healthy4u: Kalman Applbaum

How Terrible Health IT (And Other Healthcare Toxic Waste) Gets Pushed on Naïve and Malleable Physicians, Hospital Executives and Governments

Over at "<a href="http://brodyhooked.blogspot.com/">Hooked: Ethics, Medicine, and Pharma</a>", University of Texas Medical Branch at Galveston (UTMB) Institute for the Medical Humanities professor <a href="http://www.utmb.edu/imh/faculty.asp?FacID=53">Howard Brody MD, PhD</a> offers a fascinating piece "<a style="font-weight: bold;" href="http://brodyhooked.blogspot.com/2010/06/how-does-drug-industry-exert-power.html">How Does the Drug Industry Exert Power? An Anthropological Perspective</a>." The piece is based on writings of of <a href="http://www4.uwm.edu/letsci/anthropology/faculty/applbaum.cfm">Kalman Applbaum</a>, of the Department of Anthropology, University of Wisconsin-Milwaukee, and summarizes how the drug industry achieves its aims in today's society. In Prof. Brody's post: <blockquote>... Applbaum begins by teaching us marketing neophytes about "channels." Marketing drugs is highly complicated because there's no direct pipeline from the manufacturer to the end-user. Lots of folks control and manipulate the pathway that delivers the drug eventually to the mouth or body of the patient--most notably the physician who has to write the prescription, but also insurance companies, government regulators, managers of hospital formularies, and numerous other players. The key to selling drugs successfully today is first, to be able to control the channel: "Pharmaceutical manufacturers, like other marketing-driven enterprises, have realized that it is less in the product, the brand or even the patent where their fortunes lie, but in the stream, the marketing channel. Once you control the channel, you can insert any product you like into it, no matter how useless or dangerous." [Such as grossly <a href="http://sydney.edu.au/engineering/it/%7Ehitru/index.php?option=com_content&task=view&id=91&Itemid=146">unfit for purpose</a>, clinically disruptive, <a href="http://www.tinyurl.com/hostileuserexper">mission hostile</a> healthcare IT - ed.] But, if Rule One is control the channel, Rule Two is not to appear obviously to do so. </blockquote> Read the entire post at the above link. The observation that "once you control the channel, you can insert any product you like into it, no matter how useless or dangerous" explains many observations about the healthcare IT industry as well, such as how reports from the U.S. <a href="http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12572">National Research Council</a> and many others (e.g., <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=2009">here</a>, <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=readinglist">here</a>, and <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=firstnet">here</a>) can simply be ignored. In the health IT industry, that "channel" is controlled, right up to the highest levels of numerous governments. Observations such at my April 2010 post "<a href="http://hcrenewal.blogspot.com/2010/04/healthcare-it-corporate-ethics-101.html">Healthcare IT Corporate Ethics 101: A Strategy for Cerner Corporation to Address the HIT Stimulus Plan</a>"; at my post just a few days later on the "disappearance" of materials cited in my above exposé, "<a href="http://hcrenewal.blogspot.com/2010/04/corporate-ethics-101-paper-and-website.html">Cerner - Fuqua School of Business 'Corporate Ethics 101' Paper and Website Disappear</a>"; and at my Jan. 2010 post "<a href="http://hcrenewal.blogspot.com/2010/01/more-on-perversity-in-hit-world.html">More on Perversity in the Healthcare IT World: Is Meditech Employing Sockpuppets?</a>" (where I exposed a likely industry shill through IP forensics), among others, can be placed better into context as components of "controlling the channel" for health IT, and not appearing obvious in doing it. Physicians especially need to re-learn the mantra "Critical thinking always, or your patient's dead" of my late mentor, cardiothoracic surgery pioneer Victor Satinsky MD. Medical schools also should be developing and teaching courses in how the healthcare industries attempt to "control the channel." These issues go far beyond the mere "tension management" issues of forbidding students, residents and attending physicians from accepting coffee cups, lunches, stethoscopes or other gifts of nominal value from the industry. -- SS

How Terrible Health IT (And Other Healthcare Toxic Waste) Gets Pushed on Naïve and Malleable Physicians, Hospital Executives and Governments

Over at " Hooked: Ethics, Medicine, and Pharma ", University of Texas Medical Branch at Galveston ( UTMB) Institute for the Medica...

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