Only two countries worldwide allow direct-to-consumer (DTC) advertising of prescription drugs: The United States and New Zealand. Over 20 years (1997 to 2016) DTC prescription drug advertising in the U.S. increased from $1.3 billion to $6 billion "with a shift toward advertising high-cost biologics and cancer immunotherapy" (JAMA Network, January 1/8, 2019). According to the JAMA-published study, pharmaceutical companies bombarded the American consumer with 4.6 million ads in 2016. This includes 663,000 TV commercials (compared to 72,000 in 1997). The authors' conclusions: "Despite the increase in marketing over 20 years, regulatory oversight remains limited."
Topics: Dr. Ken's Corner
Instead of retiring at age 65, many doctors choose to continue practicing medicine well into their 70s and 80s. A national trend to test the competency of these older physicians appears to be gaining momentum, especially among some of the nation's largest hospital systems. Hospitals report growing concern that the mental and physical skills of some of their older physicians have deteriorated to the point of putting patient safety at risk. Paying special attention to "weeding out" impaired physicians once they have reached a certain age is proving to be a sensitive issue, to say the least.
Robotic surgery, gene therapy, and deep brain stimulation are so-called "frontiers" of medicine. Now there's a new frontier--telemedicine. "Research firm IHS Markit estimates that telemedicine visits will soar from 23 million in 2017 to 105 million by 2022" (Associated Press, 2/6/19). By then, one in ten doctors' visits could be via telemedicine. This could be an understatement if practitioners, health systems, and investors keep discovering new ways to expand telemedicine's reach.
Despite reports of burned out doctors abandoning their careers, many other doctors simply want some time off -- perhaps a year or more -- to take a breather, spend time with family, or take a sabbatical abroad. The AMA warns that leaving clinical practice for an extended period of time should not be taken lightly: "Lack of retraining before reentry raises questions about patient safety and the clinical competence of reentered physicians." Doctors need to be aware that, "getting back in the game is expensive, time-consuming, and sometimes nearly impossible. So before you take a hiatus from medicine, ask yourself--can you afford it?" (medpage.com)
Supply and demand – it's basic economics. But what happens when demand outweighs supply? And what happens when the demand is for doctors to care for people?
That’s what’s happening right here in America, as the demand for physicians continues to outweigh the supply. What we have now is a physician shortage that limits access to medical care – and sadly, rural communities have been hit especially hard.
One of the more serious side effects of commonly prescribed drugs is depression. According to a recent article in the Journal of the American Medical Association (June 12, 2018), 37 percent of U.S. adults are taking prescription medications that can potentially cause depression or increase the risk of suicide. Although there's been a 25 percent increase in suicides in the U.S. since 1999, the risk of depression as a side effect of prescribed drugs is widely under-appreciated by doctors and patients alike.
Topics: Dr. Ken's Corner