Here is an interesting blog about Ethics, Medicine, and Pharm.

Here's an interesting blog about Ethics, Medicine, and Pharm. It is written by a medical doctor, Howard Brody, M.D., Ph.D., who is an academic and an ethicist. Commendably, he is not ambiguous in his criticisms of the pharmaceutical industry and of their payments to greedy doctors who, for payment, compromise their integrity by lending their names and reputations to recommend drugs and medical devices unworthy of recommendation.

NHS family doctors are being paid thousands of pounds not to send their patients to hospital for specialist treatment

Doctors paid thousands not to send patients to hospital for treatment
Report in the Sunday Telegraph

Extract:

"Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.

Under one scheme, GPs stand to gain £59 for every patient not referred to hospital, if they cut an average referral rate by between two and eight per cent.

Torbay care trust in Devon will pay up to £15,000 to the average-sized GP practice if it hits a swathe of targets, including reducing hospital referrals.

NHS managers say referral rates, which rose 16 per cent nationwide during the first quarter of this year, have to be cut to save money. They claim many patients can receive equally good care from community NHS staff, such as physiotherapists and nurses.

But critics fear that patients could suffer if GPs' decisions are swayed by the prospect of a cash bonus.

A leading surgeon said that patients' cancers had already gone undiagnosed after they were denied specialist care under two such "referral management" schemes.

Orthopaedic surgeon Stephen Cannon, former president of the British Orthopaedic Association and a consultant surgeon at the Royal National Orthopaedic Hospital, described the cases as an "absolutely terrible" warning that decisions by non-specialist doctors could have devastating consequences.

He said: "I recently encountered two cases in which patients referred to physiotherapists later turned out to have a malignant tumour. If they had been sent to a consultant the outcome may have been very different.

"In one case a young man was referred to a physiotherapist because of sudden knee pain. Had he come to a specialist the symptoms should have been recognised and he should have been urgently referred to an oncologist. In this case, after the delays, the outcome was amputation. It was devastating for the patient and his family."

Dozens of practices across London, Essex, Oxfordshire, Devon and Wiltshire have signed up for schemes which pay GPs up to £4.50 for every patient on their list if they hit targets, including a target to reduce the proportion of patients they send to hospital.

The average family doctor, with a patient list of about 2,000 patients, stands to make between £6,000 and £9,000 if they achieve all the targets, on top of a performance-related pay system which already gives the average GP an income of £110,000."

New GP contracts have delivered "eye watering" pay rises for doctors, while some services to patients have declined, a damning report by MPs says.

GPs given 'eye watering' pay rises for less work, say MPs
Article in the Telegraph

Extract:

"Family doctors' hours have been cut and their productivity has fallen at the same time as some received up to 58 per cent salary increases, according to the Commons Public Accounts Committee.

The Department of Health's failure to properly estimate how much the deal would cost has also led to an overspend of £1.8 billion, the report says.

MPs on the committee also criticise the newly introduced system to link GP pay to performance, which its says allowed family doctors to earn salaries much greater than expected.

Controversy has surrounded the new contracts since they were introduced in 2004.

They were widely criticised for handing GPs large pay rises at the same time as allowing them to opt out of out-of-hours cover.

The report also attacks the contracts for failing to significantly improve access to GP services or increase the number of family doctors in deprived areas.

Edward Leigh, the committee's chairman, said that the new deal "has so far failed to live up to expectations".

"Partners in GP practices are now putting in less time and their productivity has decreased. Only their pay is burgeoning, having increased on average by an eye-watering 58 per cent since 2003," he added."

The incompetence of the Department of Health never fails to amaze. They are certainly no match for the medical profession's skilled negotiators...)o:

Italian police have arrested 13 doctors from a private hospital in Milan who allegedly performed unnecessary surgery to claim more insurance money.

Milan doctors performed unnecessary surgery for insurance cash
Article in the Telegraph

Extract:

"At least five patients at the Santa Rita clinic in Milan died after operations that were not needed, investigators said. The former lawyer of the clinic was also arrested.

According to investigators, the entire team of surgeons from the clinic's thoracic team were involved in the fraud.

Colonel Riccardo Rapanotti, a police spokesman, said the operations were "useless, damaging, ill-considered and inexplicable given the cases of the patients". The surgeons performed 10 lung transplants allegedly in order to cure tuberculosis.

One 92-year-old woman was operated on three times in seven months and died under the knife."