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MDchat Transcript May 17, 2011

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    #MDchat

    Healthcare Hashtag Twitter Transcript

    From: Tue May 17 18:00:00 PDT 2011

    To: Tue May 17 19:00:00 PDT 2011

    Customize transcript dates and layout

    Learn more about #MDchat at The Healthcare Hashtag Project

    MD_chat Welcome to the MDChat Twitter chat! For the next hour, well be talking familymedicine and patient-centered care #MDChatTue May 17 18:00:12 PDT 2011

    PracticalWisdom Full Disclosure: 4 2nights Topic. My parents R Founders @FieldsMfg 5-starsupplierpromotional products. No Pens. #MDchatTue May 17 18:00:39 PDT 2011

    MeredithGould @rawarrior May lurk #MDChatTue May 17 18:00:45 PDT 2011

    MD_chat For the next hour, we assume that all tweets to #MDChat are your opinions (and notyour employers) unless otherwise stated.Tue May 17 18:01:00 PDT 2011

    PhilBaumann Hi all - wishing @RichmondDoc the best on leading #MDchat tonight. Thank you forhelping out the cause!Tue May 17 18:02:10 PDT 2011

    NateOsit Hey all, Nate here, scrappy health IT pro, ready to swim in a sea of knowledge! :)#MDchatTue May 17 18:03:22 PDT 2011

    RichmondDoc Mark, family doc in #RVA, standing in to give @PhilBaumann a break, moderating this

    week w/ official permission. :) #mdchatTue May 17 18:03:29 PDT 2011

    PracticalWisdom @philbaumann@RichmondDoc You both do a swell job. Swell- June Clever wordfrom the Rascal! ; < ) #MDchatTue May 17 18:03:31 PDT 2011

    peds_id_doc #mdchat hey all , Nick Bennett from Upstate NY - Peds ID Fellow.Tue May 17 18:03:36 PDT 2011

    EinsteinMed David Flores, social media manager for Albert Einstein College of Medicine. Glad t be

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    back. #mdchatTue May 17 18:04:08 PDT 2011

    PracticalWisdom @NateOsit: Nate=http://gary2idaho.files.wordpress.com/2007/05/popeye.jpg #MDchatTue May 17 18:04:30 PDT 2011

    PracticalWisdom Waving to David.RT @EinsteinMed: David Flores, social media manager for AlbertEinstein College of Medicine. Glad t be back. #MDchatTue May 17 18:04:51 PDT 2011

    PracticalWisdom Lisa Professional Speaker: Leadership/MBTI/SoMe/Commun. Morph the ho-hum intocompelling. Rascal. #MDchatTue May 17 18:05:34 PDT 2011

    NateOsit LOL! :D RT @PracticalWisdom: @NateOsit:Nate=http://gary2idaho.files.wordpress.com/2007/05/popeye.jpg #MDchatTue May 17 18:05:41 PDT 2011

    PracticalWisdom @MD_Chat@jsonyoung@NateOsit@EinsteinMed. Thanks HI Back. #MDchatTue May 17 18:06:10 PDT 2011

    kenyasaidso Hello! Looking forward to another #mdchat!Tue May 17 18:06:16 PDT 2011

    EinsteinMed Thanks! Waving back. @PracticalWisdom@EinsteinMed#mdchatTue May 17 18:06:58 PDT 2011

    PracticalWisdom @peds_id_doc: Hey back. Hey thought was southern Talk? Welcome. #MDchatTue May 17 18:07:00 PDT 2011

    sarasteinmd Hi all - Sara Stein, Obesity doc, Cleveland in the rain - I actually made it on timetonight! #mdchatTue May 17 18:07:12 PDT 2011

    cartooninperson Hi everyone, Ashley here. @RichmondDoc, loved blog post. Doc told me I needTiazac, not generic. Noticed "Tiazac" pen in office. #MDchatTue May 17 18:07:33 PDT 2011

    EinsteinMed You too! RT @MD_Chat: @jsonyoung@NateOsit@EinsteinMed@PracticalWisdomHi! Good to see yall #mdchatTue May 17 18:07:36 PDT 2011

    PracticalWisdom Come Play @nateOsit says water is Great! RT @MeredithGould: @rawarrior May lurk#MDchatTue May 17 18:07:37 PDT 2011

    MD_chat @sarasteinmd@kenyasaidso Good you have you both here. #MDChatTue May 17 18:07:51 PDT 2011

    MD_chat First question coming up. Please add Q1, Q2, etc to your replies to help follow theconversations. #MDChatTue May 17 18:08:04 PDT 2011

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    jsonyoung @PracticalWisdom Your tweets are as entertaining as enl ightening L isa, good to "see"you #MDChatTue May 17 18:08:37 PDT 2011

    MD_chat @cartooninperson Welcome. #MDChatTue May 17 18:08:39 PDT 2011

    sarasteinmd@MD_Chat have my anti-hijack gear on tonite!! #mdchatTue May 17 18:08:48 PDT 2011

    PracticalWisdom No T1, T2?RT @MD_Chat: First question coming up. Please add Q1, Q2, etc to yourreplies to help follow the conversations. #MDchatTue May 17 18:09:02 PDT 2011

    MD_chat Q1 will start off from this article: http://cot.ag/ktVp56#MDChatTue May 17 18:09:23 PDT 2011

    MeredithGould

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    sarasteinmd I dont think accepting samples and "industry connections" are the same. Going to fakedinners and getting paid for it is a joke #mdchatTue May 17 18:14:02 PDT 2011

    sarasteinmd @RichmondDoc samples are often all we have for the un- and under-insured. Pharmasays rely on mcaid. Mcaid is broke in Ohio. #mdchatTue May 17 18:14:43 PDT 2011

    jsonyoung @MeredithGould Many rural docs say they are often getting as much comm. from EHR

    firms as pharm reps these days #MDChatTue May 17 18:15:02 PDT 2011

    NateOsit T1 I think samples are only helpful b/c drugs are so expensive, though. Give with onehand... #MDchatTue May 17 18:15:24 PDT 2011

    peds_id_doc T1 even in UK drug reps still visited - pretty young lady assured me it was worth themoney, even under the NHS. #MdchatTue May 17 18:15:57 PDT 2011

    sarasteinmd @MD_Chat The author should sit with me for a day and figure out how to get HTN andDM meds to someone in the shelter #mdchatTue May 17 18:15:57 PDT 2011

    PracticalWisdom Tipping the Odds Implant MakerMe Too! RT @peds_id_doc: T1 I have # contact w/pharm cos through drug studies than a sales pitch. #MDChatTue May 17 18:16:01 PDT 2011

    ePatientDave @PracticalWisdom Q1 vs T1? Heh, Q is prob the Latin abbreviation for T. :-) #MDchatTue May 17 18:16:10 PDT 2011

    RichmondDoc @ePatientDave@PracticalWisdom Comes from my spending time on #hcsmLA: inSpanish, Q1 is more familiar, and I overlapped... #mdchatTue May 17 18:17:00 PDT 2011

    nursefriendly Hello Everyone, Andrew Lopez, RN from New Jersey, lurking mostly tonight. #mdchatTue May 17 18:17:14 PDT 2011

    cartooninperson @peds_id_doc Pharma paying for medical studies on drugs needs to stop. #MDChatTue May 17 18:17:32 PDT 2011

    peds_id_doc @hrana agreed - but at our hospital here, Dept chair has banned a ll drug sponsored

    events! #MdchatTue May 17 18:17:42 PDT 2011

    MeredithGould @cartooninperson And who else is going to pay for them? #MDchatTue May 17 18:18:04 PDT 2011

    RichmondDoc @sarasteinmd Working to make low-cost generics more broadly available for thosesituations could make a difference. #mdchatTue May 17 18:18:12 PDT 2011

    peds_id_doc @cartooninperson pharma HAS to pay for them, who else? They have to do the

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    research to get FDA approval to sell. #MdchatTue May 17 18:18:38 PDT 2011

    RichmondDoc Q1 there is suggestion that *any* contact w/ PhRMA (even samples) can affect the waythat docs interpret information and write Rx. #mdchatTue May 17 18:18:43 PDT 2011

    sarasteinmd @RichmondDoc Agree, low cost and free generics would help, still some will needsamples. I dont think samples are the ethical issue #mdchatTue May 17 18:19:09 PDT 2011

    hrana @cartooninperson Pharma studies or not... the buck stops with the FDA panels.@MeredithGould@peds_id_doc#mdchatTue May 17 18:19:43 PDT 2011

    MeredithGould T1 The suggestion that *any* contact taints decision making is insulting to medicalprofessions (docs, PA, RNs, et al.) #MDchatTue May 17 18:19:47 PDT 2011

    MD_chat To tweak Q1/T1 a bit: How much industry contact with individual doctors isacceptable? What level would be excessive? #MDchatTue May 17 18:19:48 PDT 2011

    hrana @RichmondDoc Agree... there is a funding problem. Do Americans want to allocatemore tax money for drug research? @cartooninperson#mdchatTue May 17 18:20:28 PDT 2011

    RichmondDoc @MeredithGould Social science research at least suggests that any level of contact(esp if gifts involved) affect prescribing. #mdchatTue May 17 18:20:47 PDT 2011

    peds_id_doc @MeredithGould T1 insulting it may be, especially personally, but unfortunately itseems to be the case overall :-/ sad. #MdchatTue May 17 18:20:51 PDT 2011

    sarasteinmd @NateOsit@RichmondDoc I wonder how much influence Pharm reps actually havewith individual docs. Who has time to listen! #mdchatTue May 17 18:20:57 PDT 2011

    MeredithGould @RichmondDoc Well, I are a social scientist & can tell you that even our research canbe suspect! #MDchatTue May 17 18:21:48 PDT 2011

    sarasteinmd @PracticalWisdom LOL!! Jenny Craig sponsored which diet is the best and consumer

    reports fell for it!! LOL #mdchatTue May 17 18:22:07 PDT 2011

    peds_id_doc MT @RichmondDoc: T1 Its also worth noting: "free samples" arent free. We are allpaying for them, so we are simply shifting costs. #MdchatTue May 17 18:22:17 PDT 2011

    HumpbacksRule @PracticalWisdom@sarasteinmd@RichmondDocT1 f Pharma Sponsors research isit really Science.

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    Tue May 17 18:22:34 PDT 2011

    peds_id_doc @PracticalWisdom@sarasteinmd@RichmondDoc T1 different kind of science.Industry always interested in limited answers. #MdchatTue May 17 18:23:08 PDT 2011

    invisiblejules Recent grad taking a gap year before applying to med school here. Listening in on myfirst #MDChat. Just want to say this is v. interesting!Tue May 17 18:23:31 PDT 2011

    sarasteinmd @MeredithGould LOLOLOL!! #mdchatTue May 17 18:23:31 PDT 2011

    MD_chat Q1a What can we do to minimize the influence such industry contact would have onphysicians? #MDChatTue May 17 18:23:38 PDT 2011

    MeredithGould @MD_Chat "Limits of industry contact"...defined as what & by whom? No pettingbelow the waist? #MDchatTue May 17 18:23:44 PDT 2011

    peds_id_doc @invisiblejules Welcome! #MdchatTue May 17 18:24:01 PDT 2011

    hrana @PracticalWisdom It happens quite often. MDs do the pharma company "teaching." Isat through an Abilify lunch 2 weeks ago. #mdchatTue May 17 18:24:11 PDT 2011

    PracticalWisdom You bet me: Good for you. RT @MeredithGould: @sarasteinmd Wait...Jenny Craig isntthe best? J/k #MDChatTue May 17 18:24:13 PDT 2011

    peds_id_doc @cartooninperson@RichmondDoc@MeredithGould@peds_id_doc Not just Govtfunded - need independent investigators/protocols! T1 #MdchatTue May 17 18:24:35 PDT 2011

    MeredithGould Q1a: Educate medical students about the hermeneutic of suspicison #MDchatTue May 17 18:24:40 PDT 2011

    MeredithGould suspicion... #MDchatTue May 17 18:24:55 PDT 2011

    peds_id_doc @MeredithGould@MD_Chat LOL! #MdchatTue May 17 18:24:59 PDT 2011

    NateOsit Maybe advertising course requirements? RT @MeredithGould: Q1a: Educate medicalstudents about the hermeneutic of suspicison #MDchatTue May 17 18:25:39 PDT 2011

    sarasteinmd @hrana did they tell you 1/3 of patients develop a combinedanxiety/akathisia/agitation side effect within the first month? Bet not! #mdchatTue May 17 18:25:45 PDT 2011

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    MeredithGould Really think the issue is both broader & deeper; one about ethics and beliefs #MDchatTue May 17 18:25:57 PDT 2011

    cartooninperson @JoshGriffin Shows the state of healthcare system if you need to rely on samples toget drug access. #MDChatTue May 17 18:26:10 PDT 2011

    sarasteinmd @MeredithGould I think pharma is trying to sell, and providers are trying to treat/heal.Different intentions cause problems #mdchatTue May 17 18:26:59 PDT 2011

    MD_chat Q1b How transparent should physicians be regarding industry contacts? And howbest to communicate those contacts? #MDChatTue May 17 18:27:15 PDT 2011

    RichmondDoc @drval There are many non-industry-sponsored resources out there...but many aresubscription only b/c no PhRMA $. #mdchatTue May 17 18:27:51 PDT 2011

    PracticalWisdom @jsonyoung@hrana Very aware & Agree. How 2 Win MD & Influ Scripshttp://www.npr.org/templates/story/story.php?storyId=130730104#MDChatTue May 17 18:28:29 PDT 2011

    sarasteinmd @hrana I always nod my head incessantly when the food is good! Fortunately I turnmy ears off!! #mdchatTue May 17 18:28:29 PDT 2011

    richmeyer #mdchat I had the best response when new biotech firm replaced sales people withinformation people who had med degreesTue May 17 18:28:30 PDT 2011

    peds_id_doc @drval t1 agreed, but have to be aware of potential for info bias/omission. #MdchatTue May 17 18:28:34 PDT 2011

    RichmondDoc @hrana@sarasteinmd I remember the Ketek rep addressing liver failure risk: "onewas a drinker" wink, wink. Now black box warning. #mdchatTue May 17 18:28:39 PDT 2011

    MD_chat @MeredithGould Communicate to patients/caregivers, for sure. #MDchatTue May 17 18:29:10 PDT 2011

    NateOsit @MD_Chat Q1b Have every rep that comes in displayed on a board in the front of theoffice. Full transparancy! :) #MDchatTue May 17 18:29:37 PDT 2011

    PracticalWisdom @MD_Chat Q1B: As Transparents as Possible. When I sign Contract 2 SpeakBreastfeeding Conf. Disclose to ties to Pharma Formula Folks #MDChatTue May 17 18:29:50 PDT 2011

    MeredithGould But what does "transparency" mean? How is that operationalized? Pts already seebranded crap all over the office. #MDchatTue May 17 18:30:03 PDT 2011

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    richmeyer Problem is most drug sales people are programmed and not able to have a peer topeer conversation with docs #mdchatTue May 17 18:30:27 PDT 2011

    RichmondDoc @NateOsit Maybe also have a listing of who you accept direct $ from? #mdchatTue May 17 18:30:30 PDT 2011

    MD_chat Great discussion on Q1...Q2 coming up in a moment. #MDchatTue May 17 18:30:48 PDT 2011

    MeredithGould @RichmondDoc Switching gears? As a pt, I want to know that the med might work &have access to the data you have. Also, a notepad. #MDchatTue May 17 18:31:02 PDT 2011

    MD_chat Q2 Is going to be based on this article: http://cot.ag/iyOlvk#MDchatTue May 17 18:31:15 PDT 2011

    PracticalWisdom @MD_Chat Q1B WIC will not allow conflict of interest Pharma 2 Sponsor

    Breastfeeding Conf. #MDChatTue May 17 18:31:20 PDT 2011

    nursefriendly @RichmondDoc Have to agree, contact with pharmaceutical reps is almostunavoidable, however all contact is suspect. #mdchatTue May 17 18:31:29 PDT 2011

    MD_chat What about your thoughts regarding medical specialty societies interactions withindustry? #MDchatTue May 17 18:32:33 PDT 2011

    richmeyer @sarasteinmd I dont believe that any doc would sell out at expense of patients#mdchatTue May 17 18:33:18 PDT 2011

    PracticalWisdom @hrana@peds_id_doc: Think I just found out Medical Journal is run by MedicalPublishing Company. #MDChatTue May 17 18:33:56 PDT 2011

    RichmondDoc Q2 I think that increased industry $ is going to societies as there are limits on contactsw/ individual docs. #mdchatTue May 17 18:34:05 PDT 2011

    peds_id_doc @richmeyer@sarasteinmd some would...some will without even realizing it. Power ofsuggestion. #MdchatTue May 17 18:34:40 PDT 2011

    apjonas Spec soc perfectly reflect majority of doc position on industry$. Slimy & ignorant &pathetic at present #mdchatTue May 17 18:35:18 PDT 2011

    richmeyer @peds_id_doc Maybe for some main stream drugs but not for others #MdchatTue May 17 18:35:34 PDT 2011

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    MD_chat @hrana Sorry: http://cot.ag/kvXqNY#MDChatTue May 17 18:35:35 PDT 2011

    MeredithGould Having renounced TV for 10+ yrs, I was shocked to see the number of pharma adsthese days. #MDchatTue May 17 18:35:37 PDT 2011

    cartooninperson @MeredithGould Nice point about drug brand influencing patients. #MDchatTue May 17 18:35:58 PDT 2011

    richmeyer @MeredithGould And the pharma ads are having LITTLE effect on driving Rxconversion #MDchatTue May 17 18:36:20 PDT 2011

    TheNerdyNurse @meredithgould oh my. How did you go 10 years without TV? #MDchatTue May 17 18:36:28 PDT 2011

    drval #mdchat I agree with @meredithgould The bigger problem is DTC advertising andcreating new disease/syndrome language that drives demandTue May 17 18:36:29 PDT 2011

    PracticalWisdom @MeredithGould: Got rid of my Boom Tube in 2000. #MDChatTue May 17 18:36:35 PDT 2011

    charlesornstein Eager for your thoughts on our latest story #mdchat Cardiac Society Draws Bulk ofFunding From Stent Makers http://t.co/yuJOmdiTue May 17 18:36:37 PDT 2011

    richmeyer @MeredithGould Research shows that DTC TV ads are having less of an impact#MDchat

    Tue May 17 18:37:10 PDT 2011

    MeredithGould @sarasteinmd The Bachelor. Online. #MDchatTue May 17 18:37:10 PDT 2011

    NateOsit T2 I wonder if industry influence on specialty societies is contributing to the PCPshortages? More glitz & glam seen there #MDchatTue May 17 18:37:10 PDT 2011

    KatieBe_NC Not sure most patients care how doc learns about Rx as long as they work. #mdchatTue May 17 18:37:16 PDT 2011

    MeredithGould @richmeyer I find al l that research highly suspect. #MDchatTue May 17 18:37:34 PDT 2011

    nursefriendly @charlesornstein So the question is, what does that funding entitle them to at theevent? #mdchatTue May 17 18:37:35 PDT 2011

    richmeyer @MeredithGould What I am really worried about is that patients are making selfdiagnosis via info on the web and not seeing doc #MDchatTue May 17 18:37:39 PDT 2011

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    PracticalWisdom I sure as (fill in the Blank) CARE.RT @KatieBe_NC: Not sure most patients care howdoc learns about Rx as long as they work. #MDChatTue May 17 18:37:55 PDT 2011

    richmeyer @MeredithGouldhttp://bit.ly/ijgsIh#MDchatTue May 17 18:37:58 PDT 2011

    MeredithGould @richmeyer I know, lots of worries among docs about competition from Dr. Google!#MDchatTue May 17 18:38:19 PDT 2011

    drval There are pharma insiders who wish DTC never happened. #mdchat Overmedicalizing everything is costly and unhelpful.Tue May 17 18:38:28 PDT 2011

    RichmondDoc The influence on societies bothers me more in some cases b/c they help write clinicalguidelines that affect many other docs. #mdchatTue May 17 18:38:37 PDT 2011

    sarasteinmd @apjonas that makes me sad. I hope underneath we still believe we help people, notmarket for some huge conglomerate #mdchatTue May 17 18:38:42 PDT 2011

    nursefriendly @charlesornstein Does that give them carte blanche to pitch their products at focussessions, special events and "sponsor" lectures? #mdchatTue May 17 18:38:48 PDT 2011

    richmeyer @MeredithGould I dont. What is happening is that people see an ad on TV than goonline to see what others say about it #MDchatTue May 17 18:38:50 PDT 2011

    EinsteinMed Lots of interest in the subject. Google "Financial Ties Bind Medical Societies" & getseveral pages of results from many sites. #mdchatTue May 17 18:38:52 PDT 2011

    TheNerdyNurse @richmeyer pts need to be informed, but need to go to the MD with questions basedupon research, not set in stone opinions/requests #MDchatTue May 17 18:39:09 PDT 2011

    richmeyer @MeredithGould There is less than a 20% ROI for TV ads in general today #MDchatTue May 17 18:39:15 PDT 2011

    sarasteinmd @charlesornstein (I went to Penn too! what year?) #mdchatTue May 17 18:40:12 PDT 2011

    ShrinkRapRoy Hi. Just joining in. First mdchat, but longtime #hcsm user. #MdchatTue May 17 18:40:17 PDT 2011

    cartooninperson @KatieBe_NC Not always clear if drug works, especially if efficacy is determined bypatient testimony. Could just be placebo effect. #MDChatTue May 17 18:40:35 PDT 2011

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    MD_chat Q2a Similar to the previous questions, what can we do to minimize industry influenceon physicians via medical societies? #MDChatTue May 17 18:40:44 PDT 2011

    richmeyer @MeredithGould Ah but research also shows that less than 20% of patients get drugthey ask for #MDchatTue May 17 18:40:52 PDT 2011

    sarasteinmd And by the way device manufacturers are just as guilty as Pharma in influencepeddling IMHO #mdchatTue May 17 18:40:57 PDT 2011

    apjonas @shrinkraproy Welcome. You will like this one, too. #mdchatTue May 17 18:41:11 PDT 2011

    MD_chat Are unrestricted grants OK? Disclosure on conference materials sufficient? #MDchatTue May 17 18:41:16 PDT 2011

    TheNerdyNurse Funding for CEs has to come from somewhere. If they eliminate Pharma where will itcome from? @richmonddoc: #mdchatTue May 17 18:41:32 PDT 2011

    MeredithGould @richmeyer Yes...and so? #MDchatTue May 17 18:41:49 PDT 2011

    nursefriendly @thenerdynurse@richmonddoc God forbid we pay for CEUs out of our own pockets. .. . #mdchatTue May 17 18:42:21 PDT 2011

    PracticalWisdom @sarasteinmd: Exactly: Makes me Sick!Tipping the Odds for an Implant Makerhttp://www.nytimes.com/2011/04/03/business/03implant.html#MDChatTue May 17 18:42:25 PDT 2011

    RichmondDoc @thenerdynurse I would argue that there can be other funding...or maybe look toimprove on-demand, web-based CEs. #mdchatTue May 17 18:42:25 PDT 2011

    apjonas @thenerdynurse@richmonddoc Professionals should pay for their own Cont Ed.Good investment #mdchatTue May 17 18:42:49 PDT 2011

    charlesornstein @nursefriendly All societies say the $$ does not influence positions. Even w/o quidpro quo, some statements leave out risks. #mdchatTue May 17 18:42:52 PDT 2011

    richmeyer @MeredithGould So DTC has l imited ROI at a time when marketing dollars are hard tocome by #MDchatTue May 17 18:43:04 PDT 2011

    TheNerdyNurse @richmonddoc who will fund the web-based CEs? or the research? #MDchatTue May 17 18:43:07 PDT 2011

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    RichmondDoc @nursefriendly@thenerdynurse Agree on my part. Docs who complain about CMEcosts, in this economy... #mdchatTue May 17 18:43:12 PDT 2011

    nursefriendly There will always be a "sponsor" willing to pay for the privilege of access. RT@thenerdynurse: Funding for CEs has @richmonddoc: #mdchatTue May 17 18:43:15 PDT 2011

    MeredithGould @sarasteinmd@richmeyer Me? I rely on pharmacists, preferably PharmD to give meaccurate info #MDchatTue May 17 18:43:16 PDT 2011

    RichmondDoc @thenerdynurse The professional societies themselves? Public orgs (like CDC, NIH,etc). #mdchatTue May 17 18:43:41 PDT 2011

    ShrinkRapRoy Umm, the docs? RT @thenerdynurse: If they eliminate Pharma where will it comefrom? @richmonddoc: #MdchatTue May 17 18:43:50 PDT 2011

    richmeyer You can fund societies but they have to remain independent if they are to besuccessful #MDchatTue May 17 18:44:07 PDT 2011

    PracticalWisdom @EinsteinMed@RichmondDoc@thenerdynurse: Where does AHEC get money?They pay fair wages for speakers but no advertising/Sponsors. #MDChatTue May 17 18:44:17 PDT 2011

    sarasteinmd @thenerdynurse I know I know!! RAISES HAND...CME from SOCIAL MEDIA!!! WOOT!!(Dr Stein does the slam dunk dance) #mdchatTue May 17 18:44:28 PDT 2011

    ShrinkRapRoy Drug reps pay visits to pharmDs, too. #MdchatTue May 17 18:44:35 PDT 2011

    TheNerdyNurse I suppose you are right @nursefrienIdly but who would sponsor them? @cocacola ?@mcdonalds ? #MDchatTue May 17 18:44:47 PDT 2011

    RichmondDoc @PracticalWisdom@EinsteinMed@thenerdynurse AHECs are publicly funded.#mdchatTue May 17 18:44:48 PDT 2011

    charlesornstein As context, @ProPublica does not take position on whether funding from industry isgood or bad. We do support transparency. #mdchatTue May 17 18:44:51 PDT 2011

    neel_shah problematic-ACOG lobbies against expensive drug that limits access while alsoadvertising it in their journal http://bit.ly/kbBwGA#mdchatTue May 17 18:44:54 PDT 2011

    MeredithGould @sarasteinmd You rock. #MDchatTue May 17 18:45:04 PDT 2011

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    richmeyer @sarasteinmd But what is happening more and more is that patients mistrust pharmaand check other sources of info #mdchatTue May 17 18:45:05 PDT 2011

    ShrinkRapRoy +1 RT @sarasteinmd: @thenerdynurse I know I know!! RAISES HAND...CME fromSOCIAL MEDIA!!! WOOT!! (Dr Stein does the slam dunk dance) #MdchatTue May 17 18:45:13 PDT 2011

    TheNerdyNurse In the tough economic times when you have to choose between CEs and dinner on

    the table, dinner wins @practicalwisdom#MDchatTue May 17 18:45:29 PDT 2011

    richmeyer @MeredithGould@sarasteinmd Yes my wife is a Pharn D at Amgen #MDchatTue May 17 18:45:33 PDT 2011

    RichmondDoc @neel_shah Nice catch there. Ugh. #mdchatTue May 17 18:45:35 PDT 2011

    MeredithGould @shrinkraproy Yes, but in my experience, PharmDs at least know the biochemistryinvolved. #MDchatTue May 17 18:45:48 PDT 2011

    PracticalWisdom @sarasteinmd@thenerdynurse: or Matt Dance around the country:http://www.youtube.com/watch?v=zlfKdbWwruY #MDChatTue May 17 18:46:05 PDT 2011

    MD_chat Going to try and sneak in a quick Q3: do patients care about doc/industryconnections? Would they care if they knew more about it? #MDChatTue May 17 18:46:19 PDT 2011

    MeredithGould @richmeyer So YOU have no worries! ;-) #MDchatTue May 17 18:46:24 PDT 2011

    richmeyer @sarasteinmd#mdchat The bad news is that there is a lot of bad health informationonlineTue May 17 18:46:29 PDT 2011

    apjonas @thenerdynurse@practicalwisdom Might want to increase fees or negotiate highersalary to fully fund prof life #mdchatTue May 17 18:46:58 PDT 2011

    richmeyer @MeredithGould I wish she is up against the ol boys sales network #MDchatTue May 17 18:47:03 PDT 2011

    TheNerdyNurse The government is already broke #MDchat@apjonas@PracticalWisdom@EinsteinMed@RichmondDocTue May 17 18:47:06 PDT 2011

    NateOsit Are different research models utilized in other countries? It seems like pharma hasmore influence in US vs. other countries #MDchatTue May 17 18:47:13 PDT 2011

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    ShrinkRapRoy @MeredithGould Docs used to know, but more time since med school, it fades if notused. #MdchatTue May 17 18:47:13 PDT 2011

    nursefriendly @nursefriendly@charlesornstein the influence they can exert by just being there ininevitable. Pens, special opportunities they #mdchatTue May 17 18:47:28 PDT 2011

    MeredithGould @ShrinkRapRoy I know...sad but true. #MdchatTue May 17 18:47:30 PDT 2011

    ShrinkRapRoy YES! RT @drval: My CME idea: docs answer pt ques for free, attach great articles/litthat theyve read, get credit from non-profit. #MdchatTue May 17 18:47:54 PDT 2011

    PracticalWisdom Q3: Please remember the Stats from Pew Research Gen. Public even the ones inspicy years R getting Savvy Med education on the Web. #MDChatTue May 17 18:48:27 PDT 2011

    sarasteinmd @shrinkraproy Perfect. Until the industry gets to the reporters!! OY #mdchatTue May 17 18:48:54 PDT 2011

    richmeyer @MeredithGould right but from a patients standpoint its all confusing #MDchatTue May 17 18:48:55 PDT 2011

    NicholasMagers @ShrinkRapRoy Reps try 2 impact their product market - as the physician officesclose expect more DTC & reach to ancillary providers #MDChatTue May 17 18:49:08 PDT 2011

    sarasteinmd @MeredithGould@richmeyer I take pride in my confusion! #mdchatTue May 17 18:49:56 PDT 2011

    RichmondDoc T3 I think pts would want to know who their doc gets $ from:http://projects.propublica.org/docdollars/#mdchatTue May 17 18:50:07 PDT 2011

    richmeyer @MeredithGould Which is why their is an opp to replace sales person with medtrained info person to help cut through BS #MDchatTue May 17 18:50:17 PDT 2011

    drval @EinsteinMed@ShrinkRapRoy I pitched that CME idea many times over the years...Maybe just need right ears to hear? Need platform. #mdchatTue May 17 18:50:22 PDT 2011

    charlesornstein Patients do care. See what our partners at Consumer Reports found.http://t.co/XAM5ssv#mdchatTue May 17 18:50:27 PDT 2011

    ShrinkRapRoy In our recent Shrin Rap poll, folks voted 3:1 to disallow DTC. #MdchatTue May 17 18:50:39 PDT 2011

    RichmondDoc T3 Looked up docs I know in thatn listing: I found some getting over $57k for workingw/ industry. Does that impact their practice? #mdchat

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    Tue May 17 18:50:41 PDT 2011

    apjonas @MeredithGould@richmeyer Good point. Docs are marginalized/stunned w/currentmandates. Powerlessness abounds. Get out the 12 steps #mdchatTue May 17 18:50:49 PDT 2011

    nursefriendly Can picture the scene, a rep chatting up a doctor on an article or presentation theymade. Next step, invite them to consult on a #mdchatTue May 17 18:51:00 PDT 2011

    MeredithGould @apjonas Really. #mdchatTue May 17 18:51:05 PDT 2011

    sarasteinmd @charlesornstein Uh Charles, consumer reports has completely discreditedthemselves with the Jenny Craig buy an advertorial fiasco #mdchatTue May 17 18:51:29 PDT 2011

    EinsteinMed Pro Public article on ConsumerReports research about patients worries over doctorsand pharma industry. http://bit.ly/mgYdqe#mdchatTue May 17 18:51:36 PDT 2011

    mojonimbus @richmonddoc#mdchat if all education including CEU/CME were publicly fundedwould be better & if healthcare was too , that problem goneTue May 17 18:51:36 PDT 2011

    MeredithGould @sarasteinmd Gee, you and Jenny Craig. Sounds like you two need an intervention.#MDchatTue May 17 18:52:05 PDT 2011

    richmeyer @apjonas And they need to learn to become marketers now because patients areconsumers of healthcare #mdchatTue May 17 18:52:10 PDT 2011

    RichmondDoc MT @mojonimbus: #mdchat if all education including CEU/CME were publicly fundedwould be better & if healthcare was too #mdchatTue May 17 18:52:10 PDT 2011

    sarasteinmd @RichmondDoc You know I need to rethink this food as medicine paradigm. Myneighborhood farmers market is not kicking back to me #mdchatTue May 17 18:52:15 PDT 2011

    nursefriendly Consult on a project-in small incremental planned steps, they rope you into givinglectures which ultimately let them pitch drugs #mdchatTue May 17 18:52:17 PDT 2011

    ShrinkRapRoy @NicholasMagers Good point. I agree. #MdchatTue May 17 18:52:42 PDT 2011

    RichmondDoc @PracticalWisdom T3 I think pts are able to take that info into account...but they needto have the info. #mdchatTue May 17 18:52:50 PDT 2011

    richmeyer @PracticalWisdom Remember that average reading level of health info should be 7thgrade #MDChat

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    Tue May 17 18:52:50 PDT 2011

    RichmondDoc @sarasteinmd Maybe demand they give you a pen? :) #mdchatTue May 17 18:53:02 PDT 2011

    EinsteinMed @charlesornstein You beat me to that. :) Interesting article though. #mdchatTue May 17 18:53:08 PDT 2011

    chemosabe ...they r just doin wot they need 2, to keep their jobs...take ur issue to the pharma, notthe rep pls #mdchatTue May 17 18:53:15 PDT 2011

    PracticalWisdom Not TransRT @nursefriendly: Consult on project-in small increm. planned steps, theyrope U in2 giving lectures let them pitch drugs #MDChatTue May 17 18:53:39 PDT 2011

    sarasteinmd @thenerdynurse@chemosabe We dont hate the reps - we hate the lies that they areinstructed to tell #mdchatTue May 17 18:54:04 PDT 2011

    richmeyer @MeredithGould Exactly docs told me in research make it 6th grade #MDchatTue May 17 18:54:19 PDT 2011

    PracticalWisdom Agree RT @RichmondDoc: @PracticalWisdom T3 I think pts are able to take that infointo account...but they need to have the info. #MDChatTue May 17 18:54:20 PDT 2011

    MD_chat Coming to the end of the hour, here. Time to wrap up and give us any partingthoughts. #MDChatTue May 17 18:54:24 PDT 2011

    TheNerdyNurse Thats why social media is so important in healthcare. Easy access to info and quick@practicalwisdom@sarasteinmd@charlesornstein#MDchatTue May 17 18:54:24 PDT 2011

    MeredithGould @RichmondDoc EXactly..which is why I harp on it being a bigger issue. #MDchatTue May 17 18:54:39 PDT 2011

    ShrinkRapRoy (This chat is much more ... manageable ... Than #hcsm.) #MdchatTue May 17 18:55:04 PDT 2011

    PracticalWisdom G8 way 2 explainRT @sarasteinmd: @thenerdynurse@chemosabe We dont hate thereps - we hate the lies that they are instructed to tell #MDChatTue May 17 18:55:07 PDT 2011

    docmarkgreene There are pharma insiders who wish DTC never happened. #mdchat Overmedicalizing everything is costly and unhelpful.Tue May 17 18:55:25 PDT 2011

    RichmondDoc @charlesornstein@ProPublica Looking forward to the update. Lots of interesting infoalready has developed out of your work. #mdchatTue May 17 18:56:22 PDT 2011

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    chemosabe not sure how it works up there, but down here, buy us food 4 meeting, get maybe 5mins 4 pitch. think we do alright out of it really #mdchatTue May 17 18:56:41 PDT 2011

    drval #mdchat Final thts: pharma makes some great products & some redundant/not sogreat prods.They are for-profit, but not evil.Transparency keyTue May 17 18:57:13 PDT 2011

    NateOsit Final thoughts: Transparency is needed to create doctor/patient relationships basedon trust and respect. #MDchatTue May 17 18:57:17 PDT 2011

    apjonas @drval@EinsteinMed@ShrinkRapRoy Those ideas have been considered by AAFPCOCME. Pt focused CME credit exists in many forms. #mdchatTue May 17 18:57:20 PDT 2011

    PracticalWisdom Rock On! RT @NateOsit: Final thoughts: Transparency is needed to createdoctor/patient relationships based on trust and respect. #MDChatTue May 17 18:57:57 PDT 2011

    sarasteinmd @chemosabe I think they tried to kill us with all that pizza. #mdchatTue May 17 18:58:09 PDT 2011

    charlesornstein MT @drval: #mdchat pharma makes some great products & some redundant/not sogreat prods.They are for-profit, but not evil.Transparency keyTue May 17 18:58:22 PDT 2011

    MD_chat Thanks, everyone, for a great hour. Appreciate the views. Have a great week until thenext #MDChatTue May 17 18:58:34 PDT 2011

    nursefriendly T3: Was very tempted to ask a doctor if he or his "professional" association had beengetting funding from the maker of a prescribe #mdchatTue May 17 18:58:49 PDT 2011

    apjonas Final: Human side of docs, pharma, hosp, industry could be upgraded to serve betterand misdirect $ less #mdchatTue May 17 18:58:59 PDT 2011

    nursefriendly t3 From the maker of a new drug I was being prescribed, when lots of genericalternatives were on the market. #mdchatTue May 17 18:59:22 PDT 2011

    sarasteinmd Final thoughts MDs & Pharma are a love-hate bad marriage. It only works if we focuson the patients. #mdchatTue May 17 18:59:24 PDT 2011

    DrJonathan Never underestimate the power of a quality doctor-patient relationship. Neveroverestimate the opposite. #mdchatTue May 17 18:59:56 PDT 2011

    EinsteinMed Transparent plug: If you have a chance, check us out on Facebook and LIKE us athttp://www.facebook.com/EinsteinCollegeofMedicine #mdchatTue May 17 18:59:59 PDT 2011

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