Major parts of the US government may be shut down over a dispute about health care reform legislation made law several years ago, but Health Care Renewal (http://hcrenewal.blogspot.com), written by volunteers and (barely) funded by individual contributions, soldiers on....
Round and Round Spins the Revolving Door, Unimpeded by "Obamacare," Nor By Those Protesting "Obamacare"In which I found many recent examples of how government officials who regulate health care and legislators who make health care policy have become interchangeable with lobbyists and health care industry insiders. Can we trust officials and legislators to put patients' care and the health of the population first when they are looking over their shoulder at those who might provide them lucrative employment opportunities in the private sector? While there is a battle raging over the recent US health care reform legislation, currently resulting in a partial government shutdown, neither the opponents or proponents of this reform legislation seem concerned about the potential for corruption provided by the "revolving door." To truly improve health care we must attack such obvious conflicts of interest.
Vested Interests and Their Influence on Physicians- New Understanding from Cognitive and Social PsychologyA long time ago, some of your Health Care Renewal bloggers were active participants in research on how physicians' human cognitive limitations made it difficult for them to make judgments and decisions consistent with the best evidence from clinical research Now a paper by Sah and Fugh-Berman showed how physicians' cognitive limitations can enable rationalizations that favor continuing relationships between physicians and industry. For example, ego or self-serving bias allows physicians to deny their personal susceptibility to bias due to financial relationships, while acknowledging that other physicians might be so biased. In addition, the paper demonstrated how marketers of pharmaceutical marketers and presumably of other health care products and services can use social psychological principles to enable manipulative and deceptive practices as well as conflicts of interest. For example, the principle of reciprocity means that deliberate creation of even small conflicts of interest by marketers can lead to favorable results: even small gifts create the need for reciprocity, and the easiest way for physicians to reciprocate is to prescribe drugs favored by the gift giver. (Do physicians ever think of inviting drug reps to lunches to reciprocate for the lunches given them? ;-) ) While much thought about cognitive and social psychology went into the creation of marketing schemes, health care professionals are not educated about how psychology may be used to manipulate and deceive them. Such education ought to be a part of true health care reform.
InformaticsMD made an interesting analogy between the distracting effect of dealing with computerized devices while driving and the likely effect of dealing with other computerized devices while taking care of patients.