Princess Health and Secrecy. Princessiccia

Princess Health and Secrecy. Princessiccia

confidentiality clause health insurance secrecy

Gusty 06:43 Add Comment

I'm trying to catch up after a busy weekend, and there is a lot to catch up on...
Last week in the Hartford Courant, an op-ed article entitled "Medically Unnecessary" offered an ear, nose and throat surgeon's heart-felt complaints about the brave new world of practice dominated by managed care.
In particular, he recounted how his practice tried to negotiate with a prominent insurance company. As a prerequesite to negotiating, the company sent the doctors a "confidentiality contract," which included penalties up to $100,000 per person for any "breach of confidentiality, [decided] solely at the insurer's discretion." The doctors refused to sign.
Here is another example of the secrecy rampant in US health care. Earlier, we had posted about how hospitals keep their often stratospheric "list prices" secret, even from patients who may later be liable to pay these prices if they have no health insurer who can negotiate discounts. We also had posted about how medical schools and academic medical centers are often willing to negotiate research contracts with sponsors whose provisions are kept confidential, perhaps to hide provisions that give the corporate sponsor, not the ostensibly academic investigators control of most aspects of the research.
There are some instances in which secrecy in health care is justifiable. Keeping patients' personal data confidential is a a core value for most physicians. It also seems reasonable for companies that manufacture products used in health care to be able to maintain trade secrets about their manufacturing processes.
However, for the most part, we should cultivate transparency and openness in health care. It is hard to conceive of legitimate reasons to keep hospitals' prices, contracts between medical schools and research sponsors, and contracts between doctors and managed care organizations secret. On the other hand, it is easy to think of how such secrecy could hide unethical business practices, and potentially even abuse of patients and corruption.
It is time to end this secrecy.

Princess Health and Secrecy.Princessiccia

Princess Health and Secrecy.Princessiccia

confidentiality clause health insurance secrecy

Gusty 06:43 Add Comment

I'm trying to catch up after a busy weekend, and there is a lot to catch up on...
Last week in the Hartford Courant, an op-ed article entitled "Medically Unnecessary" offered an ear, nose and throat surgeon's heart-felt complaints about the brave new world of practice dominated by managed care.
In particular, he recounted how his practice tried to negotiate with a prominent insurance company. As a prerequesite to negotiating, the company sent the doctors a "confidentiality contract," which included penalties up to $100,000 per person for any "breach of confidentiality, [decided] solely at the insurer's discretion." The doctors refused to sign.
Here is another example of the secrecy rampant in US health care. Earlier, we had posted about how hospitals keep their often stratospheric "list prices" secret, even from patients who may later be liable to pay these prices if they have no health insurer who can negotiate discounts. We also had posted about how medical schools and academic medical centers are often willing to negotiate research contracts with sponsors whose provisions are kept confidential, perhaps to hide provisions that give the corporate sponsor, not the ostensibly academic investigators control of most aspects of the research.
There are some instances in which secrecy in health care is justifiable. Keeping patients' personal data confidential is a a core value for most physicians. It also seems reasonable for companies that manufacture products used in health care to be able to maintain trade secrets about their manufacturing processes.
However, for the most part, we should cultivate transparency and openness in health care. It is hard to conceive of legitimate reasons to keep hospitals' prices, contracts between medical schools and research sponsors, and contracts between doctors and managed care organizations secret. On the other hand, it is easy to think of how such secrecy could hide unethical business practices, and potentially even abuse of patients and corruption.
It is time to end this secrecy.

Princess Health and New Marketing Campaign "To Build Emotional Ties Between Merck and Consumers". Princessiccia

Princess Health and New Marketing Campaign "To Build Emotional Ties Between Merck and Consumers". Princessiccia

Merck public relations

Gusty 06:55 Add Comment

The NY Times reported that Merck is embarking on a big $20 million marketing campaign to "help burnish its corporate brand rather than sell its products."
Len Taconi, executive director for corporate communication for Merck, said, "It's an important time for people to know who Merck is and what we stand for as a company."
Robert Passikoff, President of Brand Keys, described by the Times as "a brand and customer-loyalty consultant," said "Merck would be wise to make sure it has more friends than disgruntled patients. Ultimately, you're better off having a tighter emotional bond to your customer base." The Times also reported that the "campaign will try in several ways to build emotional ties between Merck and consumers."
Of course, Merck is a firm that has been around for a long time, and has produced many important products that we physicians have been happy to use> Merck certainly seemed, at least through the start of the 1990's, to be one of the great American companies.
However, in the last year, Merck has come under substantial fire for putting marketing before science, and in particular for manipulating scientific evidence about its formerly hot selling drug Vioxx, now withdrawn from the market.
For example, we have posted about how Merck tried to "neutralize" Vioxx opponents; about how Merck tried to downplay negative results of studies about Vioxx; about how Merck had a New England Journal article reporting a key trial of Vioxx ghost-written; and about how Merck marketed Vioxx as a general-purpose pain reliever in the absence of evidence that it any better in this role than a variety of cheaper drugs, while again down-playing data about its adverse effects.
So perhaps rather than trying to "build emotional ties," in my humble opinion, if Merck wants to regain the profession's and the public's trust, it should rededicate itself to doing valid, honest research about its products, and then presenting its results clearly and honestly. Merck should promote evidence-based health care, rather than spending $20 million on emotion-based marketing.

Princess Health and New Marketing Campaign "To Build Emotional Ties Between Merck and Consumers".Princessiccia

Princess Health and New Marketing Campaign "To Build Emotional Ties Between Merck and Consumers".Princessiccia

Merck public relations

Gusty 06:55 Add Comment

The NY Times reported that Merck is embarking on a big $20 million marketing campaign to "help burnish its corporate brand rather than sell its products."
Len Taconi, executive director for corporate communication for Merck, said, "It's an important time for people to know who Merck is and what we stand for as a company."
Robert Passikoff, President of Brand Keys, described by the Times as "a brand and customer-loyalty consultant," said "Merck would be wise to make sure it has more friends than disgruntled patients. Ultimately, you're better off having a tighter emotional bond to your customer base." The Times also reported that the "campaign will try in several ways to build emotional ties between Merck and consumers."
Of course, Merck is a firm that has been around for a long time, and has produced many important products that we physicians have been happy to use> Merck certainly seemed, at least through the start of the 1990's, to be one of the great American companies.
However, in the last year, Merck has come under substantial fire for putting marketing before science, and in particular for manipulating scientific evidence about its formerly hot selling drug Vioxx, now withdrawn from the market.
For example, we have posted about how Merck tried to "neutralize" Vioxx opponents; about how Merck tried to downplay negative results of studies about Vioxx; about how Merck had a New England Journal article reporting a key trial of Vioxx ghost-written; and about how Merck marketed Vioxx as a general-purpose pain reliever in the absence of evidence that it any better in this role than a variety of cheaper drugs, while again down-playing data about its adverse effects.
So perhaps rather than trying to "build emotional ties," in my humble opinion, if Merck wants to regain the profession's and the public's trust, it should rededicate itself to doing valid, honest research about its products, and then presenting its results clearly and honestly. Merck should promote evidence-based health care, rather than spending $20 million on emotion-based marketing.

Princess Health and Marketing Normal Pressure Hydrocephalus. Princessiccia

Princess Health and Marketing Normal Pressure Hydrocephalus. Princessiccia

deception marketing pharmaceuticals

Gusty 06:12 Add Comment

Joseph Friedman, a neurologist here in Rhode Island, wrote an op-ed in the Providence Journal that documented yet another story about apparently deceptive marketing, this time of devices. He recounted his discovery of a marketing campaign for the device used to shunt fluid for patients with the relatively rare condition of normal pressure hydrocephalus (NPH).
He first saw a segment on a television magazine show on NPH, and then "an avalanche of TV advertisements about the disorder." Then patients with previously diagnosed Parkinson's Disease began to show up in his office, wondering if they didn't have the much more rare condition, NPH. Since the diagnosis of Parkinson's Disease is usually clear-cut, and NPH is very uncommon, these ads may lead to a lot of unnecessary tests. Furthermore, as Dr. Friedman pointed out, "patients suffer twice: first, when they wonder if they've been mistreated for 10 years by their clueless doctor; then, when they're disappointed to learn that they haven't been misdiagnosed."
Dr. Friedman forcefully conceptualized the issues: "what I think: that the dirtbags who run the shunt company, the increasingly politicized U.S. Food and Drug Administration, and the executives who run television are willing to create false hope if it creates a market."

Princess Health and Marketing Normal Pressure Hydrocephalus.Princessiccia

Princess Health and Marketing Normal Pressure Hydrocephalus.Princessiccia

deception marketing pharmaceuticals

Gusty 06:12 Add Comment

Joseph Friedman, a neurologist here in Rhode Island, wrote an op-ed in the Providence Journal that documented yet another story about apparently deceptive marketing, this time of devices. He recounted his discovery of a marketing campaign for the device used to shunt fluid for patients with the relatively rare condition of normal pressure hydrocephalus (NPH).
He first saw a segment on a television magazine show on NPH, and then "an avalanche of TV advertisements about the disorder." Then patients with previously diagnosed Parkinson's Disease began to show up in his office, wondering if they didn't have the much more rare condition, NPH. Since the diagnosis of Parkinson's Disease is usually clear-cut, and NPH is very uncommon, these ads may lead to a lot of unnecessary tests. Furthermore, as Dr. Friedman pointed out, "patients suffer twice: first, when they wonder if they've been mistreated for 10 years by their clueless doctor; then, when they're disappointed to learn that they haven't been misdiagnosed."
Dr. Friedman forcefully conceptualized the issues: "what I think: that the dirtbags who run the shunt company, the increasingly politicized U.S. Food and Drug Administration, and the executives who run television are willing to create false hope if it creates a market."

Princess Health and Guidant's Short Circuit, Reloaded. Princessiccia

Princess Health and Guidant's Short Circuit, Reloaded. Princessiccia

Guidant ICD manufacturing problems

Gusty 06:02 Add Comment

The NY Times reported that after Guidant discovered a defect in its implantable cardiac defibrillator (ICD) that allowed the device to short-circuit and fail, it continued to ship ICDs with the defect even after it had started manufacturing redesigned devices without the flaw.
Our post about the discovery of the flaw is here.
Guidant's statement about the matter was, "After making these improvements, Guidant sold product manufactured before the improvements because the reliability data showed that the original PRIZM 2 DR, like the enhanced version, was a highly reliable life-saving device. Current data continues to support the reliability of the product."
The Times reported, "some doctors said they would be dismayed if the company allowed them to implant a device with a known flaw that had been corrected in other units."
As I said before, the decision about how to treat a patient's illness should be up to the doctor and patient, and be based on the best available data, as well as the patient's values. For a company to withold data relevant to the decision, which just happens to be unfavorable to the company's product, is plain wrong.