Saturday, September 20, 2008


When I graduated in 1975, I was so idealistic, that all of us doctors have the Hypocratic oath to guide us, and that we will treat patient to the best of our ability, not for monetary gains, but to help a fellow human being. I was so impress that my teachers would sacrifice time and energy to teach us so that we can care for those who are sick better.
When I entered the " real world", especially in the 21st century, medicine is so commercialized. I would like to share two examples.
Dr Richard Peto of Oxford ( someone whom I admire ), was recently asked whether his comments that there is no link between the increase incidence of cancers with the use of Vytorin ( a drug to lower LDL-Cholesterol, made by Schering Plough and co-marketed with MSD ), was because of the amount of money that MSD and Schering Plough, had given to his institution, for their research and projects. Apparently, since 1995, Dr Richard Peto's unit ( the Clinical Trials Service Unit ) had received 105 million pounds, from MSD and Schering Plough. This must surely constitute a severe conflict of interest when you have to comment on an MSD / Schering Plough product. I understand that Dr R Peto, had been knighted. Even the best have their problems.
Recently the US senate committee on Aging convene a committee meeting to examine the recent trend of Direct-to-Consumer ( DTC ) advertisement in USA, especially with the use of medical devices like stents, orthopedic prosthesis, neuro-prosthesis, and so on. Apparently, in USA last Nov, before an American football game, Johnson n Johnson sponsored an advertisement on the Cypher stent in the commercial channel. This has sparked the debate of whether it is proper to have DTC advert.? You could argue that it will empower the consumer to better understand devices, and so make better choices when discussing with their physicians. You could also argue that these DTC adverts are usually bias to the manufacturers advantage, plays up the good points and play down the bad. And are consumers able to understand all the fine details?
Well, what is happening in the first world will soon come to us to. What ever, it is true that medicine is now highly commercialized, and maybe that is why the government has come out with regulations in the Private Healthcare Facilities and Services Act and Regulations. However, much as I am involved in fine tuning the Regulations, I do not believe that regulations will reduce commercialism in medicine. Somehow, I still believe that you cannot legislate morality. The inner values of good and bad, and our value systems is in each of us. How good or how bad I want to be, is in me.

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