NHS funding of homeopathy

[steenkh]

This is why I say that Homeopathy is very useful in the hands of experienced doctors in the context of the proper Conventional Medicine but can also be very dangerous if used instead of evidence-based (I dislike this word) Medicine.

I see the effectiveness of your "homoeopathic" treatments, but isn't there an ethical problem involved here?

 

[fls]

You are confusing me with Linda (fls). I usually freelance, but one company (Glaxpoo-Pfizzer) gives me a variable rate, depending on pharmaceutical returns from local pharmacies according to a predetermined formula - I get $500 for each 5% increase in sales within the week following any promotional posting.

My set-up is a bit different. Because of my university appointment, I don't need to produce measurable results. I merely get a salary for regularly stating an opinion (doesn't have to be in relation to any particular drug or therapy). This provides the opportunity for subliminal messaging to be encoded within the body of my posts, using the techniques outlined in the ET Corn Gods thread. So while I may not mention a particular product, the reader will still come away with a subconscious impression that (for example) Prevnar is good. Smite-Kling-Beetches pays $48,000 annually as long as I demonstrate membership on certain high-profile forums and provide a list of 'posts' with the relevant 'Linkage Impact Factor'. Of course, there are the obligatory teaching responsibilities, but I often pass that off to one of my interns.

This income is supplemented by work similar to yours - more direct endorsement. But I often use my sock-puppet, Robinson, for that job. And occasionally I am lucky enought to get appointed (with the attendant grant money) as a 'Principal Instigator' for the NWO.

Linda

 

[Phytotherapist]

Mojo - The 684 patients that came to me are responsible as their doctors for overprescribing: in fact they convinced their doctors to overprescribe and this is why I changed the overprescribed drugs with the homeopathic remedies (i.e. with nothing) after all attempts made by me to dissuade them to take the wrong (in their particular case) medicines failed. Sometimes some doctors have to choose whether overprescribe or lose the patient to another doctor. I never overprescribe even when asked by the patient and if he tells me that he'll go to another doctor I'd be very happy because my agenda is already filled up with new and "old" patients for the next 5 months. I often ask myself how would I react at the patients request for specific drugs if I was in a bad finacial situation and with few paying patients. I don't know the answer because I never experienced such situation.

Steenkh- I think the wellbeing of my patients is more important than ethical problems but, of course, I may be wrong.

Fls and Deetee- I'm very happy for your achievements! Could you suggest how much money should I ask for my activity in the JREF Forum from the Pharma (the real one) I'm working for?

 

[Here_to_learn]

Fls and Deetee- I'm very happy for your achievements! Could you suggest how much money should I ask for my activity in the JREF Forum from the Pharma (the real one) I'm working for?

Ah, here we see the strength of the Homeopathy system. I do get payed by the Big Homeo companies for the impact I do in the threads. To make a big impact you just need to make sure that your posts have as little substance as possible.

I expect a good payoff from this one...

 

[steenkh]

Steenkh- I think the wellbeing of my patients is more important than ethical problems but, of course, I may be wrong.

I tend to agree with you, but I believe that it is currently considered unethical to prescribe placebo without informing the patients (which is somewhat self-defeating).

 

[Mojo]

Mojo - The 684 patients that came to me are responsible as their doctors for overprescribing: in fact they convinced their doctors to overprescribe and this is why I changed the overprescribed drugs with the homeopathic remedies (i.e. with nothing) after all attempts made by me to dissuade them to take the wrong (in their particular case) medicines failed. Sometimes some doctors have to choose whether overprescribe or lose the patient to another doctor. I never overprescribe even when asked by the patient and if he tells me that he'll go to another doctor I'd be very happy because my agenda is already filled up with new and "old" patients for the next 5 months. I often ask myself how would I react at the patients request for specific drugs if I was in a bad finacial situation and with few paying patients. I don't know the answer because I never experienced such situation.

Have you reported any of these doctors to the relevant professional bodies? Prescribing inappropriate medication to the extent of harming the patients, for financial gain, sounds like serious malpractice. You have a professional and moral duty to do something about it.

 

[fls]

Fls and Deetee- I'm very happy for your achievements! Could you suggest how much money should I ask for my activity in the JREF Forum from the Pharma (the real one) I'm working for?

A rough guide that I use is to count the number of pens, coffee cups and sticky note pads advertising a particular product you have laying around your office and divide that by the number of free samples in your cabinet for that particular product. Then add the number of throwaway medical journals sitting on your desk divided by the number of CME conferences you attend that you pay for yourself. The result is the number, in thousands, you should expect annually.

Linda

 

[Phytotherapist]

Steenkh - The Italian Supreme Court (Corte di Cassazione) ruled that practicing Homeopathy is a medical act and only registered medical practitioners can prescribe homeopathic remedies and registered pharmacist can sell these remedies. Telling patient that Homeopathy is Placebo presumably would involve some legal risks. There's one thing I never did: I never said to a patient that Homeopathy is effective.

Mojo - I almost weekly see the president and most council members of my professional body and often I expressed my concern for overprescribing by some members. Legally though, it is the patient that must formally lodge the complaint and not a single patient complained with my professional body over their doctors (mostly family doctors), although some of them changed their family doctor.

Fls - Thanks for the tips. Today I met the Pharma boss that told me this year I'll get a homeopathic bonus. Do you have any idea of the meanings of his words?

 

[steenkh]

OK, I realize that if the courts rule that homoeopathy is medicine, then ethics is immaterial anyway.

 

[Mojo]

I almost weekly see the president and most council members of my professional body and often I expressed my concern for overprescribing by some members.

Some members? You said that over 90% of patients who had seen another doctor had been harmed as a result of the prescription of inappropriate medication. From what you say, this appears to be an extremely widespread problem in the Italian medical profession. Hiding behind "the patient has to report it" is no good. You must make sure that action is taken.

 

[Phytotherapist]

Mojo - You may get the wrong impression that in Italy over 90% of patients are overprescribed and this is not so. As a matter of fact Italian doctors prescibe far less then USA or UK doctors (pro capita drug consumption in Italy is inferior to that of USA and UK). Italian doctors are very good (on average). In the past 20 years life expectancy in Italy has risen 6 years in women and men. Infant (newborn) mortality in 1960 in Italy was 43.9 per 1,000 born, the worst in developed countries (Austria 20.2, France 27.5, Germany 35, UK 22.5 and USA 26). In 2003 this mortality rate fell more than tenfold (in Italy) to 4.3 dead per 1,000 newborn doing better than most developed countries (Austria 5.3, France 4.6, Germany 4.5, UK 5.5 and USA 6.9). Nevertheless, overprescription ( my opinion) in Italy is still widespread giving arguments to quacks to attack the "allopathic" Medicine and doctors.

Unfortunately overprescription is, in my opinion, one of the biggest problems in the western World and political action should be taken to deal with this problem. The first step to take would be to ban all the drug advertising and take strong actions against doctors that overprescribe (usually for their own profit).

 

[Mojo]

Mojo - You may get the wrong impression that in Italy over 90% of patients are overprescribed and this is not so.

I was relying on the figures you posted above, when you claimed that 684 out of the 753 patients who had come to you after visiting other doctors had suffered "iatrogenic problems" as a result of either unneccesary overprescribing or "premature diagnosis" (by which I can only assume you mean misdiagnosis and therefore inappropriate prescription). Do you now wish to withdraw this claim?

 

[fls]

The first step to take would be to ban all the drug advertising and take strong actions against doctors that overprescribe (usually for their own profit).

How can doctors profit from prescribing?

Linda

 

[steenkh]

How can doctors profit from prescribing?

They certainly do in Denmark where they get a fee for every prescription they issue. But I do not think they get more out of prescribing more pills than fewer pills. Probably the way forward for them is to ask the patient to come for a renewed prescription more often.

 

[Asolepius]

Unfortunately overprescription is, in my opinion, one of the biggest problems in the western World and political action should be taken to deal with this problem. The first step to take would be to ban all the drug advertising and take strong actions against doctors that overprescribe (usually for their own profit).

It is a big problem, but on this board we prefer facts to opinions . I am not sure why it's thought that there is something immoral about advertising drugs. In the UK drugs are only about 11% of the total NHS spend, and all other supplies to the NHS are promoted in one way or another. I don't agree with direct promotion to patients, as in the US, but if advertising to doctors were banned the uptake of new drugs for hitherto unmet needs would be much slower. Effectively the government would have to spend more on communications to prescribers.

That's not to say that there are no instances of biassed or questionable advertising, which is why the industry is regulated. But you can for example sell fleets of ambulances to the NHS without a fraction of the regulation that applies to drugs. I need hardly mention the number of times the NHS has been ripped off by IT companies.

Apart from a few dispensing practices, no NHS doctors can profit from over-prescribing. Indeed they are already under pressure to spend less and have shifted much of the spend to cheaper generics instead of branded products. Over-prescribing is more a function of pressure on time with patients, where it's easier to prescribe than to extend a consultation. Also there may not be enough scrutiny of what patients are taking, so they tend to accumulate long term multiple treatments.

The nation with the highest per capita drug use is Japan, and the last I heard all the doctors were dispensing practices so did profit from prescribing. So it's more of a problem in the east.

 

[Phytotherapist]

Mojo - I'll try to explain: 100 patients go to doctors, 80 of them recovered from their conditions (properly prescribed and cured) and 20 got worse because over-prescribed or for other reasons. I said that over 90% of these 20 patients (20%) unproperly treated that came to me were over-prescribed or misdiagnosed. So, I don't see any reason to withdraw my claim. Patiens come to me because they know they'll receive proper treatment, e.g. I never let my patiens go out of my practice without first prescribing them a diet (as well as other medicines if needed) and advise on life-style.


Fls - How can doctors profit from prescribing? In 2003 the news headlines in all the Italian media: " One Hundred Million Euros a Year to Buy 3,000 Doctors" . "Travel, Gifts, Bribes (Money) to doctors who prescribed (over-prescribed) Glaxo Drugs. 72 More People Sued for Corruption (Glaxo managers).
In 2006 the headlines were: "Ban Sought for Eight Pharmaceutical Companies (GlaxoSmithKline one of them) on a Gigantic Scam to the Italian NHS" (a multi-million EUR fraud). I let you immagine the damage these "gentlemen" (doctors too) did to patients. Moreover, with their actions, they damaged the reputation of conventional Medicine and honest doctors and boosted NCMs (Non Conventional Medicines). Even worse is that, with all the money they have, they'll get away with it with huge (for us but not for them) fines. Do you know what GlaxoSmithKline motto is? "A leading healthcare Company that helps people to do more, feel better and live longer". Congratulations!!!!!

Another one: many pharmacists "provide" doctors with rooms for their practices for free. In exchange for what?

 

[steenkh]

Another one: many pharmacists "provide" doctors with rooms for their practices for free. In exchange for what?

That would be illegal in Denmark.

 

[fls]

They certainly do in Denmark where they get a fee for every prescription they issue. But I do not think they get more out of prescribing more pills than fewer pills. Probably the way forward for them is to ask the patient to come for a renewed prescription more often.

Apart from a few dispensing practices, no NHS doctors can profit from over-prescribing.

The nation with the highest per capita drug use is Japan, and the last I heard all the doctors were dispensing practices so did profit from prescribing. So it's more of a problem in the east.

Fls - How can doctors profit from prescribing? In 2003 the news headlines in all the Italian media: " One Hundred Million Euros a Year to Buy 3,000 Doctors" . "Travel, Gifts, Bribes (Money) to doctors who prescribed (over-prescribed) Glaxo Drugs. 72 More People Sued for Corruption (Glaxo managers).
In 2006 the headlines were: "Ban Sought for Eight Pharmaceutical Companies (GlaxoSmithKline one of them) on a Gigantic Scam to the Italian NHS" (a multi-million EUR fraud). I let you immagine the damage these "gentlemen" (doctors too) did to patients. Moreover, with their actions, they damaged the reputation of conventional Medicine and honest doctors and boosted NCMs (Non Conventional Medicines). Even worse is that, with all the money they have, they'll get away with it with huge (for us but not for them) fines. Do you know what GlaxoSmithKline motto is? "A leading healthcare Company that helps people to do more, feel better and live longer". Congratulations!!!!!

Another one: many pharmacists "provide" doctors with rooms for their practices for free. In exchange for what?

Thanks for the answers. You would be open to discipline from the relevant licensing body (including the loss of your license to practice medicine), and civil and criminal charges for those practices in the US and Canada. It's disappointing to see practices allowed that create the potential for an obvious conflict of interest.

Linda

 

[Phytotherapist]

Steenkh - I guess in Denmark it would be also illegal for the biggest Company not to pay a single cent in taxes. In Italy the biggest (in net profits) Company is Mafia and they don't pay a single cent in taxes. A Sicilian Provincial "Ordine dei Medici", the doctors professional body, was accused of having made payments to Mafia.They deny: more work for our Courts. In UK the problem is "NHS funding of Homeopathy", in Italy "NHS funding of Mafia". The worst thing (for the World) is that the Italian NHS is second (after France) in world ranking. And what about our (Italian) corrupted Football: we are the World Champions! Don't you think that there is something wrong with our World?

Fls - I would be very happy to have your Laws (and Judges) in these circumstances. But I would also like to know how can your Country spend 2 Trillion $ and having such a bad health system (according to "Sicko").

 

[fls]

Fls - I would be very happy to have your Laws (and Judges) in these circumstances. But I would also like to know how can your Country spend 2 Trillion $ and having such a bad health system (according to "Sicko").

Don't look to me to defend the US health care system!

Linda