Here is Peter’s most recent piece in The Daily Caller:
When the government talks to your doctor, who’s listening?
By Peter Pitts
4/22/2011
The government goes to great lengths to control what those who speak with physicians can say to physicians. This is done out of concern that industry representatives have an agenda that could nefariously and inappropriately influence doctors. But what happens when the government starts talking to physicians? Who will be there to make sure that the government’s agenda doesn’t influence the doctor — especially when that agenda is cutting costs, not saving lives?
Under one of the less-noticed provisions in the 2009 stimulus bill, the United States government will, for the first time, start advising doctors directly on how they should treat patients — a process known as “academic detailing.”
This raises two major concerns: what will the government advise? And what rules will govern the interaction between government representatives and physicians?
Many within the medical community are concerned that academic detailing will focus on cutting government healthcare costs — an outcome that will reduce patient outcomes and quality of care.
Academic detailing is intended to communicate the findings of government-sponsored comparative effectiveness research (CER), but the government has been silent about the kinds of research projects the government will fund. In fact, it is not clear whether academic detailing will focus on clinical effectiveness researchor comparative effectiveness research.
Clinical effectiveness measures outcomes on an individual patient level to improve understanding of how different patients respond to different treatments. This type of research helps inform doctor-patient discussions, and enables better individual outcomes. Comparative effectiveness research, on the other hand, measures outcomes on a system-wide level to compare drugs against each other. This type of research does not take patient differences into account. It prioritizes treatments that work for the most people at the lowest cost, even if for some people, they don’t work at all.
