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Latest Posts

Is The FDA Too Lenient When Reviewing Medical Devices?

I speak to people in the pharmaceutical industry much more than folks who develop medical devices. I know how pharma researchers spend years and hundreds of millions of dollars trying to develop a useful, safe new drug that the FDA will approve for marketing. Certainly there are big payoffs, but the road is filled with potholes and trapdoors and the analysis by the FDA is rigorous.

But for years we’ve been hearing that it is much less rigorous when it comes to medical devices. Artificial hip joints and stents to open blocked arteries fall into this category. And recently, the less stringent review process has been highlighted in the news. Metal-on-metal hip joints are being removed from patients who had them implanted. They thought Read more »

*This blog post was originally published at Andrew's Blog*

Stents Break The Bank And FDA Gets Bigger Budget

ACP Internist continues its look at subjects important to internal medicine. Today, we follow the money.

Evidence-based medicine
The U.S. could save one-third of the $15 billion spent on stents annually if all doctors followed COURAGE trial conclusions and used generic drugs first, and stents only if pain persists. William Boden, FACP, headed that trial, and now says that reimbursement drives clinical practice. Dartmouth’s Elliott Fisher, MD, says this “perverse incentive” doesn’t improve health care. (Wall Street Journal, CNN)

Physician reimbursement reform
Following the Food and Drug Administration’s record-breaking budget allocation, seven former agency commissioners and interest groups are still saying it’s not enough to make up for years of underfunding. Even regulated industries want more funding to boost the public perception of product safety. (ACP Internist, Los Angeles Times)

*This blog post was originally published at ACP Internist*

Heart Disease Awareness And The Four Hottest Controversies In Cardiology

heartFebruary is National Heart Disease Awareness Month, and so I invited Dr. Bill Kussmaul to make me aware of some of the hottest controversies in cardiology.  His tips and insights are invaluable to busy primary care physicians looking for the bottom line on thorny issues. Dr. Kussmaul is the Associate Director of the Cardiac Catheterization Laboratory at Hahneman Hospital in Philadelphia and an Associate Editor of the Annals of Internal Medicine. You can listen to our conversation or read my transcript below:

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Controversy #1: Cholesterol and Statin Therapy

Dr. Val: Who should receive high-dose statin therapy? Read more »

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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