Comments on: How slippery is this slope? http://www.medrants.com/archives/2435 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: R.G. Lacsamana, M.D. http://www.medrants.com/archives/2435/comment-page-1#comment-33166 R.G. Lacsamana, M.D. Mon, 11 Jul 2005 17:15:11 +0000 http://medrants.com/archives/2005/07/11/how-slippery-is-this-slope/#comment-33166 This arrangement also gives me the heebie-jeebies. The very nature of the deal should raise red flags all over medical centers with residency programs, no matter what controls have been put in place to avoid conflicts of interest. At a time when trust in physicians already has been damaged from revelations about their various conflicts of interest, it's foolhardy to keep engaging in endeavors that only tend to taint our public image further. I find it hard to accept that the sponsors of this pilot program are doing it out of benevolence rather than from speculation into lucrative future profits. While the money being doled out may be a pittance, when compared to the drug companies' humongous profits, I don't find this arrangement any different when the same companies pay physicians for trips to exotic places for meetings, or for so-called consultations. These practices are now barred. Here is another problem: Dermatology is not the only area with a dearth of specialists. There are shortages of primary care physicians, general surgeons, neurologists, neurosurgeons, and obstetricians. In fact, there is a shortage of physicians in general, with more physicians needed to meet the medical needs of Americans as the population keeps burgeoning and as the boomers begin to swell the Medicare ranks. Are we to dismiss established ethical barriers and allow companies to sponsor our educational efforts knowing they will deal with the same people they will be making profits from in the future? I'm quite certain the public would reject such scenario. The lack of money to expand current programs in a number of specialties has been a problem for sometime. I should know; back in 1964, when I applied to three medical centers for a spot in Dermatology, I was told that positions have been reserved two to three years in advance, which left me no choice except to proceed to my next favored specialty - Internal Medicine. It amazes me we see the same problem after 41 years. I think the AAD needs to examine the situation further and come up with a funding mechanism that would not raise hackles in the public and medical community. Another option would be to add just one slot for every residency program in Dermatology, which would not be much of a financial burden in those centers sponssoring these programs. This would probably add more dermatologists than the pilot program being envisioned. Did you say slippery slope? This would be the fastest way for post-medical education in this country to slide downhill. This arrangement also gives me the heebie-jeebies. The very nature of the deal should raise red flags all over
medical centers with residency programs, no matter what controls have been put in place to avoid conflicts of interest.

At a time when trust in physicians already has been damaged from revelations about their various conflicts of interest, it’s foolhardy to keep engaging in endeavors
that only tend to taint our public image further. I find it hard to accept that the sponsors of this pilot program are doing it out of benevolence rather than from speculation into lucrative future profits. While the money being doled out may be a pittance, when compared to the drug companies’ humongous profits, I don’t find this arrangement any different when the same companies pay physicians for trips to exotic places for meetings, or for so-called consultations. These practices are now barred.

Here is another problem: Dermatology is not the only area with a dearth of specialists. There are shortages of
primary care physicians, general surgeons, neurologists,
neurosurgeons, and obstetricians. In fact, there is a shortage of physicians in general, with more physicians needed to meet the medical needs of Americans as the population keeps burgeoning and as the boomers begin to swell the Medicare ranks. Are we to dismiss established ethical barriers and allow companies to sponsor our educational efforts knowing they will deal with the same people they will be making profits from in the future? I’m quite certain the public would reject such scenario.

The lack of money to expand current programs in a number of specialties has been a problem for sometime. I should know; back in 1964, when I applied to three medical centers for a spot in Dermatology, I was told that positions have been reserved two to three years in advance, which left me no choice except to proceed to my next favored specialty – Internal Medicine. It amazes me we see the same problem after 41 years.

I think the AAD needs to examine the situation further and come up with a funding mechanism that would not raise hackles in the public and medical community. Another option would be to add just one slot for every residency program in Dermatology, which would not be much of a financial burden in those centers sponssoring these programs. This would probably add more dermatologists than the pilot program being envisioned.

Did you say slippery slope? This would be the fastest way for post-medical education in this country to slide downhill.

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