Sensible doctors do not believe drug company marketing.
I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin.
On Friday, I had a drug company representative attempt to tell me ( he was hanging around my coffee area ) about the joys of Targin, a fixed-dose combination of oxycodone and naloxone. I gently shook him off, and directed him to my secretary.
Drug company representatives are usually decent human beings with lives and families. However they are poorly educated, poorly informed salesmen and women with sales targets to meet and product managers to keep happy. Even worse, they and the drug company have no accountability if a patient dies because of their recommendations. If avoidable death supervenes or if there are non-lethal complications or even just therapeutic failure, I am accountable.
Instead of relying on marketing, I rely on information from good, well performed randomised controlled studies published in reputable peer reviewed journals ( I like the NEJM ) and on meta-analyses of these. I view the results of these through a filter of scepticism, cynicism, pragmatism and a modicum of hope.
Many of my colleagues do likewise. I trust that you do the same in your respective vocations. Regrettably, there is a bell curve. I am sure that the drug companies find enough gullible prescribers out in the wild for their purposes.
"The Journal‘s reporting suggests that Theranos had been falsifying lab records to make it look like its own proprietary gear was as reliable as the industry standard.
Documents from health care inspectors also seem to show that this kind of stuff was happening.
School is only incidentally about education.
For instance, never underestimate the power of networking at a elite private school.
A few random stories, all true:
A client of mine is global <role_deleted_to_protect_anonymity> director of a multi-billion dollar Scandinavian corporation largely because a school friend knew a few board members.
A friend obtained deep access to a person, considered to be among the five most powerful people in his country, due to his school network.
Another friend was contacted by a school friend and helped him to land a job in an elite investment bank despite the lack of any relevant experience.
"A long-awaited Senate Intelligence Committee encryption bill would force companies to provide “technical assistance” to government investigators seeking locked data, according to a discussion draft obtained by The Hill."
Dyson is the Bose of vacuum cleaners, excelling in hyping their products to the gullible.
By doing that, they perform a number of valuable functions. They return profits to shareholders; they keep their staff employed ;they part the proverbial fool from his money.
"In April and May 2015, a test to measure prostate-specific antigen, or PSA, failed quality-control checks 22% of the time. The PSA test is used to help detect prostate cancer."
Ouch....
I see a string of class action suits in the future.
"Apple's reasonable technical assistance shall accomplish the following three important functions:
(1) it will bypass or disable the auto-erase function whether or not it has been enabled;
(2) it will enable the FBI to submit passcodes to the SUBJECT DEVICE for testing electronically via the physical device port, Bluetooth, Wi-Fi, or other protocol available on the SUBJECT DEVICE and
(3) it will ensure that when the FBI submits passcodes to the SUBJECT DEVICE, software running on the device will not purposefully introduce any additional delay between passcode attempts beyond what is incurred by Apple hardware.
Apple's reasonable technical assistance may include, but is not limited to: providing the FBI with a signed iPhone Software file, recovery bundle, or other Software Image File ("SIF") that can be loaded onto the SUBJECT DEVICE.
The SIF will load and run from Random Access Memory and will not modify the iOS on the actual phone, the user data partition or system partition on the device's flash memory. The SIF will be coded by Apple with a unique identifier of the phone so that the SIF would only load and execute on the SUBJECT DEVICE.
The SIF will be loaded via Device Firmware Upgrade ("DFU") mode, recovery mode, or other applicable mode available to the FBI. Once active on the SUBJECT DEVICE, the SIF will accomplish the three functions specified in paragraph 2. The SIF will be loaded on the SUBJECT DEVICE at either a government facility, or alternatively, at an Apple facility; if the latter, Apple shall provide the government with remote access to the SUBJECT DEVICE through a computer allowing the government to conduct passcode recovery analysis.
If Apple determines that it can achieve the three functions stated above in paragraph 2, as well as the functionality set forth in paragraph 3, using an alternate technological means from that recommended by the government, and the government concurs, Apple may comply with this Order in that way."
I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin.
On Friday, I had a drug company representative attempt to tell me ( he was hanging around my coffee area ) about the joys of Targin, a fixed-dose combination of oxycodone and naloxone. I gently shook him off, and directed him to my secretary.
Drug company representatives are usually decent human beings with lives and families. However they are poorly educated, poorly informed salesmen and women with sales targets to meet and product managers to keep happy. Even worse, they and the drug company have no accountability if a patient dies because of their recommendations. If avoidable death supervenes or if there are non-lethal complications or even just therapeutic failure, I am accountable.
Instead of relying on marketing, I rely on information from good, well performed randomised controlled studies published in reputable peer reviewed journals ( I like the NEJM ) and on meta-analyses of these. I view the results of these through a filter of scepticism, cynicism, pragmatism and a modicum of hope.
Many of my colleagues do likewise. I trust that you do the same in your respective vocations. Regrettably, there is a bell curve. I am sure that the drug companies find enough gullible prescribers out in the wild for their purposes.