Letters
Sidebar:
|
Bad rap for drug reps?
I read with amusement your article in the Observer on drug reps ("These drug reps come bearing facts, not freebies," July/Aug 2007), particularly the sidebar on Dr. Turton eating alone, reading his journals. In case Dr. Turton did not notice, we are in a capitalistic society. People are free to advertise and promote their products. We are free, of course, to ignore or refuse to participate in their promotional activities. It is, however, impossible to avoid them completely. While Dr. Turton is in his office reading his journals, I am wondering what he does with the advertisements.
My New England Journal of Medicine had 12 separate drug advertisements entailing 28 pages of glossy fold-outs. The journal itself had only 100 pages of clinically relevant material. The Observer had two drug advertisements with a total of five pages. When I turn on the TV, I am also hit with drug advertisements.
The value of the reduced cost of the subscriptions to me, I dare say, is much more than the cost of a pen. The issue, therefore, is not the susceptibility of physicians to the advertisements nor the value of what is offered but the appearance, whatever that means, of impropriety.
I would certainly be glad to forego all drug advertisements completely if there could be a way of constitutionally banning them. I am certainly not particularly thrilled with the soggy pizzas and wilted salads which are offered. I rarely in my busy schedule have time to go to the dinners at restaurants. I do, however, enjoy the camaraderie and the opportunity of meeting and discussing with my colleagues any clinical issues which are brought up at these gatherings. I am sure Dr. Turton is aware of the benefits of actually meeting with people to discuss cases versus going through journal articles and brown bagging it.
Brian A. Chapman, MD
Waukesha, Wisc.
Stem cell concerns
I read with some concern the front page article of the April 2007 ACP Observer entitled "California initiative gives new life to stem cell research," by Yasmine Iqbal. I feel that the article is not only misleading but certainly does not represent a large portion of your readership. The writer's biases were quite evident, but more importantly, there was a complete blurring of the line between the state-of-the-art of stem cell research, confusing adult stem cell research and embryonic stem cell research.
Any concern over the ethical issues for embryonic stem cell research remained unaddressed, other than to say there is much argument and debate going on about these issues. Unfortunately, this article obfuscates ethical concerns, and blurs any important distinctions and successes seen with adult stem cell versus embryonic stem cell research. My hope is that in the future you will see fit to provide a more balanced view.
Gary C. Prechter, FACP
Hendersonville, NC
Alzheimer's response
I am writing in response to the article, "Special Focus: Dementia," in the June 2007 issue of ACP Observer. In the article, mild cognitive impairment is described as a type of dementia, which is not true. Mild cognitive impairment is a distinct entity characterized by cognitive decline without impairment or decline of the functional status, and is not a type of dementia which is characterized by cognitive decline affecting functional status.
Mild cognitive impairment is transitional stage between normal aging and Alzheimer's disease. However, not every patient with mild cognitive impairment progresses to dementia stage. Approximately 12% of patients with amnestic mild cognitive impairment have progression to Alzheimer's disease each year, and up to 80% have progression to Alzheimer's disease after six years. Also, galantamine is also available in slow-acting form for which dose titration is 8 mg a day, followed by 16 mg a day and 24 mg a day. Its dose may be titrated at monthly interval.
Abid Iraqi, FACP
Syracuse (N.Y.) VA Medical Center
Internist Archives Quick Links
Introducing ACP Summer Session
The most popular learning formats from the Internal Medicine meeting offered at only $35 for ACP members! Combine CME and leisure time in San Francisco, CA or Orlando, FL
The International Medical Graduate's Guide to US Medicine and Residency Training
Providing an overview of residency training and life in America, this is the one-source reference tool international medical graduates have been waiting for.