Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.
It used to be so simple. Yes, we had to cope with deception in marketing. Commercial sponsors of clinical research were known to manipulate the research, and even suppress research with results unfavorable to them. Key opinion leaders spun medical education and the media. But it was all releatively straightforward in some senses. It was all at least mostly based on medical knowledge and
Traditionally, the American examples we have seen of the revolving door involved people leaving leadership positions in governmental bodies which regulate health care or make health care policy then soon obtaining jobs in the health care industry, particularly organizations which they previously regulated or were affected by the policies they made, the outgoing revolving door. These examples
Evidence-based medicine (EBM) is about medical-decision making based on critical review
of the best applicable evidence from clinical research informed by
knowledge og biology and medicine, of the patient's biopsychosocial
circumstances, the patient's values, and of ethics and morality. Advocating EBM, and evidence-based health care, public health, and health policy was sometimes slow going,
Introduction: The Issues Ignored by Discusisons of Health Care Reform
After the failed attempt to "repeal and replace" the Affordable Care Act (ACA, Obamacare) in 2017, we summarized what we thought were the main issues that traditional discussions of health care reform in the US (and sometimes in other countries) did not address.Despite some protestations to the contrary (e.g., here), the US
Why are seemingly good people complicit with bad things? In health care, we have seen seemingly good health care professionals and academics silent in the face of manipulation and suppression of clinical research; deception, attacks on free speech and the press, silencing of whistleblowers; conflicts of interest; ill-informed, incompetent, self-interested leadership; and outright corruption and
In these last few weeks, the US news has been dominated by the release of a redacted verion of the Mueller report which included extensive evidence of questionable behavior by President Trump, his campaign, and various Trump associates. This week, an editorial in Mother Jones suggested:
The Russia scandal was never, in the main, about whether the president would be prosecuted for a crime. It
I have long been a proponent of evidence-based medicine (EBM), and evidence-based health care, public health, and health policy. EBM, for example, is about medical-decision making based on critical review of the best applicable evidence from clinical research informed by knowledge og biology and medicine, of the patient's biopsychosocial circumstances, the patient's values, and of ethics and
I am old enough to remember having measles as a child, a thoroughly unpleasant experience. Some children had much unhappier results of measles than I did. So as a parent, I was happy to see that a reasonably effective measles vaccine had practically eliminated the disease from the US and most developed countries.
However, we currently are in the midst of a measles outbreak in the US. The
Transparency, honesty, and collaboration are necessary to do science, including biomedical and clinical science right. In the US, the National Institutes of Health (NIH) have always had a good reputation for transparency, honesty and collaboration, although they have had some revolving door and conflict of interest issues of late (look here, here, here here, and here).
However, an April 3
There is now never a dull moment at the Center for Medicare and Medicaid Services (CMS) an agency of the US Department of Health and Human Services (DHHS). Its current director, Seema Verma, has developed a more efficient way to combine conflicts of interest with self-interest, bad management, and possibly worse.
Outsourcing CMS Communications to Private Public Relations Firms