hotel room, plus a $2,700 stipend.

Several states have tried to rein in abuses by requiring some form of disclosure, but every state law has defects, most notably a failure to make doctor-specific data readily available to the public. Last week Senator Herb Kohl, a Wisconsin Democrat who is chairman of the Special Committee on Aging, and Senator Claire McCaskill, Democrat of Missouri, said they would push for a national registry that would force drug and medical device companies to report their gifts and payments to physicians.

The legislation ought to require electronic reporting of all payments to individual doctors for posting in a registry that could be easily searched from home computers. If there is nothing wrong with such payments, neither the doctors nor the industry should object to public disclosure.


OtRwC Day 22, Part 1: Shakespeare

Last Saturday morning as Elaine and I packed up our belongings in our cabin in Bryce Canyon, we discussed where to go next. We had tentatively considered going to Mesquite, Nevada for a day or so. Mesquite is trying to re-invent itself as a destination spot for spas, but so far has to use cheap rooms to draw customers. The cheap rooms attract me and we thought maybe we could hang around a hot tub and get massages and so on.  I looked at the map to see what we might take in on the way to Mesquite, and saw that a logical stop was Cedar City, Utah.

Cedar City is right on highway 15, which we all know goes straight to Las Vegas, and as I know also goes through Mesquite. Cedar City is home to Southern Utah University, which in turn is home to a major Shakespearean Festival. This festival goes on all summer. It seems to be a big part of the definition of Cedar City, which calls itself "festival city". Cedar City is a lot older than the festival, of course, but other than the surrounding beauty that is southern Utah, it doesn't offer all that much by itself. It has a "historic downtown" which is rather cute and seems to be functioning rather well, and in general the size of the town (27,000) means it offers all services so looks like a rather nice place to live. All of this we did not know when we set out from Bryce, a mere 80 miles from Cedar City. We figured we'd stop, take a look around, maybe take in a play, maybe stay the night.

We took highway 14 to Cedar City, passing Cedar Breaks, yet another national monument that looks incredibly beautiful (we may take that in today or tomorrow), and arrived not long after noon. We saw a sign to the Shakespeare center and followed it to the ticket office, where we bought tickets to Candida (by GB Shaw), which was playing at two that afternoon. Then, of course, we had to get a motel. The Shakespeare booklet had a list of local motels and pricing so we called one and found a room. We zipped on over to the stunning Best Value Inn, got the room, and installed Bullet. This motel offers "limited pets", according to the website, which we found means we get to pay a $7 fee each day and we also have to stay in a designated "pet room", which has certain issues (not related to pets). But it's cheap.

We saw Candida at the Randall L. Jones Theater, a really nice theater with about 750 seats. We got terrific (and a trifle expensive) seats near the front. It looked like just about any seats would have been good, though. The play has aged well - which we might expect with Shaw. Really so contemporary that you might think it's a modern playwright's idea of 1900, when in fact it's way ahead of its time.

Having soaked up that brilliance, we thought maybe another play that night. We therefore later bought tickets to King Lear and after enjoying part of an outdoor entertainment we went into the amazing Adams Shakespearean Theater to see the play. We had great seats in the top tier, where we had the cover of the partial roof (in case of rain) and the benefit of the outdoor sky to enhance the experience. The play is, of course, one of Shakespeare's best, and while it demands the attention of playgoers I felt that the staging and acting went a long way to help us past the old English. I would like to see the play again, elsewhere, so I can gain a greater understanding of the details. The fundamental story, though, is simple and heart-wrenching.

The following morning, Sunday, we decided what the heck, let's just take in a couple more plays. We signed on for three more days at the Best Value Inn, decided to lay in some food (the place has a fridge and microwave), and took to the streets. Stay tuned for the story of Sunday in Utah.