Sep 022015
 

This is belated notification of one of Forbes column from last month: “Free Speech 1, FDA 0“.

I discuss an update to my earlier Forbes piece on drug company Amarin’s fight to engage in free speech in the form of off-label marketing of one of its products.

Basically, Amarin wanted to give truthful medical information to doctors which would allow them to more effectively use one of their drugs in a way that was legal, but not FDA-approved. The FDA forbade Amarin from engaging in such speech, and Amarin sued the FDA.

Last week, Amarin won an important legal victory in federal court. Judge Paul Engelmayer came down firmly on the side of free speech.

For more details see the full text of, “Free Speech 1, FDA 0“.

(Earlier Forbes piece, “Drug Company Amarin Stands Up For Free Speech Against FDA“, 5/8/2015.)

 

My latest Forbes piece is now out: “The Positive Value of Negative Drug Trials“.

I discuss the unfortunate bias against publishing “negative” scientific results that show a drug doesn’t have much clinical benefit, and why it’s in the self-interest of drug companies to still report these.

In particular, I highlighted two interesting facts:

1) Most drug trial results are still not being reported to a central registry.

2) Negative results funded by private industry (e.g., pharmaceutical companies) are more likely to be reported than from government-funded research.

Fortunately, free market incentives are driving more drug companies towards full disclosure of both positive and negative study results — which will benefit patients.

For more details, read the full text of “The Positive Value of Negative Drug Trials“.

Jul 102015
 

US News & World Report had a nice piece on the debate over whether gun violence should be considered a “public health” issue, and they quoted me as explaining why it should not be:

But some medical providers say doctors should stay out of the debate. Dr. Paul Hsieh, co-founder of Freedom and Individual Rights in Medicine, says he views gun crime and violence as predominantly about criminal justice and individual rights.

“I remain deeply skeptical of any attempts to frame important public policy debates as also ‘public health’ issues, especially when it concerns a long-running political controversy,” says Hsieh, who writes on health care policy from a free-market perspective for Forbes.com. “Pretty much any public policy issue will ultimately have some sort of effects on the lives and well-being of Americans – but that doesn’t mean they should all be considered topics of ‘public health.’”

People are concerned that sharing information about gun ownership with doctors may not remain private, he wrote in a Forbes piece. “In short, I believe this undermines the critical doctor-patient trust necessary for the good practice of medicine,” he says.

I thought they characterized my views fairly, and I was pleasantly surprised to see that they even turned the quote into one of the lead article graphics!

 

 

My latest Forbes column is now up, “Three Good Things In Health Care Innovation“.

I highlight some under-appreciated good developments in health care, centered around the theme that innovations in processes may be less flashy than innovations in technology — but can still save lives.

In particular, I discuss the following:

1) Improvements in cardiac care

2) Improvements in matching kidney transplant donors with recipients

3) Protecting the freedom of direct pay doctors

Our current system is very mixed, with both good and bad elements. Today, I wanted to focus on some of the good elements.

For more details on each, read the full text of “Three Good Things In Health Care Innovation“.

 

 

I posted a quick piece last weekend at Forbes, “Would You Trust A Computer To Knock You Out?

This is loosely based on a talk I just gave at ATLOSCon 2015, “I, For One, Welcome Our New Robotic Overlords“.

I discuss the rise of “smart” systems to augment (and potentially replace) human physicians. And why I welcome them.

And thanks to Hanah Volokh for letting me quote her!

 

 

Note from Diana: Sorry that I didn’t post this announcement when the column was published! I didn’t realize that it was in the queue.

My latest Forbes column is now up: “Perverse Incentives and VA Health Scandals“.

I discuss the perverse incentives underlying the numerous VA health scandal. Too many on the political Left (such as New York Times columnist Paul Krugman) are quick to condemn perverse incentives in the private health system, while failing to mention similar (or worse) perverse incentives in government-run health systems.

Incentives matter.

May 082015
 

My latest Forbes column is now up: “Drug Company Amarin Stands Up For Free Speech Against FDA“.

Here is the opening:

Even as Americans heatedly argue the issue of free speech with respect to cartoon criticisms of Islam, the small drug company Amarin is striking a quieter blow for its free speech rights against the Food and Drug Adminstration (FDA).

The key issue is whether drug companies can tell doctors truthful information about their products that pertains to “off-label” uses (i.e., for applications not already explicitly approved by the FDA.)

Of course, drug companies should not be allowed to disseminate false or misleading information about their products.  That can and should be punished as fraud.

But both doctors and patients benefit when drug companies are allowed to publish truthful information.

Bonus infographic on the onerous FDA approval process!

 

 

My latest Forbes piece is now out: “Why You Should Record Your Doctor Visits“.

Here is the opening:

NBC’s Brian Williams has gone from being a respected news anchor to the butt of Internet jokes after he recanted a false story about being shot down in a helicopter over Iraq. As a result of the subsequent controversy, NBC has suspended Williams without pay for 6 months — essentially costing him $5 million.

But whether or not Williams’ story was an innocent “false memory” or a deliberate lie, it is the case that false or unreliable memories are a surprisingly common phenomenon. In a health care setting, patients’ false memories of medical conversations might cost them more than money — it might even endanger their lives. Hence, patients may wish to record their doctors’ visits to protect themselves…

During my research for this piece, I learned that “40-80% of medical information provided by healthcare practitioners is forgotten immediately” and “almost half of the information that is remembered is incorrect” (!)

Fortunately, modern technology now makes it easier for patients to record these important discussions with physicians, for instance with a smartphone.

For more information on the benefits of this practice, read the full text of “Why You Should Record Your Doctor Visits“.

 

 

My latest Forbes piece is now out, “Does Your Right To Life Include The Right To Die?

I discuss the revived debate over physician-assisted suicide, especially in the wake of Brittany Maynard’s decision to end her life following a diagnosis of terminal brain cancer. This issue is being debated in several state legislatures, including New Jersey and California, so we will be hearing much more about this in coming months.

I recognize that this is a controversial topic and that good physicians can disagree on this issue. Nonetheless, I believe this should be a legal option for patients, provided that there are appropriate safeguard to protect both the patient and the physician.

In my piece I cover three main subpoints:

1) Your life is your own.

2) The state has a legitimate (even vital) role to play in assisted suicide.

3) Physicians must not be required to participate

For more details, please read the full text of “Does Your Right To Life Include The Right To Die?

(Much of this material is drawn from the recent Philosophy In Action podcast by Diana and co-host Greg Perkins in their 1/18/2015 segment, “The Right To Die“.)

 

(Photo: Brittany Maynard by Allie Hoffman; Creative Commons Attribution – Share Alike)

 

My latest Forbes column was posted on 9/29/2014, “Who Decides What Medical Care You Receive At End of Life?

I discuss how some patients in the socialized medical systems of Canada and the UK have been put on DNR (“do not resuscitate”) status without their knowledge or consent and how that ties to the current debate over government-funded end-of-life counseling here in the US.

As I’ve said before: If you expect “somebody else” to pay for your health care, then “somebody else” will ultimately decide what care you may (or may not) receive.

I also discuss how free-market reforms for health insurance can allow patients to retain control over their end-of-life medical decision making and protect Americans from those gut-wrenching problems faced by patients in Canada and the UK.

And for some excellent practical advice on how patients can plan for such eventualities, check out this interview with Dr. William Dale by Diana.

 

 

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