Naked Medicine

Let's Face It: Medicine is Business

Category: Activism & Advocacy

Can Doctors Practice Preventive Medicine and Still Make a Living?

The mission of MDVIP is to change primary care practice in America by allowing their member doctors to practice medicine the way that MDVIP believes that medicine should be practiced: by focusing on prevention and empowering patients. According to a press release from the company in a landmark deal with Procter & Gamble, its business model is based on “exceptional doctors, exceptional care, and exceptional results.” (more…)

Google Healthcare Ads and False Claims

Jeanne Sather has written a longer response to my post on Google Coop for Health. Instead of leaving it as a “comment” I’ve decided to post it here as an article, because she has raised an important issue about Google Ads, which this site uses. By the way I’d love to use blogads, if I can get an invite from someone, because I’ve written them several times and haven’t heard a peep from the admins.

Google has a lot to answer for in the ads that it runs on the Web. The company has been very irresponsible in carrying ads for products that are nothing more than snake oil. (more…)

Commercializing Diseases and Impotent Symbols

Jeanne Sather is an assertive cancer patient who has a gagging reflex with pink ribbons. I thought I was one of the few XX chromosomal species who can’t stand the color pink, and I’m comforted to know that Jeanne passionately detests pink, especially the shade of pink that Jeanne associates with “girly, sexist expectations.”

Her article, “It’s October–Time to Gag Me With Those Pink Ribbons” makes an important point: gross commercialization of breast cancer may send the wrong message to women and concomitantly desensitize us to the seriousness of breast cancer. Furthermore, the pink ribbon is exclusionary: men get breast cancer too. If a man with breast cancer wears a pink ribbon, I bet 9 times out of 10 he’ll get asked whether his spouse or female relative has breast cancer.

A ribbon used to work when it was a symbol unto itself, attached only to the its original cause. Now I can’t remember if a black ribbon is an activist symbol against torture or melanoma or lung cancer (lung cancer ribbon is sheer with gold, but black could be a logical lung cancer color if you think about the color of a cancerous lung). (more…)

Misleading Healthcare Ads and False Claims

Google has made astronomical profit from its advertisement programs, at least $900 million. Certainly, Google’s Adsense/Adwords services has benefitted both website publishers and businesses alike. Nakedmedicine.com takes advantage of Google’s Adsense service to display contextual (relevant) ads that Google serves up from advertisers, and when visitors click through to products and services that they are interested in, this website benefits by gaining a few cents in the “Website Operations and Maintenance” kitty. Google also serves up text-based, contextual ads next to key word search results.

When you mix free speech, lax advertising content policy enforcement, and opportunistic merchants, you come face to face with asking where the buck stops when consumers are barraged with misleading healthcare ads and false claims for miracle cures. (more…)

Mental Health System is Worse than Bad

By Robert Lamberts, M.D.

When I get discouraged about the state of the healthcare system, I but need to look in one place to see that things could be worse: the mental health system. While there remains hope that there will somehow be reform and things will get better in the arena in which I work, it is very difficult for me to see anything getting better for the Psychiatrists.

One of my staff recently had a family member have a fairly major “breakdown.” I was caring for this person, mainly due to the fact that there are not close to being enough psychiatrists available to help. I have found that as a primary care doctor, I have had to become an “amateur psychiatrist” (as I call it) and diagnose and treat people whenever possible. Some of this is due to the stigma of people going to psychiatrists, but most of it is simply due to their unavailability. This was the case with this family member, and I did my best to address the needs medically, and even offered the best counselling I could.

Yet things went from bad to worse, and she ended up needing hospitalization, as she started having paranoid ideation and was very worrisome to the family that she might harm herself or her husband. I thought she simply had to go to the teaching hospital ER and they would either admit (voluntary) or commit (involuntary) her to the psych ward. I found out that the only place where an involuntary admission can occur is the state psych hospital. This was not the case when I started practice, but due to the total lack of fianancial viability of a locked psych unit, all of the others have closed down.

Of all of the places I have worked, the scariest one for me personally was at a state psychiatric hospital. This was not only scary due to the significant pathology in the patients (the worst of the worst), but the total lack of hope in that setting. There were not the financial resources available to really help those who needed to be helped, so they all were basically held there at the state hospital. It was the most helpless set of people I have ever seen.

I am sure my picture was somewhat jaded by my dislike of the clinical rotation, but it still paints a pessimistic picture of the reality of psychiatric care. These are the most needy patients, and the ones least likely to seek out care for themselves. If there is an area of healthcare that needs to be nationalized, it is psychiatric care. These people often cannot help themselves, and lack the resources to do so even if they could. I have no idea what a national psychiatric healthcare system would look like (I fear to think of it, honestly), but I don’t see many ways that things could get worse than the current system.

To all you psychiatrists out there, you have my deepest respect.

What Open Medicine Is and Is Not

A benefit – and side effect – of Internet culture is an embrace toward access and openness. I can access an abundance of free information on the web. I’ve always embraced open source applications, like the one used to create this website, and will continue to do so as long as it’s available.

However, a potential misconception called “Open Medicine” is a side effect of the Internet culture. I do not believe most people who advocate for “Open Medicine” on the web actually understand what “Open Medicine” really means, and all the ramifications and responsibilities that come with the term. When most speak of “Open Medicine” they refer to the idea that medical information should be freely available, transparent, and credible.

I don’t argue with the concept of making healthcare information available, transparent, and credible. After all, I created www.NakedMedicine.com to provide Accessibility, Honesty, and Integrity in healthcare information.

What I oppose is the misconception built around Open Medicine. In my opinion, here is what Open Medicine is NOT:

Open Medicine is not a blogging network, even if the blogging network is composed of a team of doctors, nurses, scientists, other healthcare “experts”, or anyone who has a burning desire to voice an opinion about a particular healthcare trend or drug.

In considering what Open Medicine really is, we only need to look at the basic definition of “Open” as it relates to this Internet phenomenon:

The basic idea behind open source is very simple: When programmers can read, redistribute, and modify the source code for a piece of software, the software evolves. People improve it, people adapt it, people fix bugs. And this can happen at a speed that, if one is used to the slow pace of conventional software development, seems astonishing. Source: Open Source Initiative.

In other words, Open Medicine can work only when we are allowing access to what is considered proprietary information or intellectual property, for the expressed purpose to enable collaboration to improve and innovate upon this “open” information. (more…)

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