Monday, July 02, 2007

My Three Shrinks Podcast 27: Shrinks On The Take

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Back in Dinah's back yard today. For our U.S. readers, please have a safe July 4.
And if you live in France, the UK, Canada, Cuba, or Guantanamo Bay, Dinah wants your comments on her post about Michael Moore's Sicko. Okay, okay, citizens of other countries are welcome to comment, too!

July 1, 2007: #27 Shrinks On The Take

Topics include:

  • Doctor Anonymous has new Podcast, where he talks about chatty doctors, nursing home patients, and discovers BlogTalk Radio (similar to TalkShoe).

  • Vermont Shrinks Rolling in Pharma Dough. The New York Times reported on doctors who get money from drug companies, finding that in Vermont the #1 specialty to cash in is Psychiatry. Vermont has a law requiring the reporting of such income, and the story misleading suggests that the average Vermont psychiatrist gets $45,000 from drug companies. Closer reading shows that there were 11 psychiatrists who received an average of $45,000. Still. What are they getting paid for? Here's some insight from a #2 specialty: Endocrinologists. A US Senator has suggested that all such income get reported, just like they have to do (makes sense to me).

  • Zyprexa Class Action Lawsuit for Fraudulent Marketing Zips Ahead. CL Psych informs us that a judge is allowing this suit to go forwards, based on allegations that Lilly engaged in fraudulent marketing of Zyprexa for unapproved uses. See also the March FDA Drugs for an FDA warning against Provigil. We launch into a wider discussion about off-label prescribing and combination medications. Listen to find out the #1 prescribed drug which is FDA-approved for bipolar depression (hint: it's not an SSRI).

  • Doctors Who Talk Too Much. The Archives of Internal Medicine has an article by McDaniel et al., which has been in the news. They sent fake patients into participating physician offices over the course of a year and recorded the interactions, categorizing the utterances in various ways. One-third of the visits contained physician "self-disclosures" (talking about themselves), with 85% of these not being useful. It doesn't seem that they asked the pretend patients how useful these discussions were. I view the study's conclusions with suspicion. I would like to see compliance rates and outcome measures compared between a group of patients whose physicians self-disclose and one whose physicians do not (ideally, assignment would be randomized, and a physician would have patients in both groups).

  • Q&A: Can you have a mental disorder and still become a mental health professional? Listen in as we address this question from a listener.
The song at the end is called "Talk Talk," by the group, Talk Talk. You can get it at iTunes.

Find show notes with links at: The address to send us your Q&A's is there, as well.

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Thank you for listening.