Minute Clinic Controversy

From MSNBC:

The growth of clinics in retail stores comes amid a shortage of family physicians that only promises to worsen.

Medical groups predict a shortage of 200,000 doctors in the United States by 2020. About 20 percent of Americans live in areas with a shortage of primary medical care, according to PricewaterhouseCoopers.

Wal-Mart operates 78 in-store clinics in 13 states, where the cost of a “get well” visit ranges between $40 and $65.

About half of those surveyed who visit Wal-Mart clinics have no insurance, according to spokeswoman Deisha Galberth. Another 15 percent said if there had not been a clinic, they would have gone to an emergency room instead.

As far as I'm concerned, if it offers an affordable alternative to the overloaded Emergency Rooms, than it is a good thing.

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E-Prescriptions In the North

Electronic drug prescriptions can be delivered to pharmacists in all 50 states for the first time this week as Alaska became the final state to join the technological bandwagon.

In the past year, Georgia, South Carolina and West Virginia have all joined the national network, and the change in Alaska regulations means doctors' hieroglyphic handwriting and prescription pads could soon be a thing of the past.

Dick Holm, a member of the state Board of Pharmacy, said the process took so long to get to Alaska because "we're a small state and we address things as they come up." He said the change was not mandated by the federal government.

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It may be legal, but I've never seen it.

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Crazy Coumadin

Widely used blood thinner warfarin will come with new instructions explaining that people with certain genes may need a lower dose to take the drug safely, U.S. health officials said on Thursday.

The change is part of a move toward personalized medicine in which doctors tailor treatment based on genetic makeup, the Food and Drug Administration said.

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I'm not sure of the cost effectiveness of a genetic test to figure out a dose of coumadin. When the medication is started in the hospital, with daily PT/INR monitoring, and reasonable dosing, patients really shouldn't become hypertherapeutic.

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So Why Bring It Up?

The popular heartburn drugs Prilosec and Nexium do not appear to spur heart problems, according to preliminary U.S. and Canadian probes announced yesterday.

The Food and Drug Administration and its Canadian counterpart, Health Canada, began reviewing the drugs, used by tens of millions of people, in May, when manufacturer AstraZeneca provided them an early analysis of two small studies that suggested the possibility of a risk.

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All of this excitement about today's purple pill.

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Zinc Out: No Cure For Common Cold

A new study, published online in advance of the Sept. 1 issue of Clinical Infectious Diseases, reviews 14 placebo-controlled studies from the past two decades and finds significant fault with 10 of the studies. Of the four other studies, three reported no therapeutic effect from zinc lozenges or nasal spray, and one study reported positive results from zinc nasal gel.

“The best scientific evidence available indicates that zinc lozenges are not effective in treating colds,” said Jack M. Gwaltney, Jr., MD...

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At least the cherry flavored lozenges taste pretty good!

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Pyxis @ Home

The U.S. Food and Drug Administration has cleared for marketing the INRange Systems' Electronic Medication Management Assistant (EMMA), a programmable device that stores and dispenses prescription medication for patients' use in the home.

Essentially a computerized medication box, EMMA was designed to be used under the supervision of a licensed health care provider. EMMA can reduce drug identification and dosing errors, and allow health care professionals to monitor patient adherence to medication regimens in an outpatient setting. It may be especially useful for aging patients, as well as those with complex medication regimens such as patients with HIV.

"FDA's clearance of the INRange remote medication management system puts an important safety tool directly in the hands of patients and their health care providers," said Daniel Schultz, M.D., director of FDA's Center for Devices and Radiological Health. "It will help take away some of the confusion patients can experience when taking prescription medications, and allow care providers to more closely monitor their patients' medications between office visits."

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Not So Lethal Injection

From Fox News:

The drugs used to execute prisoners in the United States sometimes fail to work as planned, causing slow and painful deaths that probably violate constitutional bans on cruel and unusual punishment, a new medical review of dozens of executions concludes.

Even when administered properly, the three-drug lethal injection method appears to have caused some inmates to suffocate while they were conscious and unable to move, instead of having their hearts stopped while they were sedated, scientists said in a report published Monday by the online journal PLoS Medicine.

No scientific groups have ever validated that lethal injection is humane, the authors write. Medical ethics bar doctors and other health professionals from taking part in executions.

The study concluded that the typical "one-size-fits-all" doses of anesthetic do not take into account an inmate's weight and other key factors. Some inmates got too little, and in some cases, the anesthetic wore off before the execution was complete, the authors found.

We Say: They use a combination of a barbituate, pancuronium, and potassium. The first two drugs are very commonly used in anesthesia, and the last throughout the hospital. If there is this concern, the simple answer is to simply give more.

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Fill the Script!

From MSNBC.com:

Druggists who believe “morning-after” birth control pills are tantamount to abortion can’t stand in the way of a patient’s right to the drugs, state regulators have decided.

In a unanimous vote Thursday, the state Board of Pharmacy ruled that drug stores have a duty to fill lawful prescriptions despite an individual pharmacist’s personal objections to any particular medication.

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We Say: The last time I checked, the Docs wrote the scripts, and the pharmacists fill them. Why are they reinventing the wheel here? Then again, couldn't the pharmacist with an objection simply not stock a particular medication at their pharmacy?

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