Leisure, Lifestyle & Wellness
Why you should care about the drugs your doctor prescribes
Patients currently have to rely on trust that their doctors prescribe them the right drugs. ProPublica’s new tool, Prescriber Check-up, for the first time allows patients to see how health care providers stack up with peers
This article was co-published in the Op-Ed pages of the Los Angeles Times. 
Your doctor hands you a prescription for a blood pressure drug. But is it the right one for you? 
You’re searching for a new primary care physician or a specialist. Is there a way you can know whether the doctor is more partial to expensive, brand-name drugs than his peers? 
Or say you’ve got to find a nursing home for a loved one. Wouldn’t you want to know if the staff doctor regularly prescribes drugs known to be risky for seniors or overuses psychiatric drugs to sedate residents? 
For most of us, evaluating a doctor’s prescribing habits is just about impossible. Even doctors themselves have little way of knowing whether their drug choices fall in line with those of their peers. 
Once they graduate from medical schools, physicians often have a tough time keeping up with the latest clinical trials and sorting through the hype on new drugs. Seldom are they monitored to see if they are prescribing appropriately — and there isn't even universal agreement on what good prescribing is. 
This dearth of knowledge and insight matters for both patients and doctors. Drugs are complicated. Most come with side effects and risk-benefit calculations. What may work for one person may be absolutely inappropriate, or even harmful, for someone else. 
Antipsychotics, for example, are invaluable to treat severe psychiatric conditions. But they are too often used to sedate older patients suffering from dementia — despite a “black-box” warning accompanying the drugs that they increase the risk of death in such patients. 
The American Geriatrics Society has labeled dozens of other drugs risky for elderly patients, too, because they increase the risk of dizziness, fainting and falling among other things. In most cases, safer alternatives exist. Yet the more dangerous drugs continue to be prescribed to millions of older patients. 
And, as has been well-documented by the Los Angeles Times and others, powerful painkillers are often misused and overprescribed – with sometimes deadly consequences. 
As reporters who have long investigated health care and exposed frightening variations in quality, we wondered why so much secrecy shrouds the prescribing habits of doctors. 
The information certainly isn’t secret to drug companies. They spend millions of dollars buying prescription records from companies that purchase them from pharmacies. The drugmakers then use the data to target their pitches and measure success. 
But when we tried to purchase the records from the companies that supply them to drug manufacturers, we were told we couldn't have them — at any price. 
We next turned to Medicare, a public program that provides drug coverage to 32 million seniors and the disabled and accounts for one out of every four prescriptions written annually. 
We filed a Freedom of Information Act request for prescribing data. After months of negotiation with officials, we were given a list of the drugs prescribed by every health professional to enrollees in Medicare’s prescription drug program, known as Part D. 

What we found was disturbing. Although we didn’t have access to patient names or medical records, it was clear that hundreds of physicians across the country were prescribing large numbers of dangerous, inappropriate or unnecessary drugs. And Medicare had done little, if anything, about it. 
One Miami psychiatrist, for example, wrote 8,900 prescriptions in 2010 for powerful antipsychotics to patients older than 65, including many with dementia. The doctor said in an interview that he’d never been contacted by Medicare. 
A rural Oklahoma doctor regularly prescribed the Alzheimer's drug Namenda for patients under 65 who did not have the disease. He told us it was because the drug helped calm the symptoms of autism and other developmental disabilities, but there is scant scientific support for this practice. 
Among the top prescribers of the most-abused painkillers, we found many who had been charged with crimes, convicted, disciplined by their state medical boards or terminated from state Medicaid programs for the poor. But nearly all remained eligible to prescribe to Medicare patients. 
If you or a loved one were a patient of one of these doctors, wouldn’t you want to know this? 
We have now taken the data and put it into an online database that allows anyone to look up a doctor's prescribing patterns and see how they compare with those of other doctors. 
This information is just a start. It can't tell you if your doctor is doing something wrong, but it can give information that allows you to ask important questions
For instance, why is your doctor choosing a drug that his peers seldom do? Does your doctor favor expensive brand-name drugs when cheaper generics are available? Has your doctor been paid to give promotional talks for drug makers? 
And we’d like to see the day when all prescribing by all health professionals – not just in Medicare – is a matter of public record. 
It’s not only patients who benefit when medicine is more transparent. Doctors too can gain by comparing themselves to their peers and to those they admire. Clinics can see how their staffs stack up. And researchers can track patterns and examine why doctors prescribe the way they do. 
One doctor told us that after studying our online database, he cornered his colleagues and peppered them with questions about their prescribing. Most, he said, were surprised when he told them their drug tallies. 
Many aspects of doctors’ practices remain private. The number of tests they order and procedures they perform. The number of times they make mistakes. These data could help inform the public, too. 
In the meantime, arming yourself with prescribing information allows you to be more active in your health care or that of an aging or disabled loved one. 
Courtesy: ProPublica.org




4 years ago

Do we have any similar website for India?

Ramesh Iyer

4 years ago

It's a pity this once-noble profession of medical practice has become so commercialized that even General Physicians routinely prescribe expensive antibiotics and such, when they could avoid prescribing them (considering their side-effects). Besides, referring to specialists and having a dozen tests done at a "designated" pathological lab has become a flourishing business. Much like the education sector, the healthcare sector is dominated by businessmen rather than those with passion for these professions. Such a shame !

SEBI to revamp delisting norms for cos

“We have already started the process of relooking at it (delisting regulations)... The work is going on delisting regulations,” said UK Sinha, SEBI chairman

Having revamped buyback, minimum public shareholding and takeover norms, market regulator Securities and Exchange Board of India (SEBI) is now set to overhaul delisting regulations for companies.


SEBI has already started the process of a relook at the existing delisting norms.


“We have already started the process of relooking at it (delisting regulations)... The work is going on delisting regulations,” said UK Sinha, SEBI chairman.


The capital market regulator has already overhauled norms pertaining to share buyback, minimum public shareholding, preferential allotment and takeovers.


Speaking at a conference in New Delhi on venture capital and private equity, Sinha said the market regulator has also received some suggestions about how the process of reverse book building is allegedly being misused by certain sections.


He also said the government would take a decision on “put and call options” shortly.


“The government procedure is taking a little time but I am quite assured that the government is going to take a call on that very shortly,” he added.


“Put and call options” given to any strategic investor in a company is a routine business globally. Such a provision in shareholder agreements gives the investor an option to either sell the shares (put option), or to buy more shares (call option) on a future date.


To a query on co-ordination between various regulators, the SEBI chief said the issue has been gaining attention worldwide especially since 2008 financial crisis.


“My own impression is that so far as the regulators of financial sector are concerned, now there is a very strong mechanism in place... The FSDC discusses issues related to financial stability and cooperation (among regulators),” he noted.


The Financial Stability and Development Council is a grouping of regulators which was set up by the government.


Peak power deficit narrows to 4.5% in June: CEA

According to the latest data by the CEA, peak power deficit—shortfall in generation during the time when consumption is maximum—for the month of June stood at 4.5% (5,729 MW) of the total demand

Power scenario in the country improved last month as the demand-supply gap narrowed to 4.5% in June this year from 6.3% in May.


According to the latest data by the Central Electricity Authority (CEA), peak power deficit—shortfall in generation during the time when consumption is maximum—for the month of June stood at 4.5% (5,729 MW) of the total demand.


This figure is better than the previous month’s deficit of 6.3% or 8,597 MW.


The demand for electricity in June stood at 1,28,612 MW, of which 1,22,883 MW was met.


Peak power shortage in the southern region nearly halved to 7% in June from 14.3% in May this year.


In terms of megawatts, deficit was to the tune of 5,339 MW in May and 2,353 MW in June.


In the three-month period (April-June), the southern region registered a peak power deficit of 16.7% or 6,508 MW.


Western region, comprising Chhattisgarh, Gujarat, Madhya Pradesh, Maharashtra, Daman & Diu, Dadra and Nagar Haveli and Goa, posted a deficit of 2.5% or 909 MW in June.


The region witnessed the least peak power deficit of 1.8%, or 693 MW, during the April-June period.


Electricity shortage in the eastern region (Bihar, Jharkhand, West Bengal, Odisha, etc) was 2.3% or 351 MW in June and overall shortage of 3.4% or 532 MW during the first three months starting April, this year.


North India logged a peak power deficit 1,915 MW or 4.6%. The northern region suffered an overall shortage of 4.4% or over 1,882 MW during the April-June period, the data showed.


North-eastern region comprising Assam, Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland and Tripura reported a deficit of 9.6% or 201 MW in June. It witnessed a peak power deficit of 9.6% in three months from April to June, this year.


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