Newsletter: February 2005

• He Shoots -- He Scores - Dr. Larry has once again been invited to play with the NHL Oldtimers.... Read about the local charity the NHL Oldtimers are playing for this year ...Find out where and when ...Get Free Tickets!
  
• "Rooney-isms" - From the Desk of Andy Rooney
  
• "The Real Drug Pushers!" - Some interesting and alarming information about how we are being manipulated and put at risk -- and what some ethical and concerned people and groups are trying to do about it.
  

Have you been missing Hockey Night in Canada? Want to see some NHL players in action? Want a few good laughs? Family fun night out? Check this out...

Dr. Larry has been invited again this year to play with the NHL Oldtimers in their Oldtimers' Hockey Challenge. He played with them last February at the new Oceanside Place Arena. This year the game will be at the Frank Crane Arena in Nanaimo and the proceeds will go in aid of the Brent McDougall Foundation. Game night is Tuesday, February 8th at 7:00 p.m. You can check out last year's newsletter about the game (and even see some photos of Dr. Larry in action) from this website and/or you can check out the Oldtimers' website: www.oldtimershockey.com for more information about the game(s) and about the charities.

FREE TICKETS!!!

Come in for a visit before 4:00 p.m. on February 4th and you can enter your name into a draw for two free tickets to the game. I will draw the name(s) at 4:00 on Friday, the 4th, and notify the winners by phone immediately.

"ROONEY-ISMS" - A little humour before the weightier stuff....
(Ed Note: The views/opinions expressed here do not necessarily reflect the views/opinions of the editors. They are intended for entertainment purposes only.)

1) Andy Rooney on Vegetarians.
Vegetarian - "that's an ancient tribal word meaning "lousy hunter".

2) Andy Rooney on Prisoners.
"Did you know that it costs forty thousand dollars a year to house each prisoner? Jeez, for forty thousand bucks a piece I'll take a few prisoners into my house. I live in Los Angeles. I already have bars on the windows. I don't think we should give free room and board to criminals. I think they should have to run 12 hours a day on a treadmill and generate electricity. And, if they don't want to run, they can rest in the chair that's hooked up to the generator."

3) Andy Rooney on Fabric Softeners.
"My wife uses fabric softener. I never knew what that stuff was for. Then I noticed women coming up to me, sniffing, then saying under their breath, "Married!" and walking away. Fabric softeners are how our wives mark their territory. We can take off the ring. But, it's hard to get that April Fresh scent out of your clothes."

In Dr. Larry's practice it is a sad, but nonetheless rather common occurence for us to see patient after patient who has had or is currently having, extremely dangerous side-affects to often long, long lists of medications they have been prescribed. Nearly everyone we see has either personal experience and/or they know someone who has a story to tell. Almost all of them experience almost immediate improvement when their medication needs are reassessed, adjusted and/or stopped. Unfortunately, our elders are the most vulnerable and therefore the most commonly manipulated segment of our population. Although we are all at risk.



The recent actions by the FDA and the forced recall of one of the most prescribed anti-inflammatory medications, has cast suspicions upon many others, but it has also gotten many of us thinking a bit more about prescribed drugs and the potential harm. Many others who are more informed, have been aware of the "chain of manipulation" for several decades. Depending upon where they are positioned on this 'chain', their own personal choices have determined what, if any action(s), they take. As health consumers we have been taught to trust our health and wellness to our medical doctors, which, in this particular 'food chain', puts us at the bottom. Our only defence is to BE INFORMED. Read REALIABLE publications and articles; check out information about drugs on the internet before you 'pop that pill'; talk to friends, family and groups with whom you are involved; seek informed consultation from alternative wellness practitioners. Do whatever it takes.

We hope that the following two articles will not only help to inform you, but will illustrate what some 'informed and involved' people, groups and associations are doing about putting a stop to some very unethical and harmful practices.

Here's the condensed version: Corporations are getting mega-rich using medical doctors who keep the population sick by prescribing drugs the doctor has been 'influenced' by the corporate 'drug reps' to prescribe that make us sicker so we will need more drugs. Repeat as necessary.

The ultimate irony is that all of this is not only legal, but the practice of all of this is not only protected by various laws and regulations -- it is guaranteed. Out on the streets of our cities -- and don't fool yourselves in our small towns too, we have the seemy, dark and evil world of Pimps, Prostitutes, Johns; we have Drug Lords, Dealers, Users. Is there really any difference? In all of these 'chains' it is always the consumer who pays the high price -- and it is always the consumer who is potentially put 'In Harm's-way'.

The following article contains excerpts from two sources:
"Dan Murphy" Subject : Article 44-03; - The Medical Journal of Australia - April 19, 2004
and
Amy Odell - NYU News - December 8, 2004
(A complete list of references used in this newsletter are available from our office and these articles are on the internet.)

"THE MEDICAL PROFESSION AND THE PHARMACEUTICAL INDUSTRY: - WHEN WILL WE OPEN OUR EYES?"

A medical doctor's article as published in the Medical Journal of Australia
(see reference above).

The leaders of the medical profession in Europe and North America are calling for a critical reevaluation of how the medical profession interacts with the pharmaceutical industry.

However, the leaders of the profession in Australia are in denial about the influence of the drug industry on the prescribing patterns of doctors, the clinical research agenda, and bias in the publication of pharmaceutical research findings.

Pharmaceutical promotion does influence the prescribing practices of doctors. There is overwhelming evidence that doctor-prescribing habits are influenced by the industry. The medical profession is dependent upon support from the drug industry. "The medical profession must look at its own conduct and not place responsibility on the pharmaceutical industry."

"The pharmaceutical industry has learnt to influence our prescribing behaviour indirectly and uses "Opinion Leaders" from within the profession to promote its products and to help identify its research agenda."

"There is also clear evidence of publication bias, selective publication and selective reporting of sponsored clinical trials."

"The pharmaeutical industry mostly consists of public companies with legally mandated responsibilities to shareholders and legitimate rights to promote their products. My criticism is of the naivete of doctors and/or their unwillingness to accept overwhelming evidence that the techniques used by the industry to increase prescribing of their products actually work." Doctors have "direct face-to-face visits from company representatives (referred to as 'drug reps rather than 'sales reps). Also common are indirect interactions via a wide range of marketing techniques, including direct mailing, advertising in medical journals and medical newspapers, and sponsorship of medical conferences and medical products (such as computer software)."

For some doctors, the interactions are "through involvement in clinical trials or in industry advisory groups, speakers panels and the like." "Although only a select few play these latter roles, they are greatly valued by the pharmaceutical industry as opinion leaders in shaping the views of the rest of the profession, especially for new medications." The drug industry seeks to alter doctor prescribing patterns by doing "Illness Promotion" (using public awareness campaigns in the general media to encourage more people to seek new treatments) and support for patient-help organizations (again indirectly encouraging more patients to present to doctors identifying either their ailment or its desired drug treatment).

Eighty to 95% of doctors see industry representatives regularly. "More frequent contact is linked to unnecessary prescribing and to increased use of new drugs. Attendance at sponsored conferences is associated with increased prescribing of the sponsor's product." The industry spends about $21,000 per year per practicing doctor on drug promotion. WOW! To be a medical "professional" implies that patients can rely upon the independence and trustworthiness of any advice or treatment proffered. "It is a significant ethical failing to aspire to such independence and to the respect and trust that underpin an effective doctor-patient relationship while willfully or ignorantly denying the evidence that the pharmaceutical industry does affect our prescribing behaviour."

IMPORTANT: "The impropriety of this stance is compounded by information asymmetry (where the patient is almost always dependent upon the doctor for information and guidance about medications) and by the fact that the prescribed drugs are usually subsidized by public funds." The author believes that doctors should choose not to see pharmaceutical company representatives, which would be a very simple step to remedy these ethical issues. Hospitals, colleges and professional associations should make their organization and their staff or members more independent of the drug industry. "Medical school faculties and medical colleges must ensure that the ethical issues surrounding relationships with the pharmaceutical industry are included in medical student and postgraduate training programs, and that knowledge and attitudes of students and trainees to the industry are included in formal assessment."

KEY POINTS FROM DAN MURPHY:

1. There are ethical problems in North America, Europe and Australia between the drug companies and the doctors that prescribe the drugs, all of which harms the patient.
2. Drug-marketing techniques affect doctors prescribing practices.
3. Drug companies influence the prescribing patterns of doctors, influence clinical research, and there is bias in the publication of drug research findings.
4. The medical profession is dependent upon support from the drug industry.
5. The drug industry primarily targets to influence "opinion leaders" in the medical field with their propanganda.
6. Drug companies engage in publication bias, selective publication and selective reporting of sponsored clinical trials.
7. Drug companies use direct face-to-face visits from drug reps, do direct mailing, advertising in medical journals and medical newspapers and sponsorship of medical conferences and medical products.
8. Drug companies use medical opinion leaders through involvement in clinical trials or in industry advisory groups, speakers panels.
9. Drug companies seek to alter doctor prescribing pattern by doing illness promotion in the general media
10. 80 to 95% of doctors see drug industry representatives regularly.
11. The drug industry spends about $21,000 per year per practicing doctor on drug promotion.
12. Prescribed drugs are usually subsidized by public funds
13. Doctors are largely in denial about all of this.

Med Students Take on Drug Companies - by Amy Odell - NYU News - 12.08.2004
The NYU chapter of the American Medical Students Association will launch the group's first "PharmFree" day this morning at Alumni residence hall, protesting the influence of the pharmaceutical industry's aggressive marketing practices on physicians. Today's event will culminate in a march to drug company Pfizer's Midtown headquarters to dump off promotional pens collected from around the country.

The association charges that industry marketing has begun to replace medical science as the primary factor influencing the way physicians prescribe medication, hurting patients. "Physicians should base their prescribing practice on the best medical evidence," Dr. Brian Palmer, the association's national president, said in a statement. "By speaking out against biased marketing, we can revitalize professionalism in medicine. Patients rightly expect and deserve this from their physicians."

Universities around the country will host events for the association's "PharmFree" day, but the national launch will take place here. NYU was chosen for the national launch, association spokeswoman Kim Becker said, because "NYU is a really strong chapter for us, and the New York students really ... wanted something in their backyard."

The PharmFree Campaign began in 2002 in response to marketing practices by drug companies, including free lunches for physicians, free drug samples and glossy pamphlets, that the association says can unethically influence health care providers. Aggressive pharmaceutical marketing not only leads to biased health care, but also significantly raises drug costs, the association says. "We're not against pharmaceutical companies," Becker said. "What we're saying is that ... the [money spent on marketing] should go into the research and development to make these drugs better."

The keynote address will be given by Dr. Bob Goodman, founder of "No Free Lunch," an organized effort to inform the public and health care providers about what their Web site calls the pharmaceutical industry's "over-zealous promotional practices" that "can lead to bad patient care." Other speakers include Gene Carbona, a former Merck Vioxx sales representative who now works for the "Medical Letter," a publication that does not accept money from drug companies; AMSA's president and a current sales representative for drug giant GlaxoSmithKline.

The PharmFree Campaign urges supporters to cut out all the drug advertisements from a single journal and mail them back to the editor. Supporters can also trade in free pens from drug companies for PharmFree pens. Becker said the medical students' PharmFree initiatives are especially admirable, considering the average debt after loans for medical school tuition is $110,000. "You'd think they would take stuff," Becker said. "They're really stepping up and saying they want unbiased information, and they want to treat their patients better, and that's what you expect from a physician."

The pharmaceutical industry links rising drug costs to incredible research and development expenses. However, since 1995 the number of marketing jobs in the industry has increased by more than 60 percent while the number of research and development jobs has remained virtually the same, according to the 2000 PhRMA industry profile. "Those commercials and direct consumer advertising all bundle together and can affect how physicians prescribe drugs," Becker said. Scientific studies have proved this, she added. Health care centers across the country are beginning to embrace the initiative. Kieser Hospital in California allows pharmaceutical representatives to visit physicians to discuss their products, but they may not leave behind pamphlets, or wine and dine doctors, Becker said. The University of Pennsylvania is organizing a similar effort.

Newsletter Editor Note: The encouraging part of this is that it is the medical students who are leading the battle. As medical systems collapse, and with it a loss of faith in the medical model i.e. Vioxx, Tylenol, Ritalin, over prescribed antibiotics, failed surgeries, and medical malpractice, the public need to know that there are alternatives from which they can choose. Chiropractic is a drug-free alternative to wellness care.

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Contact the office:
Dr. Larry Smith D.C., B.P.E.
Chiropractor

P.O. Box 307
255 Island Highway
Parksville, British Columbia
Canada V9P 2G5