Sales pitch and presents
If you accept gifts from drug reps, you probably don't believe it influences your prescribing habits. But all the evidence suggests that it does, says Breen, as he urges doctors to recognise that they are not immune from drug marketing (→ The medical profession and the pharmaceutical industry: when will we open our eyes?).
Another, less studied, area is the relationship between drug companies and medical students. Rogers et al discuss how to address the potential effects of pharmaceutical gift-giving on students, including the innovative "PharmFree" strategy of the American Medical Student Association (→ The ethics of pharmaceutical industry relationships with medical students).
Finally, what do the students themselves think? As Hutchinson, President of AMSA (the Australian Medical Students' Association) points out, their debate is so hot it sizzles! (→ Pharmaceutical companies and medical students: a student’s view)
Sex, politics, religion . . .
And PSA testing should all be on the list of what not to talk about at your next dinner party, considering the brouhaha that ensued last year when the head of Australia’s peak cancer body made public his thoughts about undergoing the test. In “PSA testing in general practice: can we do more now?”, Pinnock reports on the Australian Prostate Cancer Collaboration’s workshop on PSA and informed choice.
Acromegaly, Cushing’s disease and other pituitary syndromes can have florid presentations, but there are also subtle symptoms and signs and gentler management strategies than have previously been available, say Hurley and Ho (→ MJA Practice Essentials — Endocrinology. 9: Pituitary disease in adults).
An academic invitation
If you read the BMJ you may know that the BMJ Publishing Group has launched an international campaign to promote academic medicine. What’s it all about and how can you become involved? The editorial by Tugwell is being published in a number of journals around the world to recruit for the cause (→ The campaign to revitalise academic medicine kicks off).
All about Barrett’s
As about one in 20 people with Barrett’s oesophagus develop oesophageal cancer, there is a policy of endoscopic screening of this population. Twenty years of experience at two endoscopy units in Canberra has provided a natural experiment (Hillman et al, “Proton-pump inhibitor therapy and the development of dysplasia in patients with Barrett’s oesophagus”) as to whether proton pump inhibitors reduce the occurrence of dysplasia or cancer. But Hebbard and Nandurkar warn against jumping the gun on chemoprevention (→ Managing Barrett’s oesophagus).
A bit tough?
By the time you read this, a special Senate committee will have delivered its findings on the proposed Disability Discrimination Amendment Bill, which, if enacted, will make it legal to discriminate against illicit drug users who are not under treatment. In “Is lawful discrimination against illicit drug users acceptable?” Wodak et al debate whether this a good way to make sure people with drug problems seek treatment, or whether it’s all about looking "tough on drugs" in an election year.
This essential trace element, which has more often raised concerns about toxicity than depletion, is now being recognised as playing an important role in several biological processes, including immune function and cancer protection (Daniels, “Selenium: does selenium status have health outcomes beyond overt deficiency?”). Spurred on by concerns that our population is becoming less selenium replete, Lyons et al compared selenium levels in South Australian blood donors at several points between 1977 and 2002 (→ Trends in selenium status of South Australians).
Let the games begin
Are your ward round pearls of wisdom greeted with blank looks? Do your underlings quake when you come out with one of your curly questions? Help is on its way. A new series, Teaching on the run, begins in this issue. To kick it off, Lake gives an overview of the learning process (→ Teaching on the run tips: doctors as teachers), while Greenberg and Elliott explain why the series is sorely needed (→ Tested teaching tips).
It’s the commonest cause of hospitalisation in young babies, and we're about to enter the season when this illness is most prevalent. So take some time to read Fitzgerald and Kilham’s Clinical Update (→ Bronchiolitis: assessment and evidence-based management).
Starting in 2000, a Queensland Health project sought to raise the quality of care delivered to cardiology patients in public hospitals. From Scott et al’s description and early evaluation of the project, it wins the "most improved" prize in this issue (→ Multisite, quality-improvement collaboration to optimise cardiac care in Queensland public hospitals).
Another time ... another place...
Academicians expect too much of academic medicine. They wish for the gentility of the academician of yesteryear, the income of the cardiovascular surgeon, and the kudos of the molecular biologist who clones a new gene (provided that it is the right one, of course), and they complain if they don't get all of it.
Robert G Petersdorf, 1981
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