Boston docs on debate over cholesterol screening for kids

A couple of Boston-area docs weigh in on charges of industry influence in the debate over whether to test kids for cholesterol.  From the Globe:

CHICAGO — Should all US children be tested for high cholesterol? Doctors are still debating that question months after a government-appointed panel recommended widespread screening that would lead to prescribing medicine for some kids.

Fresh criticism was published online Monday in the journal Pediatrics by researchers who say the guidelines are too aggressive and were influenced by panel members’ financial ties to drug makers.

… Other criticism was published earlier this year in the Journal of the American Medical Association. …JAMA included additional criticism from a dissenting member of the panel that produced the kids’ cholesterol guidelines, Dr. Matthew Gillman of Harvard Medical School. He recommends more narrow screening based on family history of cholesterol problems.

… Dr. Sarah De Ferranti, an American Academy of Pediatrics spokeswoman and director of preventive cardiology at Boston Children’s Hospital, said the question should be part of a conversation parents should have with their pediatrician about heart disease risks, including weight, blood pressure, and lifestyle. She said she would have her children tested.

Most of the Peds articles are behind the pay wall. But, UCSF put out a press release on the latest comments. And the NIH guidelines are online.

From NIH: Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents

From UCSF: New lipid screening guidelines for children overly aggressive, UCSF researchers say recommendations fail to weigh benefits against potential harms

Recent guidelines recommending cholesterol tests for children fail to weigh health benefits against potential harms and costs, according to a new commentary authored by three physician-researchers at UCSF.

Moreover, the recommendations are based on expert opinion, rather than solid evidence, the researchers said, which is especially problematic since the guidelines’ authors disclosed extensive potential conflicts of interest.

The guidelines were written by a panel assembled by the National Heart, Lung and Blood Institute (NHLBI) and published in Pediatrics, in November 2011. They also were endorsed by the American Academy of Pediatrics. The guidelines call for universal screening of all 9 to 11-year-old children with a non-fasting lipid panel, and targeted screening of 30 to 40 percent of 2 to 8-year-old and 12 to 16-year old children with two fasting lipid profiles. Previous recommendations called only for children considered at high risk of elevated levels to be screened with a simple non-fasting total cholesterol test.

The call for a dramatic increase in lipid screening has the potential to transform millions of healthy children into patients labeled with so-called dyslipidemia, or bad lipid levels in the blood, according to the commentary by Thomas Newman, MD, MPH, Mark Pletcher, MD, MPH and Stephen Hulley, MD, MPH, of the UCSF Department of Epidemiology and Biostatistics and e-published on July 23 in Pediatrics.

“The panel made no attempt to estimate the magnitude of the health benefits or harms of attaching this diagnosis at this young age,” said Newman. “They acknowledged that costs are important, but then went ahead and made their recommendations without estimating what the cost would be. And it could be billions of dollars.”

Some of the push to do more screening comes from concern about the obesity epidemic in U.S. children. But this concern should not lead to more laboratory testing, said Newman.

“You don’t need a blood test to tell who needs to lose weight. And recommending a healthier diet and exercise is something doctors can do for everybody, not just overweight kids,” he said

The requirement of two fasting lipid panels in 30 to 40 percent of all 2 to 8-year olds and 12 to 16 –year- olds represents a particular burden to families, he said.

“Because these blood tests must be done while fasting, they can’t be done at the time of regularly scheduled ‘well child’ visits like vaccinations can,” said Newman. “This requires getting hungry young children to the doctor’s office to be poked with needles on two additional occasions, generally weekday mornings. Families are going to ask their doctors, ‘Is this really necessary?’ The guidelines provide no strong evidence that it is.”

The authors note that the panel chair and all members who drafted the lipid screening recommendations disclosed an “extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments.” Some of those relevant relationships include paid consultancies or advisory board memberships with pharmaceuticals that produce cholesterol-lowering drugs such as Merck, Pfizer, Astra Zeneca, Bristol-Myers Squibb, Roche and Sankyo.

“The panel states that they reviewed and graded the evidence objectively,” said Newman. “But a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles.”

Evidence is needed to estimate health benefits, risks and costs of these proposed interventions, and experts without conflicts of interest are needed to help synthesize it, according to Newman. He said that “these recommendations fall so far short of this ideal that we hope they will trigger a re-examination of the process by which they were produced.”

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Newman and Hulley have no disclosures. Pletcher has NIH funding to support research on targeting of cholesterol-lowering medications to prevent cardiovascular disease.

New Yorker: Former NEJM editor dismisses placebo claims

Arnold Relman writes in this week’s New Yorker.  He argues that researchers claiming placebos can cure are driven by ”substantial financial support for their anti-establishment views”  from NIH and private donors. From the letter’s page:

There is simply no evidence that physical diseases, such as cancer,  atherosclerosis, or organ disorders, can be cured or measurably improved by  placebos. Experienced physicians know that sympathetic concern and reassurance  can often allay subjective symptoms—at least temporarily—but only appropriate  medical treatment has a chance of curing physical disease. I suspect that the  main reason advocates of “alternative medicine” like Kaptchuk are receiving such  a friendly reception in many leading medical schools these days is that there is  substantial financial support for their anti-establishment views from one part  of the National Institutes of Health and from a few very wealthy private donors.

ProPublica: Does industry money influence medical professional societies?

 The investigative journalists at ProPublica offer a report on drug and device industry support for the Heart Rhythm Society,  which describes itself at “the leading professional group representing the allied specialties of cardiac pacing and cardiac electrophysiology, the Society plays an important role not only in education, but also as an intermediary between government regulatory agencies and its members.”

 The story notes that:

Nearly half the $16 million the heart society collected in 2010 came from makers of drugs, catheters and defibrillators used to control abnormal heart rhythms, the group’s website disclosed.

Officials of the Heart Rhythm Society say industry money does not buy influence and is essential to developing new treatments. Still, on Thursday the group unveiled a formal policy that, among other things, requires more detailed disclosure of board members’ industry ties.

The also story reports that many of the Heart Rhythm Societies board members are” paid speakers or consultants for the companies, one holds stock, and the outgoing president disclosed research ties, according to the society’s website, which does not specify how much they receive.”

Among the group:  Mark Estes, director of the New England Cardiac Arrhythmia Center at New England Medical Center reported receiving less than $10,000 consulting fees or honoraria from  Boston Scientific  and  less than$10,000 in fellowship funds from  Boston Scientific,  Medtronic, Corp. and St. Jude Medical in 2010.

For a bit of history see: “The relationship between the medical industry and health care charities: A challenge for journalists.” It seems not much has changed since 2005.

 Read the full story here:

 Financial Ties Bind Medical Societies To Drug and Device Makers

SAN FRANCISCO — From the time they arrived to the moment they laid their heads on hotel pillows, the thousands of cardiologists attending this week’s Heart Rhythm Society conference have been bombarded with pitches for drugs and medical devices.

St. Jude Medical adorns every hotel key card. Medtronic ads are splashed on buses, banners and the stairs underfoot. Logos splay across shuttle bus headrests, carpets and cellphone-charging stations.

At night, a drug firm gets the last word: A promo for the heart drug Multaq stood on each doctor’s nightstand Wednesday.

Who arranged this commercial barrage? The society itself, which sold access to its members and their purchasing power.

Last year’s four-day event brought in more than $5 million, including money for exhibit booths the size of mansions and company-sponsored events. This year, there are even more “promotional opportunities,” as the society describes them.

Concerns about the influence of industry money have prompted universities [3] such as Stanford and the University of Colorado-Denver to ban drug sales representatives from the halls of their hospitals and bar doctors from paid promotional speaking.

Yet, one area of medicine still welcomes the largesse: societies that represent specialists. It’s a relationship largely hidden from public view, said David Rothman, who studies conflicts of interest in medicine as director of the Center on Medicine as a Profession at Columbia University.

Professional groups such as the Heart Rhythm Society are a logical target for the makers of drugs and medical devices. They set national guidelines for patient treatments, lobby Congress about Medicare reimbursement issues, research funding and disease awareness, and are important sources of treatment information for the public.

Dozens of such groups nationwide encompass every medical specialty from orthopedics to hypertension.

“What you’re exploring here is the subtle ways in which the companies and professional societies become partners and — wittingly or unwittingly — physicians become agents on behalf of the interests of the sponsoring company,” said Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic.

“It has a not very subtle effect on medicine,” said Nissen, an expert on the impact of industry money.

‘This is our business’

Nearly half the $16 million the heart society collected in 2010 came from makers of drugs, catheters and defibrillators used to control abnormal heart rhythms, the group’s website disclosed.

Officials of the Heart Rhythm Society say industry money does not buy influence and is essential to developing new treatments. Still, on Thursday the group unveiled a formal policy that, among other things, requires more detailed disclosure of board members’ industry ties.

“This is our business,” said Dr. Bruce Wilkoff, the incoming society president. “We either get out of the business or we manage these relationships. That’s what we’ve chosen to do.”

The society is one of a handful of groups that make public details about their finances. Most don’t. As non-profits, they must disclose their tax returns but not their specific sources of funding.

Sen. Charles Grassley, R-Iowa, requested the information [5] from the Heart Rhythm Society and 32 other professional associations and groups that promote disease awareness and research.

Their responses and reporting by ProPublica showed wide disparities in money the groups accept from medical companies, what they disclose and how they manage potential conflicts of interest.

With billions of dollars at stake, companies can court entire specialties by helping to bankroll doctors’ groups. The Heart Rhythm Society’s 5,100 members represent a particularly lucrative market.

One implantable cardioverter defibrillator — a device that jolts the heart back to a normal beat — can cost more than $30,000. A single electrophysiologist, a physician specializing in heart-rhythm disorders, can implant dozens a year. World sales of the devices totaled $6.7 billion last year, according to JPMorgan.

All the defibrillator manufacturers are at this week’s conference, including market leaders Medtronic, Boston Scientific and St. Jude Medical, which together gave the society $4 million last year.

These companies and others not only provided financial support to Heart Rhythm but paid many of its board members: Twelve of 18 directors [6] are paid speakers or consultants for the companies, one holds stock, and the outgoing president disclosed research ties, according to the society’s website, which does not specify how much they receive.

Board members at other medical societies have similar arrangements. The American Society of Hypertension does not post disclosures on its website, but records provided to Grassley show that 12 of its 14 board members had financial ties to medical companies.

Grassley, the top Republican on the Senate Judiciary Committee, said these groups commonly say the money doesn’t affect what they do, but he has doubts. “I don’t think it’s believable,” he said. “There are a lot of incestuous relationships that really bother me.”

Big Booths Boost Devices

As competition among cardiac-device makers has intensified, so have questions about whether their products are being used and marketed appropriately.

In January, a study in the Journal of American Medical Association found that more than one in five patients [7] who received cardiac defibrillators did not meet science-based criteria for getting them.

Weeks later, the Heart Rhythm Society disclosed it was assisting a U.S. Justice Department investigation [8] of the issue.

Two of the society’s biggest funders — Boston Scientific and St. Jude Medical — have paid millions since 2009 to settle federal allegations that they improperly paid kickbacks to unidentified physicians to use their cardiac devices. Neither company admitted wrongdoing.

Top sponsor Medtronic also has disclosed to shareholders that the Department of Justice is investigating the advice it gave purchasers on how to bill Medicare for defibrillators and payments it made to buyers of the devices.

In a statement, Medtronic said societies play an important role in educating physicians about their devices. Boston Scientific declined to comment, and St. Jude did not respond to questions.

At this week’s conference, Medtronic is front and center [9] with a 12,000-square-foot booth to demonstrate its products and allow physicians to examine them.

Medtronic spent $543,000 at last year’s meeting on a similar exhibit, part of $1.6 million it paid to prominently display its name around the conference and fund educational grants. The Minnesota device maker also paid unspecified speaking or consulting fees to eight of the society’s 18 board members.

…Through the years, groups such as the Heart Rhythm Society have expanded the range of sponsorships they offer to drug and device makers. Companies can now fund Wii game rooms or put their names on conference massage stations and on the shirts of the masseuses.

Some deals give companies more than name exposure. Last month, the American College of Cardiology attached tracking devices to doctors’ conference ID badges [13]. Many physicians were unaware that exhibitors had paid to receive real-time data about who visited their booths, including names, job titles and how much time they spent.

Dr. Westby Fisher, an Evanston, Ill., electrophysiologist, called the practice “Tag and release.” [14] College officials say they’ll do a better job of notifying doctors next year.

Attendees at the Rhythm Society conference also have tracking badges. Society officials say exhibitors are not getting doctors’ personal information.

Two years ago, the American Society of Hypertension teamed with its biggest donor, Daiichi Sankyo [15], to create a training program for drug company sales reps. The society says about 1,200 Daiichi reps have graduated — at a cost of $1,990 each — allowing them to put the “ASH Accreditation symbol” on business cards.

In fiscal 2009, Daiichi gave the society more than $3.3 million — more than 70% of its total industry funding — according to financial records it provided Grassley. Daiichi makes four hypertension drugs.

“I think it’s an obscenity,” said former ASH president Michael Alderman, professor emeritus at Albert Einstein College of Medicine in New York City. “I can see how it would play out in the doctor’s office: ‘I’m a Daiichi sales rep. But let me tell you something: The American Society of Hypertension is backing me.’”

Alderman and some other prominent members of the group quit after a dispute in 2006 about industry influence.

Current ASH President George Bakris said the training program is science-based and doesn’t focus on specific drugs. The reps “ought to know what they are talking about,” he said.

The 1,900-member group has revised its policies since 2006, he said. Financial conflicts disclosed by board members, however, are available only to members, who must request them in writing and explain why they want them [16], according to the group’s conflict of interest policy.

A Question of Influence

Bakris and leaders of several other professional groups say industry funding is essential for much of what they do. It reduces conference registration fees, subsidizes the cost of continuing medical education courses and provides money for disease awareness.

Dr. Jack Lewin, chief executive of the American College of Cardiology, said the money is helping build registries of cardiac procedures [17] that track side effects and flag whether physicians are using devices in the right patients.

The “circus element” of the exhibit booths doesn’t unduly influence attendees, Lewin said. “I don’t buy a soft drink just because of the advertising… I buy it because I like it.”

Researchers say companies are not spending millions solely for altruistic reasons. “If it weren’t influencing the doctors, they wouldn’t be doing it,” said Dr. Gordon Guyatt, a health policy expert at McMaster University in Ontario.

There are fledgling efforts to push medical societies toward stricter limits on industry funding: 34 groups have signed a voluntary code of conduct calling for public disclosure of funding and limits on how many people on guideline-writing panels have industry ties.

“The general feeling is that the societies need to be independent of the influence of companies,” said Dr. Norman B. Kahn Jr., chief executive of the Council of Medical Specialty Societies, which helped draft the code.

Grassley, too, is continuing his efforts to make the groups publicly accountable. In initial responses to his December 2009 request for information, some said they planned to post financial information on their websites. This week, the senator followed up with letters to some groups, asking why they hadn’t done so.

He hopes the political pressure succeeds: “You might conclude that maybe they don’t want to give the information out because it might be embarrassing.”

Multimedia

Related Story:
Heart Society’s Tip Sheets Fail To Mention Risks

Related Story:
The Heart Rhythm Society Responds to ProPublica’s Questions

Related Story:
Medical Groups Shy About Detailing Industry Financial Support: Read the background or see the documents.

Tracking the Money

• Our Dollars for Docs Database
  We compiled tens of thousands of records from all the companies that have disclosed their payments to doctors so far. Search for your physician.
  May 5, 2011: We are currently adding the latest records to our database; expect to see an update in the coming weeks.

 

Globe:More transparency needed from Harvard on misconduct

In a staff editorial, The Globe calls on Harvard to offer more information about the scientific misdeeds of  one of its star psychology researchers. For more on the case and other local news on scientific misconduct, click here for Nature Network Boston post.  

THERE’S CLEARLY something wrong with some of Harvard psychology professor Marc Hauser’s research, including an influential but now retracted 2002 paper on whether monkeys can learn rules and patterns. But neither the scholar nor the university is explaining the flaws in his work in any detail. This oblique approach might help Hauser and Harvard save face in the short term, but it avoids the duty that both have to the cause of open scientific inquiry.

Lots of New England in the NE Journal of Medicine

The latest NEJM includes lot of New Englanders:

Researchers from Harvard asked – What motivates “whistleblowers” who report health care fraud?

This study identified several commonalities in whistle-blowers’ experiences. Generally, whistle-blowers’ first move was to try to address problems internally; they became litigators either accidentally (while pursuing other claims) or as a last resort. The most prevalent motivations reported were personal values and self-preservation rather than financial incentives. These findings provide a number of useful insights into the qui tam mechanism as a tool for addressing health care fraud.

MIT’s Jonathan Gruber comments on costs.

In summary, analysis by both the Congressional Budget Office and the CMS actuary show that the ACA (Affordable Care Act) will substantially reduce the federal deficit, only slightly increase national medical spending (despite an enormous expansion in insurance coverage), begin to reduce the growth rate of medical spending, and introduce various new initiatives that may lead to more fundamental reductions in the long-term rate of health care cost growth. The ACA will not solve our health care cost problems, but it is a historic and cost-effective step in the right direction.

Jon Kingsdale from the Commonwealth Connector  on health insurance exchanges.

I believe in exchanges’ potential to help manage competition. But I’m a realist: I know that controversies will arise over their proper function and mission. The opponents of change will try to hobble exchanges, market skeptics will try to convert them into purely regulatory schemes, and even when exchanges succeed in increasing transparency and demand for value, other critical links must be forged in the supply chain of managed competition. After all, an accessible, customer-friendly, easy-to-use market is still only as good as the products it offers. Whether an insurance exchange looks more like a Walmart than a flea market will depend on whether doctors organize themselves into efficient, patient-responsive systems of care. In the United States, reforming the organization and delivery of medical care has always been the biggest challenge in the struggle to produce better care at sustainable cost.

 

A team led by folks from the Dartmouth Institute for Health Policy and Clinical Practice asks – in places where patient receive much more care that usual, are the patients sicker or are they being overtreated?

To address this question, we followed Medicare beneficiaries for 2 years before and 3 years after a move and found that a move to a region with a higher intensity of practice as compared with a move to a region with a lower intensity of practice was associated with greater increases in diagnostic testing, the number of recorded chronic conditions, and HCC risk scores, with no apparent survival benefit.”

Partners limits questionable moonlighting for docs

The New York Times reports:

Senior officials at the two hospitals, Massachusetts General and Brigham and Women’s Hospitals in Boston, must limit their pay for serving as outside directors to what the policy calls “a level befitting an academic role” — no more than $5,000 a day for actual work for the board. Some had been receiving more than $200,000 a year. Also, they may no longer accept stock.

Criticism has been mounting in recent years as the conflicting roles of some medical leaders have been disclosed through Congressional investigations, lawsuits and reports in the news media. Those disclosures have raised questions about bias and the cost and quality of patient care at the nation’s medical institutions.

enior faculty in leading teaching hospitals are in high demand on medical product boards, but corporate filings show that Partners and Harvard Medical have a disproportionate share.

The story points out that Dr. Samuel O. Thier was president of Partners when he was named to the Merck board in 1994. He is now retired from Partners.

Dr. Joseph B. Martin, dean of the Harvard Medical School from 1997 to 2007, was named to the board for Baxter International in 2002. Dr. Thier and Dr. Martin each receive over $200,000 a year from the corporate boards.

Dr. Martin, a professor of neurobiology, declined to comment. Dr. Thier did not return calls seeking comment.

For more on medical conflict of interest and research integrity, click here.

Senate hearing: Industry support for medical education

Lots of locals at Thursday’s Senate hearing on health care industry support for continuing medical education (CME) for doctors.

Click here for the video.

From the U.S. Senate Special Committee on Aging web site.

Dr. Eric Campbell, Associate Professor at Harvard University, discussed the Institute of Medicine’s (IoM) recent study on conflict of interest in medical research, education, and practice.

Jack Rusley, a fourth year medical student (at Brown) and the Chair of the Culture of Medicine at the American Medical Student Association (AMSA) provided information on the AMSA Scorecard and its methodology for ranking medical schools’ policies on transparency in medical education, as well as his personal experience as a student advocate for reform.

 Dr. Thomas Stossel, Professor at Harvard University and Director of Translational Medicine at Brigham Women’s Hospital, offered testimony concerning the newly formed Association of Clinical Researchers and Educators (ACRE), which contends that restricting industry funding of education programs would be counterproductive and may ultimately harm both patients and the practice of medicine.

BHN exclusive: Relman on ACRE conflict of interest meeting

During his 14 years as editor of the New England Journal of Medicine – most of the 80’s and some change – Dr. Arnold S. Relman often commented on the influence of money on medicine. He still doesn’t like it. BHN noticed him at last week’s meeting of Association of Clinical Researchers and Educators (ACRE) “an organization of medical professionals dedicated to the advancement of patient care through productive collaboration with industry and its counterparts.”  (See previous blog post about the meeting.)

So, we asked for his thoughts about the presentations. Here they are:

“I sat through the whole program, which was a sustained diatribe against conflict-of-interest regulations rather than a scholarly, balanced discussion of the issues. There was practically no time for audience questions or comments, but instead an almost unrelenting barrage of ideological and anecdotal criticism of what was said to be a misguided “belief system” that worries excessively over relations between industry and the medical profession. There was an occasional informative and reasonable contribution, but for the most part sarcasm and anger prevailed.

 

The heavily industry-related audience loved the performance, but the obviously biased, self-serving, and often grossly flawed presentations should have embarrassed the organizers. Although neither Harvard Medical School nor the Brigham & Women’s Hospital sponsored or formally endorsed the meeting, the HMS Dean did give the initial welcoming remarks, and the Hospital offerred its facilities for the event. One can only hope that they are now having second thoughts.”

 

here are some other reports on ACRE and the meeting: Policy and Medicine, Postscript and The Carlat Psychiatry Blog. 

BHN Exclusive: Mass gift ban takes a beating from ACRE

Thursday’s inaugural meeting of the Association of Clinical Researchers and Educators drew a full house to the Bornstein Amphitheater at Brigham and Women’s Hospital.  Members of the group believe that disclosure rules and gift bans for doctors – like the one that just went into effect in Massachusetts –  are too strict.  The meeting program describes the issue this way:

Under mounting pressure from interest groups, the media, and select government officials, academic medical centers have begun adopting restrictive conflict of interest policies that often sever productive relationships between industry and physicians involved in clinical research and educational outreach.

(See this Globe story for  background on the topic or click on the “research integrity” category to the left. Critics of industry support for academic researchers say it creates to conflicts of interest. Supporters believe it encourages innovation. )

So, with portraits of notable BWH doctors looking down on them, researchers, lawmakers and industry reps made a lot of jokes about the corrupting influence of pens with drug company logos. A sampling of the speakers found that they ranged from measured and informative to shrill and angry.

This from a session on the Massachusetts gift ban, which prohibits drug and device companies from marketing products by courting doctors with high end meals, Red Sox tickets and four-star travel.  

–State Representative Michael J. Rodrigues, vice chairman of the legislature’s Committee on Public Service, said doctors need to be more involved in fighting the laws like the state’s gift ban law.

“I was very happy with the support I got from industry. But throughout the debate I was wondering – where are the physicians. “

–Sarah Elisabeth Curi, a lawyer with the Mass Medical Society, explained the new law and said the law will focus on industry compliance, not doctors.

 “No physician in Massachusetts is going to be arrested for not complying with the law”

Click here for her powerpoint.

–Dr. Carey D. Kimmelstiel, head of clinical cardiology at the Tufts University School of Medicine talked about the benefits of having clinicians give industry-sponsored talks. Preparing the talk educates the speaker. He or she gets feedback and an audience of busy docs gets a quick update.

 Audio:

  Kimmelstiel argues that the rules have tamed some excesses.

 But, he worries they go too far.

 

– Dr. Henry R. Black  Hypertension Division, New York University Medical Center, President, American Society of Hypertension :On Value of Collaboration to Medical Training Programs & Professional Associations

Audio: Part 1, Part 2

There were also a few supporters of conflict rules and gift bans in the crowd, including former NEJM editor Arnold Relman, who offered post meeting comments. The American Medical Student Association– a group worried about conflicts  of interest for industry-funded professors  – also sent a few people. Nitin Roper, a University of Connecticut medical student, had this to say about the meeting.

   

Roper ACRE

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Finally, here are some other reports on ACRE and the meeting: Postscript,  The Carlat Psychiatry Blog and Policy and Medicine

 

What patients should know about marketing of meds: May 14 MIT event

FROM MIT:

Many of us take daily medications for conditions such as high cholesterol or hypertension, but in the face of constant advertising of prescription medications, it’s easy to wonder: is there something newer and better I should be taking? Physician panelists at “Ask Your Doctor”… Medications, Marketing and Safety on May 14 will share their experiences as they tackle this common patient question.

William M. Kettyle, M.D., medical director at MIT Medical, will moderate the panel consisting of Marcia Angell, M.D., former editor-in-chief of the New England Journal of Medicine and senior lecturer in Harvard Medical School’s Department of Social Medicine; and Leslie Jackowski, M.B.B.S. (M.D.), visiting scholar on Harvard’s Faculty of Arts and Sciences who has developed programs to educate physicians about appropriate prescribing practices.

The session, which is free and open to the public, takes place on Thursday, May 14 from 4–6 p.m. in the Tang Center (Building E51). A question-and-answer period will follow the panel, which is part of the Catherine N. Stratton Lecture Series on Aging Successfully.