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René Árpád Spitz (1887 – November 11, 1974) was an American psychoanalyst of Hungarian origin.
Biography Edit
Rene Spitz was born in Vienna and died in Denver, Colorado. From a wealthy Jewish family background, he spent most of his childhood in Hungary. After finishing his medical studies in 1910 Spitz discovered the work of Sigmund Freud. In 1932 he left Austria and settled in Paris for the next six years. and taught psychoanalysis at the Ecole Normale Superieure. In 1939 he emigrated to the United States and worked as a psychiatrist at the Mount Sinai hospital from 1940 until 1943, Spitz served as a visiting professor at several universities before settling in Colorado. He based his observations and experiments on psychoanalytic findings, developed by Freud. We still find some of Freud's ideas in our present contemporary developmental thinking. Where Freud did psychoanalytic studies in adulthood, Spitz based his ideas on empirical research in infancy.
It was in 1935 that Spitz turned to the area of child development. He was one of the first researchers who used child observation. Not only disturbed children found his interest, but he also focused on the normal child development. He pointed out the effects of maternal and emotional deprivation. This became the field of his greatest contributions.
Spitz valued several aspects: Infant observation and assessment, anaclitic depression, hospitalism, developmental transitions, the processes of affective communication, and understanding developmental complexity.
Spitz developed the term 'anaclitic depression' for partial emotional deprivation (the loss of a loved object). When the love object is returned to the child within a period of three to five months, recovery is prompt. If one deprives a child longer than five months, they will show the symptoms of increasingly serious deterioration. He called this total deprivation (hospitalism).
In 1945 he did research on hospitalism in children in a foundling home. He found that the developmental imbalance caused by the unfavourable environmental conditions during the children's first year produces a psychosomatic damage that cannot be repaired by normal measures. An other study of Spitz showed that under favourable circumstances and adequate organisation a positive child development can be achieved. He stated that the methods in foundling homes should therefore be carefully evaluated.
Spitz recorded his research on film. The film Psychogenic Disease in Infancy (1952) shows the effects of emotional and maternal deprivation on attachment. The film was the cause of major change, especially in childcare sections of institutes, homes and hospitals, due to the fact that people gained knowledge about the impact of deprivation on child development.
Spitz died in Denver.
Ego developmentEdit
Spitz noted three organising principles in the psychological development of the child:
- the smiling response, which appears at around three months old in the presence of an unspecified person;
- anxiety in the presence of a stranger, around the eighth month;
- semantic communication, in which the child learns how to be obstinate, which the psychoanalysts connect to the obsessional neurosis.
Books and articles Edit
- Spitz, R.A. (1957). No and yes : on the genesis of human communication. New York : International Universities Press.
- Spitz, R.A. (1965). The first year of life : a psychoanalytic study of normal and deviant development of object relations. New York : International Universities Press.
- Spitz, R.A. (1945). Hospitalism—An Inquiry Into the Genesis of Psychiatric Conditions in Early Childhood. Psychoanalytic Study of the Child, 1, 53-74.
- Spitz, R.A. (1951). The Psychogenic Diseases in Infancy—An Attempt at their Etiologic Classification. Psychoanalytic Study of the Child, 6, 255-275.
- Spitz, R.A. (1964). The derailment of dialogue: Stimulus overload, action cycles, and the completion gradient. Journal-of-the-American-Psychoanalytic-Association, 12, 752-774.
References Edit
- Editorial (1964). René Spitz: seventy-five plus. The Journal of Nervous and Mental Disease, 139 (2), 101-102.
- Emde, R. N. (1992). Individual meaning and increasing complexity: contributions of Sigmund Freud and Rene Spitz to developmental psychology. Developmental Psychology, 22 (3), 347-359.
- Grote Spectrum Encyclopedie (1980). Uitgeverij Het Spectrum bv, Utrecht / Antwerpen.
- Spitz, R.A. (1946). Hospitalism; A follow-up report on investigation described in volume I, 1945. The Psychoanalytic Study of the Child, 2, 113-117.
- Spitz, R. A. (1965). The First Year of Life. A Psychoanalytic Study of Normal and Deviant Development of Object Relations. New York: International Universities Press, inc.
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COLUMBUS, Ohio (AP) -- Republican Josh Mandel isn't ready to write off his political future after his unsuccessful challenge to U.S. Sen. Sherrod Brown last fall in one of the most bitter, closely-watched and expensive elections in the country.
Mandel confirmed this week that he plans to seek re-election as Ohio treasurer next year.
"Obviously it's impossible to predict the future, but you know, I think the best course forward for me is just do a good job as state treasurer, which I believe we have been doing and I'll continue to do," Mandel said Thursday during a legislative preview session for journalists organized by The Associated Press.
Asked to reflect on the rancorous campaign and its potentially damaging effect on his political ambitions, Mandel rattled off a few Ohio politicians who he said bounced back after their "political obituaries" were written. He noted that George Voinovich had a double-digit loss in a 1988 Senate race before becoming governor and later U.S. senator, and that current Ohio Attorney General Mike DeWine lost a 1992 challenge to then-Sen. John Glenn but won a Senate seat two years later. DeWine lost the seat to Brown, a Democrat, in 2006.
Mandel said he's glad voters will decide whether he's re-elected treasurer, not politicians like the state party leaders.
Shortly after November's election was decided, Ohio Democratic Party chairman Chris Redfern suggested that the 35-year-old would be remembered as the candidate who chose to accept $40 million in special interest money and "wallow in the mud."
"He's six months away from appearing on Fox News as a regular analyst," Redfern said at the time. "He will join the likes of Ken Blackwell and others who will slip away into the past. And we'll recognize him from time to time as that fellow who followed Sarah Palin."
Mandel vowed in his concession speech to continue promoting government accountability, lower taxes and fiscal responsibility.
"I feel comfortable putting it in the hands of the voters," he said Thursday of re-election.
Mandel credited Brown with running "a very effective campaign" and said he blames himself, not his staff or consultants, for falling short in the race. Mandel said the election taught him that he and other Republicans must do a better job communicating with black voters and that he must be more accessible to media informing the public.
Mandel went nearly two years as treasurer without a news conference regarding the business of his office, and during that time was criticized for ignoring his official duties to attend far-flung fundraisers and campaign events.
More than half the money spent in the Senate race came from outside groups, including the U.S. Chamber of Commerce and Republican strategist Karl Rove's American Crossroads organization. The onslaught of mostly negative ads against Brown is thought to have damaged Mandel in the eyes of Ohio voters -- who favored Brown by a 6 percent margin.
Secretary of State Jon Husted, who was speaker of the Ohio House when Mandel was a fledgling state representative, sat next to Mandel during this week's panel. He chimed in with support.
"If I were the Democrats, and Josh was out there, I'd want to write his obituary, too, but a guy that ... did as well as he did, who's in his mid-30s, he's got a very bright future," Husted said.
Associated Press Writer Julie Carr Smyth contributed to this report.

subset: commoncrawl


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North Florida Regional reveals layoffs
Published: Friday, March 22, 2013 at 6:08 p.m.
Last Modified: Friday, March 22, 2013 at 6:08 p.m.
North Florida Regional Medical Center confirmed that it has laid off "less than 1 percent" of its total workforce recently but would not say how many people lost their jobs.
According to the latest published information, the hospital had about 1,700 employees.
Director of Marketing Pamela Rittenhouse said the hospital implemented a "small, planned restructure in workforce following a period review of our positions and community health-care needs."
She said the layoffs were primarily nonclinical positions and they do not anticipate any impact on patient care.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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Christmas Lights by Jean Herman
Welcome! You are browsing as a guestWould you like to see 97 projects made from this pattern and much more? create a free account What am I missing?
© knitblue19
© hannekesieben
© hannekesieben
© VinGirl
Christmas Lights
This pattern is available as a free Ravelry download
Tightly crochet each bulb for best results. : )


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It's that time of year again! Allow me the IMMENSE honor of introducing you to the 2012 Sharpie Squad! Over the past 3 years we have showcased some of our FINEST fans and this year is no different! From amazing artwork to customized sneakers and too-cool-for-school rides- these ultra-fine folks are jazzed to share how they are starting with Sharpie with you!
Scroll on down to get to know these 12 talented Sharpie fanatics and be sure to check back on the reg' for news, updates and awe-inspiring ideas straight from the Sharpie's mouth!
Aimee Alexander
At just 3-months-old Aimee traced the pattern of her grandmother's shirt with her tiny finger, and eventually moved on to crayons, finger paint, glitter and Sharpie of course! . Aimee discovered the professional art world at the age of 12 on a trip to San Francisco for a friend's graduation from fashion design school and hasn't looked back since. Aimee studied art at Sacramento State University and moved to the San Francisco bay area where she started Artisticle, a fabulous website where Aimee shares her Sharpie creations! Check it out and follow Aimee socially as spends her time coloring and participating in art shows and festivals around northern California!
Website Facebook Twitter Pinterest Blog
Alyse Dietel
Alyse grew up in San Mateo, California and started drawing when she was still in her cradle! Her mom made an art table for her when she was three and it took off from there! Alyse loves surrealism and her favorite artist is Salvador Dali. To her, art is not about drawing what you see, but creating what doesn't exist anywhere but in your mind. She balances her passion for art with her other passions which include rock climbing and the enjoying the outdoors. She's a big fan of nature, and is even currently majoring in Environmental Studies at Northern Arizona University.
Amanda Shupp
The majority of Amanda's abstract work is done with her Sharpie Paint Markers, and Sharpie Permanent Markers. She's always loved drawing with Sharpies, dating back to high school when she'd cover an entire page in her note book with drawings. These days, she sets out to cover an entire canvas, piece of paper, or table top with free flowing colorful designs. This lady doesn't plan any of her creations; she simply just goes with the flow and lets her marker guide her. Her favorites are the large scale pieces she creates and would love to cover an entire wall with her art someday! Amanda is also an avid animal lover and enjoys spending my time at the beach with her friends and, of course, her pets. Keep up with Amanda by checking in on her through social networks!
Website Facebook Pinterest YouTube Zazzle MySpace
Instagram: @imaginationartshop
Chris Dunlop
Chris Dunlop is an accomplished artist best known for his Sharpie Art Cars. Chris began as an airbrush artist and custom painter and later picked up pin-striping and Sharpie art. Many of the cars Chris has customized have been featured in publications such as Yahoo!, MSN, Sharpie.com, AutoBlog, LSX Tv, and many others. He's spent the past several years developing his skills at custom paint shops around the country and now resides in California working at CW Restoration Shop. Chris is a devoted artist that loves what he does and spends much of his time practicing his art, but also loves to skateboard and spend time with his wife, Caitlin. Wanna know more? Then take a ride through his social portfolio:
Darion Cortez
Darion Cortez is a 21-year-old aspiring shoe designer who loves to be creative and draw the crazy, wild, and fun things the dance in his mind. He has been drawing since he can remember and has loved Sharpie markers for just as long! Follow Darion in real time on Twitter!
Drew Michael
Drew Michael is a 20-year-old senior currently studying at Ohio University. He graduated with his associate's degree in graphic design and is now pursuing a bachelor's degree in studio art. Drew loves using all different types of media to create his art and works on various different surfaces – one of them being his favorite, shoes! Drew focuses on his work every day and continues to try new things with his art and learn to expand his horizons. Get to know this college cutie even better by checking out all of his channels:
John Clark
John Clark is a Michigan based portrait artist. He spends most of his time doing two things, making his wife laugh and washing Sharpie ink from his fingers. He knows a bit too much about things that won't help him in the least, like comic books, video games, and classic 80′s wrestling, and as far back as he can remember, he's been obsessed with drawing faces. Currently he creates black and white, film noir inspired, Sharpie portraits on old book pages. He's pretty sure he's the only one that does that. See his work at www.johnclark.etsy.com or at www.society6.com/johnclark.
Lauren Seal
Lauren Seal is a 21-year-old student from Bay St. Louis, Mississippi. She is a senior at Mississippi State University where she is studying to become a physical therapist once she graduates! Lauren has expressed herself through her art art for as long as she can remember and even began her education as an major! She took a Sharpie to her first pair of Converse shoes when she was in high school and has created more than twenty different pairs of canvas shoes since! Lauren values her Sharpie collection so much that she tries to use them in just about every piece of art she creates. She even used them to color a drum set once! Lauren is inspired by everything around her, and her creativity never stops and is excited to be a part of the 2012 Squad to help her to continue to grow as an artist. This sassy little lady is rockin' the social space, kick it with Lauren and follow her by clicking below!
Facebook Twitter Instagram: LaurenMarieSeal
Melissa Dalton
Melissa Dalton started her love affair with Sharpie on March 8th 2007 when she got her very first package for her birthday. She used them to draw all over, drawing cartoons and eventually, as she realized their potential, she started using them to draw psychedelic artworks and even a 70 page comic called Under the Bed. Melissa is currently enrolled at the University of Nevada, majoring in Art and she still loves drawing with Sharpie to this day, OBVIOUSLY, it's what she is here– check out all of her comic genius by checking out her sites below!
Website www.grimhalls.com www.coroflot.com/applesauce38
Sara Holt
Sara Holt is an award winning artist who works in various mediums including drawing, painting, writing, and photography. Her work is internationally published and collected and she was even a Featured Director on The Independent Film Channel for her short animated film, "In the Mourning". Check out more of Sara's work by checking where else she plays on the world wide web!
Website Facebook Twitter Deviant Art
Timothy Goodman
Timothy is a designer, illustrator, and an art director based in New York City. Currently he runs his own studio, working on a variety of design and illustration projects for clients such as the Ace Hotel, Apple Inc., New York Public Library, Newsweek, The New York Times, Time magazine, and Suntrust Bank. Previously, Timothy worked in-house at Apple Inc., where he helped integrate Apple's visual language, domestically and internationally, across third party environments, retail stores, events and campaign launches. Born in Cleveland, Ohio, Timothy graduated from the School of Visual Arts in NYC, where he now teaches. Wanna know even more about this stylin' city fella? Just get to clickin' below:
Zehra Ali
Zehra is an 18-year-old college freshman who grew up in the States, and just last year, moved to Saudi Arabia (!!!). Zehra is passionately obsessed with music, drawing much of her inspiration from it. She began creating Sharpie art as a means to express herself and used doodling as a creative outlet to purge the ideas in her head into something beautiful. With her art, Zehra hopes she is able to enlighten someone or at least bring a smile onto someone's face, which we think she does beautifully! Follow this Sharpie muse right here…
2012 is looking pretty snazzy, don't ya think?! Welcome our new Squad members by leaving a comment or question below– and you never know… next year this could be YOU!
What are you gonna' start?


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The Mystery Science Theater 3000 Crew Returns To TV With "Total Riff Off" [VIDEO]
Confession time. Thanks to YouTube and Netflix, I religiously watch old episodes of the cult TV hit 'Mystery Science Theater 3000'. If I could pick any dream job, it would be to write riffs for TV and movies. I will catch myself watching any show and I will come up with witty commentary. Mostly for self-indulgence, hey, I have to start somewhere! So when I read some of the guys from the old show would be riffing Nat Geo shows, I went nuts!


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25 Things About 'Joyful Noise' Star Keke Palmer
You first met Keke Palmer in Akeelah and the Bee in 2006; now she's all grown up and ready to take on the world in Joyful Noise. Here's everything you need to know about her!
-Lucia Peters
Remember way back in 2006 when a little movie called Akeelah and the Bee introduced the world to a huge new star? That star was 13-year-old Keke Palmer, and gee, wasn't she just the most adorable little thing! But guess what? Little Keke Palmer grew up, and boy, has she come into her own. After a successful three-year stint on Nickelodeon, Keke, now 18 years old, is set to take the screen by storm in Joyful Noise. Out on Friday, Joyful Noise co-stars Dolly Parton and Queen Latifah as two very different women who must band together when budget cuts threaten to shut down their small-town choir. Keke plays Queen Latifah's teenage daughter Olivia, an eager-to-date singer in the choir who kicks up a steamy romance with Dolly Parton's character's grandson, Randy (Jeremy Jordan). Hot!
But how much do you actually know about this shining new star? Here's a crash course in everything you need to know about Keke Palmer. Fire away!
1. Keke was born on August 26, 1993, which makes her 18. Man, that makes us feel old!
2. Her dad, Larry, works for a polyurethane company, and her mom, Sharon is a high school teacher who works with children with mental disabilities.
3. Here's a fun fact: Both of her parents have twins. It's a wonder Keke didn't end up with one as well.
4. She's originally from Illinois.
5. If you think "Keke" sounds like a nickname, you're right: Her full name is Lauren Keyana Palmer. "Keke" is a shortened version of her middle name.
6. Like most of her contemporaries, Keke is up on her Internet: She's got a Twitter, an official website, and a MySpace page.
7. Wait a minute—MySpace? Yep. MySpace may be antiquated as a social networking site, but it's still great for musicians, so that's what Keke uses it for: her music. Smart.
Keke with Laurence Fishburne in 'Akeelah and the Bee.'
Read Happy Birthday, Kate Middleton! Duchess Catherine's 12 Best Looks of 2011
8. In 2002 when she was just nine years old, Keke auditioned for the role of Young Nala in the Broadway musical The Lion King.
9. Alas, she didn't get the part; but her parents saw her promise as a young performer, so they all moved to L.A. two years later to help her pursue a career in film.
10. Keke was one of the hopefuls on American Idol spin-off American Juniors during the summer of 2003, but unfortunately her audition scenes were edited out. Ah well; since the show was cancelled after one season, it wasn't too big of a loss.
11. The first year in L.A., Keke and her parents lived out of hotels. "My parents spent everything to take me to California to pursue my dream, she told AJC. "We went from hotel to hotel. We stayed in a hotel for a year. We didn't have anything." Talk about sacrifice.
12. Luckily, success came quickly; her first week in California, she landed a national commercial for Kmart. Hey, everybody's got to start somewhere!
13. Her first film was 2004's Barbershop 2: Back in Business. She appeared as Queen Latifah's niece. Excellent preparation for Joyful Noise, in which she's playing Queen Latifah's daughter!
More facts about Keke, including how she met her boyfriend and what's in the future for her, up next!


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Ben Rhydding residents have challenged ward councillors and Ilkley's MP about what they are doing to support oppon-ents of a proposed new development.
A residents' action group recently met amid concerns about proposals for 188 new homes on land between Ben Rhydding Drive and Wheatley Grove.
The land is earmarked as a potential development site in Bradford Council's planning strategy documents.
But Woodroyd Gardens resident, Norma Scott, says she was "disappointed" no local councillors attended the meeting. She also wrote to Ilkley MP Kris Hopkins asking how he is going to support his constituents.
Mrs Scott cited a recent House of Commons debate, in which Secretary of State for Communities and Local Government, Eric Pickles, spoke out about the merits of green belt as protection against urban sprawl, and asked why Mr Hopkins was not there to speak up for constituents.
"I would like Mr Hopkins to ask Mr Pickles to explain how the infrastructure is going to cope with this increase in population," she said.
The initial draft of Bradford Council's Local Plan Core Strategy suggested 1,300 new houses should be built in Ilkley.
Ward councillor Anne Hawkesworth (Con, Ilkley) said the area's district councillors were actively supporting the residents of Ilkley campaigning against over-development in the valley, leading the call through the formation of the Wharfedale Alliance group.
Mr Hopkins said it was "crucially important" local people and residents' groups make their voices heard.
He added: "In a response I received last month from Nick Boles, the Planning Minister, he acknowledged the importance of the green belt as a protection against urban sprawl. He also rightly emphasised the fact councils remain in control of their green belt boundaries, which they can alter in exceptional circumstances.
"But, crucially, this can only happen through the Local Plan process involving consultation with residents and formal examination of the proposal in public."


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Reed Krakoff Fall 2012
Okay, so let's imagine that it actually gets cold next winter—since the opportunity to bundle up in fantastic coats this year seems to have come and gone, though simply writing that almost ensures a snowstorm in April. Anyway, let's say in eight or nine months it's cold. This will be one way to warm up: throw on a long, silky blouse because wherever you end up (the office, dinner) will have central heating. Over that goes a blazer or straight, simple jacket, probably in leather or wool. On top of that will be either a giant fur snood, which you'll tuck your hair into or another jacket, this one supercropped with a fur hood or tall stand-up collar. Got it? If not, even after the variations of this pile-it-on theme we've seen in New York, Reed Krakoff's fall show reinforced the idea of a topped-off urban woman from the first look: Aymeline in a black silk dress underneath a severe, long wool vest and oversize zip-up beaver collar. From there, Krakoff showed shrunken hooded vests over jersey blazers and jackets with trompe l'oeil layers. There was a real sense of sportswear in the way these pieces were paired with easy, straight pants and simple T-shirts.
Backstage before the show, Krakoff said that this season was about working with fewer ideas and exploring them more deeply. He scaled back on the color scheme—Krakoff frequently is inspired by the vibrant palettes of artists, but this season chose to work in black, cream, and a touch of cherry red—and focused on texture. It was about how the clothes feel and then how those surfaces work together.
If there was one sign that Krakoff is becoming more comfortable as a ready-to-wear designer, it was in the absence of accessories. They inarguably are one of his strengths, but also could be seen as a crutch. In spring, he sent twelve bags down the runway. This season there were a well-edited three.


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100K or Bust
I'm still so excited about NC24 that I'm actually considering running another ultra. For something a little different I was hoping people here could recommend a good trail 50K for a novice who hasn't run trails in years and would be looking for something non-technical and preferably with not a lot of elevation gain.
2017 Goals: for races not to be exercises in futility
Uh oh... now what?
Try: http://www.ultrarunning.com/calendar.html
Select Calendar.
Select Distance/Time: 50 km
Start discarding.
This one seems pretty good: http://www.adventuretourtime.com/?page_id=1628
When and where do you want to run a trail 50K? Why do you want to remove technical terrain and elevation? That is what makes trails fun. Otherwise you can run on roads and call them "trails".
There's this little one in your neck of the woods next week.
You've already got your long training run in too!
Trail and Ultra Running User Group
Welcome to the dark side, George.
If I run one it would be some time next year Spring or Fall. Late Spring would be preferable since I'd like to go back to NC24 in September. I'm at least concerned, if not fearful, of hurting myself on a technical trail. One of the reasons I stopped running on trails was the uncommon frequency of falls, twisted ankles, and other mishaps. I'm also afraid of biting off too much. I've still got so much to learn after finishing just my first ultra, especially with eating and drinking during long races. Adding yet another factor like learning to run technical trails seemed too much for me to handle. Maybe I have a misconception of what constitutes a technical trail. I'd be willing to race on trails like some of the well traveled trails I've hiked on in state and national parks.
The xc team warned me about that.
I did the Dirty German in Philadelphia's Pennypacker Park last spring, I thought the trails were very nice and not much elevation gain (just my humble opinion). Not sure how far that is for you?
I haven't been up that way in ages, but it couldn't be more than 60-90 minutes even with Philly traffic since I'm out on the Western Main Line.
. I'm also afraid of biting off too much. I've still got so much to learn after finishing just my first ultra, especially with eating and drinking during long races. Adding yet another factor like learning to run technical trails seemed too much for me to handle. Maybe I have a misconception of what constitutes a technical trail. I'd be willing to race on trails like some of the well traveled trails I've hiked on in state and national parks.
If you can run a marathon, you can run a 50K. You don't need any complex fueling strategies for that kind of distance. Heck, my last 50 miler took 10 hours and I took 20 gels (one every 30 minutes), a few salt tabs, and water/heed. Nothing complicated or beyond what I would do for a marathon.
Best Present Ever
The Holliday Lake 50K is a lot of fun and a common first trail ultra. It's in Virginia, near Appomattox.
Go back through this forum and look for reports--might be some from your area.
Go to the trailer trash forum and look for reports--they have quite a few Pennsylvania/Maryland runners.
This can be a hard time to pick a first trail ultra, weather being what it is, it can add a whole new dimension to that "only five more miles [which is totally a myth and hides a lot of effort needed on some 50k events] stuff.
Most important -- find a few trails of various levels (it might get muddy soon) and find out what it is that pulls folks to the trails.
Wandering Wally
First, congrats on being an ultra runner!
Lots of good ones in your vicinity George. Just do what John suggested and look at the ultrarunning.com calendar and see what's close to you. The New Jersey Ultra Festival at the end of March looks interesting. The Mohican 50K in Ohio in April also looks interesting. Keep checking back because I'm sure more will be added as we get closer to the new year.
Run! Just Run!
Trail Runner Nation Podcast
By the name alone - Dirty German I would pick it if I lived close. In many ways a 50k trail run is easier than a marathon. It can have a much slower and more relaxed tempo, softer surface and more friendly community of runners / volunteers. As long as you are wired the right way, if you are wired competetively and do not take time to enjoy a view or 2 or talk to some aide stations volunteers it can be harder.
I am fuller bodied than Dopplebock
Some great suggestions here. I've bookmarked the ultrarunning and ultrasignup websites for future reference. I have running friends in Virginia and made a new friend at NC24 who lives in MD. They might have some good suggestions or personal recommendations for those areas. One of my guardian angels needs IN, so I may see what she recommends in that area.


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We Watch Too: 13 Unexpected TV Shows We Love!
The idea that Black people only watch Black shows is so last century. These days you'll find us waxing poetic about everything from Downton Abbey to New Girl and Modern Family. Just in time for the Emmys later this month, we're taking a look at 13 shows we're watching.


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Weekend Of A Champion
Dir: Frank Simon. France-UK. 2012. 93mins
Two champions - one of the racetrack, one of the big screen - are reunited four decades on in a long-unseen documentary by the late Frank Simon, dusted down and updated with an intriguing coda. The 1971 film originally entitled Jackie Stewart: Weekend Of A Champion - and barely screened since its premiere at the 1972 Berlin Film Festival - featured Roman Polanski following Formula One racing driver Stewart over four days in Monaco, culminating in him winning the Grand Prix.
When the film gives us its up-close racing footage, it's hard not to join in and make "vroom vroom" noises - as an enthusiastic Polanski does in the closing interview.
The new film consists of Simon's original, trimmed by some 30 minutes, followed by an interview between Stewart and Polanski, reunited in Monaco in 2011, talking about Stewart's life and what's changed in his sport over 40 years.
The film is more revealing about Stewart's technique than about either his personality or the inner workings of Monaco and the Formula One world - although, even when he's talking technical, as he mostly does, Stewart's engaging, no-nonsense good humour shines through. But the film, containing some ferociously intense racing footage - plus some precise driving tips from a world-class expert - will be a must-see for lovers of the sport. Non-initiates may not find it as involving as, say, Asif Kapadia's more narratively propelled documentary Senna, but fans will follow it to the last lap, ensuring healthy success on the ancillary circuit above all.
The film begins with the Scottish driver and his wife Helen walking to the track in May 1971, Stewart muttering darkly about prospects of rain. It skips back to the Thursday before Stewart is due to compete for the Grand Prix, driving for team owner Ken Tyrrell. Shooting on 16mm, Simon follows Stewart closely, taking us into the driving seat with him in several sequences - using on-board cameras to shoot over Stewart's shoulder as he drives through heavy rain, or to give us what amounts to a masterclass as Stewart takes Polanski for a spin, explaining in detail how he shifts gears to negotiate the curves of the Monaco track.
Stewart goes into further technical details in interview with Polanski, with whom he has an easy rapport. But some of the most revealing glimpses of a generally relaxed and straight-talking Stewart come as he limbers up for Sunday's drive - whether cheerfully entertaining winners of a British newspaper prize, imparting advice to teammate François Cevert, or running the gamut of autograph hunters.
In the run-up to the race, Stewart gets visibly more tense, especially as he feels his car - reconstructed after a recent crash - is unlikely to deal with wet weather conditions. And there's a revealing, and ominous interview with Helen Stewart before the race, brooding on how many of the couple's friends have been killed in action (Cevert himself would die in 1973). On the Sunday, Stewart goes on to win the race, while his voice-over recorded shortly after the event mulls over his pre-event nerves.
Some of the most revealing material comes in the epilogue, as Polanski and Stewart meet again in the same hotel room seen 40 years earlier. The key material in this relaxed chat concerns the two men's mystification over their earlier hairstyles, and the change in racetrack safety, resulting in a drastic reduction of deaths.
The greatest revelation from the thoughtful Stewart is that for him, climbing into a racing car is like being given an anesthetic: "You lose all relation to grief, pain and emotion." It's a rare moment of self-analysis from a man mostly seen imparting technical wisdom. But when the film gives us its up-close racing footage, it's hard not to join in and make "vroom vroom" noises - as an enthusiastic Polanski does in the closing interview.
Production company: RP Productions, Mark Stewart Productions
International sales: Pathé International
Producer: Roman Polanski
Executive producers: Mark Stewart, Timothy Burrill
Cinematography: Bill Brayne, Pawel Edelman
Editors: Hervé de Luze, Shawn Tracey, Derek York
With: Jackie Stewart, Helen Stewart, Roman Polanski


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Slow Down in Style
Charter by trawler is a great value that's increasingly popular—in places you might not expect.
By Kim Kavin — July 2004
From the Pacific to the Atlantic, couples and families are discovering that they need not cruise far or fast to have a terrific vacation. Trawlers are an increasingly available option in places that aren't necessarily traditional charter destinations.
"The kind of people who come to us—fairly high-powered, high-stress people—there's a world of difference between the day they arrive and the day they return," says Bill Shermer of Blue Goose Charters on the Chesapeake Bay. "The trawler, by its nature, slows the people down. It makes them relax."
Baltimore Harbor, where Shermer is based, has always been a boating mecca, but not necessarily a charter-business magnet. Still, it's perfect for a vacation aboard a trawler: easily accessible from major airports, plenty of things to see and do, and a shoreline that's beautiful to cruise along. These same qualities are also bringing trawler charter clients to places like San Francisco, Southwest Florida, and parts of New England.
At a typical speed of 6 to 10 knots, trawlers are great for beginners who want hands-on instruction and for anyone who simply finds navigating to a place as much fun as getting there. Trawler charters can also be invaluable for anyone considering buying a trawler. Several companies cite liveaboard charter/training courses as a main draw for their Mainships, Marine Traders, Grand Banks, Kadey-Krogens, and Nordic Tugs.
Barbara Hansen, who with her husband, Vic, owns Southwest Florida Yachts, says another thing luring charterers is trawlers' economic value. "Versus a motoryacht that's burning 15, 20 gallons an hour, you've got a trawler that's burning between three and six gallons an hour," she says. "Our Grand Banks 32 burns about one and a half gallons an hour. That's about the same as a sailboat."
Some privately owned trawlers, like the handful that visit New England each year, offer full-on crewed experiences. The Royal Passagemaker 57 Fine Romance is a great example. Part of the Newport Yacht Management fleet, this boat is run by the husband-and-wife team that owns it. For a virtually all-inclusive rate of $8,500 per week, the husband acts as captain and the wife acts as stewardess/chef for another couple or for a couple with a child.
A handful of similarly crewed trawlers make their way to ports around the country each year depending on their owners' schedules, but most charter trawlers are within bareboat fleets. Some companies will provide a captain for a semicrewed experience, while others prefer to have clients learn from captains for a few days (if necessary) before going cruising on their own.
"Philosophically, I'd rather teach you than give you the boat with the captain, but we'll do it," says David Forbes, general manager of Club Nautique in California. "We want to make sure people know what they're doing, and we want to encourage people to feel comfortable chartering."
The following is a sample of options, along with information about what you can expect for your charter dollar.
Next page > Chesapeake Bay > Page 1, 2, 3, 4, 5
This article originally appeared in the June 2004 issue of Power & Motoryacht magazine.


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Meatless Monday is a global movement, a way of life. It's not a campaign to turn everyone in the world vegetarian or vegan; in fact, many involved are meat-lovers. Eating less meat has been proven to reduce the risk of disease, curb obesity and has important environmental impacts, too. Will you join us in giving up meat, just for one day a week?
When faced with the option to bake or fry, you don't have to choose between flavorful and healthy. You can have both. For dinner tonight, try Ellie's Zucchini Parmesan Crisps. First they're lightly coated in olive oil, bread crumbs and Parmesan, then they're baked in a 450° oven, so you'll get the same satisfying crunch of the fried version without all the extra oil. There won't be too much grease, and there will just be just as much flavor. Win, win.
This recipe can qualify as both an appetizer and snack, but when paired with a simple green salad, it makes the perfect Meatless Monday dinner. It's easy to add your own special twist, too. Substitute panko for the breadcrumbs or add in dried herbs or garlic powder. Serve with marinara sauce for dipping or enjoy them straight from the oven. Whether you change the ingredients or keep the recipes as is, adults and kids alike will love these toasty crisps.
Zucchini Parmesan Crisps
Cooking spray
2 medium zucchini (about 1 pound total)
1 tablespoon olive oil
1/4 cup freshly grated Parmesan (3/4-ounce)
1/4 cup plain dry bread crumbs
1/8 teaspoon salt
Freshly ground black pepper
Preheat the oven to 450 degrees F. Coat a baking sheet with cooking spray.
Slice the zucchini into 1/4-inch thick rounds. In a medium bowl, toss the zucchini with the oil. In a small bowl, combine the Parmesan, bread crumbs, salt, and a few turns of pepper. Dip each round into the Parmesan mixture, coating it evenly on both sides, pressing the coating on to stick, and place in a single layer on the prepared baking sheet.
Bake the zucchini rounds until browned and crisp, 25 to 30 minutes. Remove with spatula. Serve immediately.
More Meatless Baked, Not Fried Recipes:
Baked Meyer Lemon Fries
Baked Green Tomatoes and Zucchini
Oven Baked Onion Rings
Baked Cauliflower with Sliced Garlic, Lemon and Olive Oil


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NASHVILLE, Tenn. (AP) - The Tennessee Titans now have interviewed both of Cincinnati's coordinators in their search for a new coach.
The Titans confirmed Thursday they have finished interviewing Bengals defensive coordinator Mike Zimmer two days after interviewing Cincinnati offensive coordinator Jay Gruden. The Redskins introduced Gruden as their new coach Thursday.
The team's plane picked Zimmer up Thursday morning outside Cincinnati, and the plane left Nashville for Cincinnati just before 5 p.m. EST.
Zimmer has been Cincinnati's defensive coordinator since 2008, and his defense ranked No. 3 overall this season. He also was defensive coordinator at Atlanta in 2007 and also was defensive coordinator with the Dallas Cowboys. He interviewed with Miami and Tampa Bay in 2012 and with Cleveland in 2013.


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Feeder and stocker cattle markets continue to show strength through October, which is annually the month with the most pressure from spring-born calf sales and shipments of previously contracted cattle.
Despite the lightest inventory in 60 years, there are literally millions of calves currently leaving the ranch for their first time. These calves are going to feedlots, pre-condition yards, and wheat fields for continued weight gain, but the stress of the relocation and the volatile weather patterns take a toll on their health.
Price trends are not available due to the nearly three week federal government shutdown, but a sizeable amount of information continued to be collected by state departments of agriculture that normally work in accordance with USDA market reporters.
However, the closing of the USDA Agricultural Marketing Service website took away the main source of dissemination for these valuable market reports. The much anticipated cattle-on-feed report due out this Friday has been rescheduled for release on October 31st.
This week's available regional weighted average feeder cattle prices were $2-$5 higher than the last available from the last full week of September. The full advance was noted in the Southern Plains on true yearling feeders and on 5 weight calves for wheat pasture. Although, some market pressure has been noted on 6 weight unweaned calves in which supplies always outweigh demand of this time of year.
The promise of less expensive feed grains continues to become a reality as the first half of October has seen ideal harvest conditions. Winter wheat planting also moved at a brisk pace this fall and this should also increase cattle grower options for affordable feed. The one extreme exception to the mild fall has been the freak blizzard that crippled the western Dakotas and eastern Wyoming where reportedly as many as 100,000 head of cattle perished.
There is no doubt why sales receipt percentages of heifers are much lighter than usual while 500-600 lb replacement quality heifer calves in Kearney, NE on Wednesday brought $201-$208.25. Farther north and west in Valentine, NE on Thursday a 243 head string of fancy 492 lb steer calves sold for $220.25, while a 100 head load of big brothers weighed 553 lbs at $198.75.
Yearling sales also warranted mention this week like the nearly 320 head of 800-850 lb yearling steers in Green City, MO that averaged 822 lbs at $170.76. Fed cattle markets are very near all-time record highs with live sales from $129-$131 and dressed from $202-$204. This week's incomplete reported auction volume included just 39 percent over 600 lbs and 39 percent heifers.


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About the Book
This 80-page, beautifully illustrated, book is about heraldry; a centuries old practice that most of us have encountered in one form or another, from sports teams to state and national symbols. It is specifically about the family history and heraldry of the Globe family.
Heraldry has rightly been described as the shorthand of history for it relates in symbolic form the hopes and aspirations, the achievements and failures of our ancestors. It also provides a rich pictorial source of genealogical and historical information.
The arms on these pages have been designed by the Serbian heraldist and artist Prof. Ljubodrag Grujic, Pancevo, Serbia, Heraldic Artist to the Royal House of Karageorgevich of Serbia.
The author, Richard Globe, was born in Canada but has lived most of his life in Europe; first in England before finally settling in Scandinavia. He is a Danish citizen and has traveled widely throughout North America, Asia and North Africa. Now retired, his hobbies include gardening, genealogy, family history and more recently, heraldry. This is the author's first book.
About the Creator
Want to make a book and publish it on your own? Or maybe an E-book? Our husband and wife team has helped many first-timers self publish books. We are experienced common sense professionals, creative and comfortable with computers, pixels, and Blurb BookSmart software! We specialize in MEMOIRS, photo-journals and other family & personal books. To review some of our recently published books from our store go to: http://bookcrafters.net or browse through our Blurb Bookstore on this website. Ask us about E-Book conversions! We work together to design and publish many different types and styles of books, from personal memoirs, children's books, wedding albums, travel journals, blog books, and art portfolios. For many, the actual writing and compilation of a book is the easy part. Now you need to get it published. There are many options but most of all you have to overcome the "fear factor." BookCrafters can help. Email us at email@example.com.
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Dollars for Docs Mints a Millionaire
New data show drugmakers' payments to hundreds of thousands of doctors, and some have made well over $500,000.
Update Mar. 11, 2013, 4:55 pm: This post has been updated to reflect a response by Dr. Vladimir Maletic to questions from ProPublica.
Dr. Jon W. Draud, the medical director of psychiatric and addiction medicine at two Tennessee hospitals, pursues some eclectic passions. He's bred sleek Basenji hunting dogs for show. And last summer, the Tennessee State Museum featured "African Art: The Collection of Jon Draud."
But the Nashville psychiatrist is also notable for a professional pursuit: During the last four years, the 47-year-old Draud has earned more than $1 million for delivering promotional talks and consulting for seven drug companies.
By a wide margin, Draud's earnings make him the best-paid speaker in ProPublica's Dollars for Docs database, which has been updated to include more than $2 billion in payments from 15 drugmakers for promotional speaking, research, consulting, travel, meals and related expenses from 2009 to 2012.
Payouts to hundreds of thousands physicians are now included.
Draud is not the only high earner: 21 other doctors have made more than $500,000 since 2009 giving talks and consulting for drugmakers, the database shows. And half of the top earners are from a single specialty: psychiatry.
"It boggles my mind," said Dr. James H. Scully Jr., chief executive of the American Psychiatric Association, referring to the big money paid to some psychiatrists for what are billed as educational talks.
Paid speaking "is perfectly legal, and if people want to work for drug companies, this is America," said Scully, whose specialty has often been criticized for its over-reliance on medications. "But everybody needs to be clear — this is marketing."
When Dollars for Docs launched in 2010, it gave the first comprehensive look at the money that drug companies spend to enlist doctors as a sales force. The new data show how payouts to psychiatrists like Draud and other doctors have added up over time. And they underscore the key role physicians play for drugmaker profits even as scrutiny and criticism of such payments grows.
The companies say physician speakers are the best messengers to teach their peers about new and effective treatments. But critics counter that the speakers are little more than highly credentialed pitchmen who typically use the drug companies' slides and talking points to sell rather than educate.
Attention to the issue has prompted prominent medical schools to tighten rules on faculty acceptance of drug company money for such talks. Questions about undue industry influence also have bedeviled medical journals and professional groups representing physician specialists.
Susan Chimonas, a research scholar at the Center on Medicine as a Profession at Columbia University, said many medical centers that regulate interactions between drug companies and their doctors would be "alarmed" by the high tallies in the updated Dollars for Docs.
"How do these folks have time to do their real jobs if they're speaking so much?" Chimonas said. Hospital administrators, she predicted, would be "concerned not only about the conflict of interest, but also the conflict of commitment."
Draud's $1 million in drug company earnings is probably a minimum figure. Some of the seven companies he represented have reported their payouts for only a short time. And Draud has separately disclosed ties with at least four additional companies that haven't revealed how much they pay speakers.
Draud has friends among the other highest-paid doctors in the database. He teaches continuing medical education courses with fellow psychiatrists Rakesh Jain and Vladimir Maletic. Jain, of Lake Jackson, Texas, has earned $582,049. Maletic, of Greer, S.C., made $527,850 , according to Dollars for Docs. Both also speak for other companies that keep their payments private.
Draud did not return several messages seeking comment. But in an interview, Jain said he loves teaching and delivers the same lectures about drugs and medical conditions regardless of whether a drug company is paying him.
"I am not a marketer, I am an educator," Jain said.
In a later email, Jain said he is proud of his collaboration with Draud. "He's been fair, balanced and is wickedly smart. And I like smart people who serve community needs."
In written responses provided after this story published, Maletic said he speaks about treatments for mood disorders, schizophrenia and sleep-wakefulness disorders because he believes that "good quality education about pharmaceutical products may be beneficial to both physicians and their patients."
Maletic said he uses company-prepared presentations because they are required to ensure compliance with federal rules. Asked how often he speaks, he replied, "The frequency of speaking varies, but based on the numbers that you have quoted, it may possibly be too often."
Jain, Maletic and many top earners also have active clinical or research practices.
Next year, every drug and medical device maker that pays physicians will have to report such spending to a federal database as part of the Affordable Care Act health reform law. The first disclosure, scheduled for public release in September 2014, will include payments from August to December of this year.
The companies in Dollars for Docs accounted for about 47 percent of U.S. prescription drug sales in 2011. It's unclear what percentage of total industry spending on doctors they represent, because dozens of companies do not publicize what they pay individual doctors. Most companies in Dollars for Docs are required to report under legal settlements with the federal government.
Even the $2 billion total underrepresents spending by these companies. Some in the database have begun reporting only in the past year, and others report spending in only a few categories. In addition, two companies reported some payments in ranges, so that spending was excluded from the total.
Overall, roughly half the payments were for research. A third went to speakers and the rest was for consulting, educational materials, meals and travel.
For Some Docs, An Earnings Drop
The push for transparency on physician payments started years ago.
Studies began showing that even trinkets doled out by drug sales reps could affect physician attitudes. At the same time, drugmakers were settling federal lawsuits alleging that they paid kickbacks and encouraged doctors to push drugs for unapproved uses. Two U.S. senators began calling out prominent physicians for not properly disclosing financial ties to the companies.
Dollars for Docs took transparency a step further by putting the available payment disclosures in one place and making them easy to search.
In 2010, many universities and teaching hospitals were surprised to find that their faculty members were engaged in promotional speaking. ProPublica compared the faculty lists of institutions with conflict-of-interest policies barring such speaking with the database and found a number of physicians in violation.
Drug firms, too, learned of problems with their chosen speakers. ProPublica found their rosters peppered with some physicians who had serious disciplinary actions against their medical licenses.
Both the drug companies and academia tightened their policies.
Only a handful of doctors who were among the 20 highest-paid in 2010 have maintained their level of income from speaking, the new data show.
Ten of the doctors dropped from making about $100,000 a year to less than $20,000 in 2012. Some doctors whose payments declined spoke about drugs the companies are no longer pushing. Others, like prominent cancer expert David Rizzieri at Duke University School of Medicine, faced new restrictions from their employers.
Rizzieri had been a speaker for Cephalon, GlaxoSmithKline and Novartis in 2010 and 2011. But after Duke restricted participation in speakers' bureaus, his speaking pay dropped markedly in 2012, the new data show. All told, Rizzieri has received at least $567,300 in speaking and consulting payments since 2009.
Dr. Ross McKinney Jr., director of the Trent Center for Bioethics, Humanities and History of Medicine at Duke, said university officials "had multiple discussions" with Rizzieri, who "is getting more restrained."
McKinney said Duke physicians can deliver paid talks about diseases, but only if they use their own slides and presentation materials. "The general tone is a little bit more distant and less cozy than it used to be," he said.
In an email, Rizzieri said he still did some paid speaking that is allowable within Duke's new guidelines, but has focused his attention on a series of educational talks developed by the Division of Cellular Therapy at Duke.
New Drugs, New Dollars
Drug companies say their spending often reflects market realities — not a changing opinion on the use of physician speakers. Should a top-selling drug lose its patent, allowing cheaper generics to compete, there's no impetus to push sales. A new drug or a new approved use for an existing drug, conversely, may prompt a burst of speakers.
New York's Forest Laboratories, for example, is a fraction the size of its Big Pharma brethren Pfizer, AstraZeneca and Merck. But when it comes to paying doctors to promote its products, the drugmaker has recently dwarfed its rivals.
During the first three quarters of 2012, Forest spent $31 million on doctors who touted the virtues of such drugs as Bystolic for high blood pressure, the antidepressant Viibryd, and Daliresp for chronic obstructive pulmonary disease. Nine doctors each made nearly $100,000 from Forest in that time alone, the data show.
Pfizer — whose U.S. sales are five times greater than Forest's — spent a fifth of Forest's total, paying out $6.2 million to promotional speakers during the same period. AstraZeneca, second to Pfizer in sales, spent $12.2 million.
Forest spokesman Frank Murdolo said in an email that the company spends more on speakers because it doesn't use pricey direct-to-consumer TV marketing. It also has more new drugs than its competitors, Murdolo said.
In contrast, GlaxoSmithKline spent $52.8 million on speakers in 2010. That fell to $24.1 million in 2011 and $7.6 million in the first three quarters of last year.
Glaxo spokeswoman Mary Anne Rhyne wrote in an email that the company's spending tracks with new drugs or new uses for existing products. "That activity has been relatively low in the past year, so spending for speaker programs has been lower, too," she said.
The top recent speaking programs for Glaxo involved Advair, a drug for asthma and chronic obstructive pulmonary disease, and Jalyn, which treats problems with urination for men with enlarged prostates, Rhyne said.
Glaxo and other top pharmaceutical companies have laid off thousands of workers in the past couple of years as their top drugs have lost patent protections, the pipeline of new drug approvals has slowed and cost pressures arose.
Other companies contacted by ProPublica about their spending would not reveal which products they paid speakers to extol or why.
"We don't disclose how we allocate our speaker program budget," Tony Jewell, a spokesman for AstraZeneca, said in an email. AstraZeneca's spending on promotional speakers decreased from $31.6 million in 2010 to $17.6 million the following year and $12.2 million in the first three quarters of 2012.
"The decrease in spending is based on a variety of factors, including where our medicines are in their life cycles and brand budgets and strategies," Jewell wrote.
The company's blockbuster antipsychotic drug Seroquel went off patent last year. Another top drug, Nexium, which treats acid reflux, goes off patent in 2014.
Because each company is in a different stage with its blockbuster drugs, it's difficult to compare their outlay on speakers and consultants head to head.
It may be too soon to tell whether continued publicity over the spending will cause companies to cut back further, said Chimonas, of the Center on Medicine as a Profession. But transparency might be having some effect.
At a recent conference, Chimonas said she heard that pharmaceutical companies themselves are using the disclosures about payments to "push back on doctors who are greedy."
"They can say, 'No. We see you're taking this amount of money from our competitor. Why should we give you more than that?'" she said.
A Harder Sell For Antipsychotics
Once a reliable profit machine for drug companies, psychiatric drugs are now a challenge. And drugmakers are fighting hard to stanch the losses.
Starting in the 1990s, when the second generation of antipsychotics hit the market, drugmakers enjoyed a period of wild profitability. Doctors embraced these new drugs, such as Risperdal, Seroquel and Zyprexa, as safer and causing fewer of the troubling side effects of older psychiatric drugs. Domestic sales of Seroquel hit $4.7 billion in 2011, the year before it went off patent.
But as the drugs lost their patent protection, their makers have tried to shift the market to newer drugs in their stables. Critics say these new drugs are not appreciably different, but the drug companies claim they are easier to take or have fewer side effects.
Johnson & Johnson, for example, lost its Risperdal patent in 2008 but now markets Risperdal Consta, a long-acting injection, and Invega, another antipsychotic. AstraZeneca lost Seroquel but is now marketing Seroquel XR, which works for an extended period.
The pressure to reclaim sales is great. Overall, the market for antipsychotics dropped from $18.5 billion in 2011 to $13.7 billion last year, according to IMS Health, which closely tracks the industry's ups and downs.
The newer drugs, like their predecessors, need someone to explain their benefits, several doctors said.
"I actually enjoy the aspect of educating my counterparts about developments in the field," said Dr. Gustavo Alva, a California psychiatrist.
Alva has received $663,751 speaking and consulting since 2009 for the companies in Dollars for Docs. He separately discloses speaking for other companies as well.
Tighter restrictions on speaking and consulting mean doctors will be less up to date on new treatments, according to several current physician speakers.
Psychiatrists aren't always among the highest-paid. In 2010, when Dollars for Docs first launched, endocrinologists represented 11 of the 43 top money-making speakers. From year to year, the in-demand specialists are largely a function of the market.
But critics say psychiatrists are a particular concern because of their controversial role when the first waves of new antipsychotics hit the market.
AstraZeneca, Johnson & Johnson and Eli Lilly have paid billions in settlements to the federal government over allegations that they paid doctors to push these drugs for unapproved uses from children to seniors with dementia. One lawsuit alleged that a Florida psychiatrist switched patients from drug to drug based on his relationships with companies.
Texas psychiatrist Jain acknowledges the excesses of the past and said he does not excuse them. But he said he sees real value in the new brands because they give psychiatrists options if their patients are not responding to older drugs.
He said he has recently spoken on behalf of Forest's antidepressant Viibryd, Merck's antipsychotic Saphris, Lilly's ADHD drug Strattera, Pfizer's antipsychotic Geodon and its antidepressant Pristiq.
Having the financial support of drug companies does not lessen the value of this teaching, he said.
Jain's tally in Dollars for Docs does not reflect his work with another group that is heavily sponsored by drugmakers.
Jain, top-paid speaker Draud and Maletic all serve on the advisory board and steering committee of the U.S. Psychiatric and Mental Health Congress, which will hold its annual convention in Las Vegas in September and October. Maletic is the 2013 program chairman.
The convention receives financial support from several drug companies, and some of its presentations are sponsored by the firms, according to information on its website. Much like professional medical societies, the congress also collects fees for drug company ads on things attendees see at their conventions, from tote bags to hotel room keys.
The congress is owned by North American Center for Continuing Medical Education, LLC, a for-profit New Jersey company that provides continuing medical education courses. Health professionals must take such classes periodically to retain their licenses. Draud, Jain and Maletic also teach classes for the company.
In response to written questions, Randy P. Robbin, president of the company, said members of the steering committee have "demonstrated experience and expertise in mental health and commitment to providing the highest quality education possible."
The trio are paid for their work for the congress, but the money does not come from pharmaceutical sponsors, Robbin said. In continuing medical education courses, he said, drug companies don't have a say in the educational content or speaker selection.
Jain said in an interview that his talks for the company are reviewed for bias before and after he speaks. "I cannot present anything at the Psych Congress that hasn't been vetted repeatedly," he said. "Pharma is not able to influence anything that I do at the Psych Congress."
Scully, of the American Psychiatric Association, said he hopes all the drug company money doesn't taint relationships between patients and their doctors.
"The public trust," he said, "is too important."
41 comments
One million dollars is a large sum of money, no question. But the editor in chief of propublica makes close to half million dollars a year. Most investment bankers makes that in a month. If the doctors in your story have done unethical acts, they should not only be reported by propublica, but be brought before their state medical boards, sanctioned or have their licenses suspende . But, if their only offense is to make money from pharma,that just seems like good old capitalist mentality most Americans subscribe to. I think a bigger issue is lack of access to quality health care,in particular mental health care. It might be nice if propublica reported a bit more on those issues.
I think the sentiment of Mr. Giramonti is shared by many, in that many will suspect or hear in the reporting of people getting big money for working for a drug company by news media as an attempt of "liberal media" to make it a morality issue. There is nothing immoral about big salaries. But one can't help, but wonder if the doctors here are under full disclosure. And there is a difference in paying for an "official objective expert endorsement" and regular marketing like a commercial.
As a citizen of a democratic society, I have the responsibility to elect officials and engage those officials when necessary to support legislation and/or policies that can improve America. I cannot do this effectively without knowing the difference in a commercial (a paid for endorsement) and objective professional assessment. The Big tobacco case should be enough of a lesson for all of us. But if not, reference the paid for economics opinions of some academics that that supported deregulation that bankrupted Iceland.
In addition, if full disclosure were required, the cost of these endorsements might be less thereby reducing the cost of sales for Pharmaceutical companies and either reduce cost of the drugs or improve profits available for further research. Since it is liely thre is no "silver bullet" that will fix the 2X premium Americans pay for health care while getting poorer care by nearly all objective measures, everything much count.
Doctors have contracts with overseas pharmaceutical companies and some VA pharmacists list their home address as their business address for tax reasons. Doctors in Colorado that were on the list previously and had a HIGH number of kickbacks and was in the Denver Post investigation are not found on this current list.
You can search any advisory board and clinical trials and disease data bases for Primary Investigator, researchers, clinical trials and pharmaceutical sponsorships. Use their names. expose them for what they are.
Goes a long way to explain why there are people who have to eat cat food to be able to afford their prescriptions, doesn't it? Because the cost of all this has to be paid by someone, more than likely the product. This is why so many in the medical profession are against Medical marijuana… Because who is gonna pay them millons to teach someone how to roll a joint?
The medical industry is like the mafia, the real business in conducted behind closed doors and under the table.
Sounds like Bill Clinton's whopping fees while his wife is a senator and then Secretary of State. Guess everbody needs to make a dollar.
Make all the money you want, the way it is obtained is immoral, through persuasion, payoffs and the damage done to unwitting people and those who don't need the pharmacide to begin with is immoral.
Even for a dollar.
the mafia was gutted at one time, too.
fACTS LIKE THIS ONE are the causes behind the debt crisis of the West.
The spirit of Morris Fishbein is alive and well.
It's not what you get , it's what you ask for speaking .
I think a lot of comments miss the point. There is an inherent conflict of interest between a doctor's duty to his or her patient and patient efficacy, and pitching and pushing drugs for pharma. While I'm sure there are good intentions abound, there is a loss of objectivity when a doctor is lavishly compensated for an opinion, similar to economists, he is placed in a position where he is beholden to the paymaster.
And, the real question that no one asked is: why does pharma need doctors to go push its products to other doctors? The answer is quite simply: legitimacy. Pharma clothes the efficacy of its drugs in the M.D. of the messenger, as if that messenger is actually well versed in the underlying biochemistry of the drug and its interactions. This also goes to a larger problem with medicine generally; doctors are not scientists, and should not be treated as such.
Missing from this article is also how doctors are lured to these conferences to hear these speakers. The circle of marketing becomes complete, where doctors are made evangelizers, pharma commercials make health consumers evangelizers, and in the doctor's office they will meet.
This is about greed and lack of a moral compass.
The drug companies have brought us AIDs and Cancer too https://www.youtube.com/watch?feature=player_embedded&v=13QiSV_lrDQ#t=161s
The article indicates that "every drug and medical device maker that pays physicians will have to report such spending to a federal database as part of the Affordable Care Act health reform law."
Will this disclosure include the names of the specific drugs the doctor is being paid to support in some way?
If not then we should ask our legislators to require it so that we can see which drugs our doctors have an incentive to prescribe—and we can then choose to decline the prescription or select another doctor…
I spent 39 years as a pharmaceutical sales representative and I can honestly state that the idea of paying doctors a fee to shill for a specific product needs to put under very strict control… even more so than currently. I found this practice nothing more than a free meal for the attendees, a windfall for the restaurants where they are held and of no really educational use what so ever. Personally I found this practice unacceptable and tried to avoid them as much as possible and still keep my job. Please also forget the term "fair balance"... you want that?... don't pay the speaker.
Frank and Eric, when you buy a computer, do you ask an Apple employee what brand of computer you should get? Probably not, because you already know their answer, and you wouldn't trust someone with an obvious stake in your decision.
Now, if you're paying a doctor to advise you through an illness, what does it do to your confidence in the relationship, if your doctor is also accepting payments to sell drugs to his patients?
Keep in mind that we're talking about pharmaceutical companies like Bayer. Back in the '80s, Bayer was found to have used HIV-tainted plasma in medication for hemophiliacs. See a good overview of the story in Wikipedia's "Contaminated hemophilia blood products" article, but it might surprise some to learn that the story doesn't end by destroying the tainted batch as soon as they learned there was a problem.
I'd also point out that you seem to misunderstand capitalism. That's about being paid to create value. If you're getting money for scamming people, ignoring conflicts of interest, or doing nothing, that's usually a strong indicator of socialism or other planned economy.
What d'ya think the Doctor Phil show is all about? He's always getting people, especially the young, 'help' but it's all about psychological tests, and the drugs that go with them. The audience laps it all up, can't believe how generous and caring he is but he's actually conditioning his audience to accept psychiatry and drugs as the only means to help a youngster with problems, usually with just behavioral problems resulting from lousy parents and school pressures. But Phil wants you 'In The System.' He actually tells people there is something wrong with them and they need help, and folks do not open themselves up to any other options or possibilities.
.... or my new favorite, that windbag Dr. Oz!!!!
see CCHRINT org , they deal with these monsters and psychiatric abuses, they investigated the MKUltra mind control experiment and more, they have compassion re these abuses. If not, let me know.
I can't stand Dr. Phil, oprah, OZ or any of that psychobabble and clinical trials which is abusing the public with these deceptions and dangerous pharmacides. no one needs to take these poisons,
see radiobiology of xrays, CT and the dangerous MRI metal Gadolinium, it gets into your cells and radiation damages 67% of your cells DNA in 1mS with that flash photons, high energy, xrays are biologically damaging and accumulate cellular damage, see web rad train org columbia edu, radiation interaction w matter, we are NOT matter, see abused by the research scientists who knowingly did radiation experiments and denied it, interviews with researchers open gov doe acre report radiation experiments. They are no different then, but they are worse, See Freddie Boyle and Fernald School, survivors of the radiation experiments/quaker oats, read The Plutonium Files by Eileen Welsome, good indication of the healthcare SYSTEM today and even the congressional hearing in The Treatment by Martha Stephens and BEIR VII report and the ACHRE report, if you think radiation is not damaging, you are wrong, ever wonder why Kligman, Sanger and Carl Heller lived so long to ages 90 and made millions? they avoided xrays and they denied they caused harm. They CAUSED harm and still are, glad they are gone.
Thank you for the youtube video on the African Green monkey and the AIDS virus and how they laughed about it. and cancers, too. Everyone should see this, wait for it to load, can say it won't, but it will come up.
In 2007, Dr. Daniel Carlat, a psychiatrist, had an interesting column in the New York Times about his experiences as a doctor educating other doctors about a particular drug and why he decided to stop doing so. Check it out at http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html.
The Dr. Carlat article in the NY Times should be required reading (by law if necessary) before any medical provider can speak for a pharmaceutical company. The same criteria should apply to medical device companies who up until recently had controls managed by the companies themselves. That was like putting the fox in charge of hen house security. When you mix unlimited earning potential with the practice of medicine no good will come from it…..!
Just to show how corrupt and unbalanced this scam perpetrated by Pharma is, realise that no doctor would ever accept any liability for the ill-effects caused by the industry poisons. The victims are simply those young who cannot defend themselves, the elderly who have blindly accepted the counsel of proven liars, and those who have been actually "frightened to death" to take so-called medicines. These doctors are simply immoral shills who take no responsibility for their actions, and like politicians, are probably courted far more lavishly behind the scenes.
here you go, RedCap
NHIS National Health Interview Survey population based interview
NAMCS Nat'l Ambulatory Medical Case Survey
NHAMES National Hosp Ambulatory Medical Care Survey
Meps Medical Expenditure Panel Survey
HCUPS Inpatient Based Health Care Utilization Project
NSFG women based expanding to men Nat'l Survey on Family Growth
BRFSS population based (telephone) Behavioral Risk Factor Surveillence Survey this should have gone to the data mining article, but still applies.
NHANES pop based Interview and Exam
national Health and Nutrition Examination Survey
NHCHA agency based National Home Care and Hospice survey
Two words….snake oil.
Ellen, despite my dislike of the pharmaceutical companies, I wouldn't go that far.
I think their products are undertested, overprescribed, overpriced, and exploitative, and I think the companies themselves are highly unethical, but I don't think they're worthless. The problem isn't the drug, it's in convincing doctors (and paying them to convince other doctors) that the drug is a panacea…at least until the patent expires, at which point it's crap and a new drug is the panacea.
There are people who are helped by Prozac. There are many more people whose lives are destroyed by it. As long as it only goes to the former group, I'm all for it. The problem is the degree that's not happening.
Can you say "paid whore"?
It seems easy for the "Tims" of the world to call names and interject comments that have nothing to do with facts. Physician educators have as much right as you or I do to make a living and to make money doing it. We live in a capitalistic country. Drug companies are primarily publically owned and traded on the stock market. These companies are beholden to their investors, some of whom have likely been critical of doctors in the Propublica story. These companies hire great speakers to educate other physicians about their products. Without this, billions of dollars that are spent in the development of treatments of mental and physical illness would not be recouped by the drug companies. These companies would eventually stop developing newer, more effective drugs. How are physicians to learn of newer treatments if not through continuing medical education? Would it be less of an issue if I taught physicians about new medications? I have no medical background. Would you want your doctor trained by anyone other than another physician? I would rather receive treatment from a physician who is cognizant of the latest treatments, not one whose knowledge is based on treatments 20 years ago.
Go Pharma! My 401 K has you in it! For those of you reading this, your's does too.
Why is it the refrain "we live in a [capitalist] country" a good justification for the behavior of these doctors and the pharma companies that pay them? Does your definition of "capitalism" allow for unethical behavior, compromise of patient efficacy all in the name of a return on investment?
While I think Tim's comment is a bit strong, your comments ignore all of the problems outlined by the comments and the article. And, drug companies already have armies of sales people to "educate" doctors about their drugs. In fact, drug companies spend a whopping 33% of their revenue on advertising, while they spend a pitiful 6% on research. And, many of the new drugs are actually old ones for which they have patented new uses, which in turn have extended their patents.
Who cares if pharma is in your's or my 401k? Are you willing to compromise the greater good for your retirement? And, by the way, one consequence will be that you will pay higher drug costs while in your retirement. Interesting notion.
Psychiatry is a HUGE scam. It is that simple.
other data bases to search your information:
www ahrq gov
www cdc gov /nchs/
don't do any survey monkey online or in schools, nutrition centers, grocery stores, nothing, this is a data base and widely exploited though they say hipaa restrictions, they share info like you wouldn't believe, not just on their data sites, but old fashion gossip, too.
What a bogus report. ProPublica is pursuing an ancient, out of date angle in regards to the thesis of this series.
Doctors do not make decisions about what medication they prescribe just on what they hear at a drug sponsored lecture. The attendance at such lectures and the frequency of such lectures has become almost nil in recent years. Drug companies have moved from direct marketing to physicians to direct marketing to consumers. Sightings of drug company field sales people at a doctor's office have become as rare as dodo bird sightings. Just open any Lady's Home Journal or Readers Digest and you will see more ads for pharmaceuticals than for any other sales item.
Physicans are too busy trying to keep their practices open in a medical market of more government regulation and lower and lower reimbursments. They don't have time for such frivolous events. With the demands on their time to see more patients faster because of diminishing profit margins, listening to Big Pharma propaganda is a waste of time. You are guilty of white washing all US physicians with the motivations of a excedingly small fraction of the total number of US physicians, most of which are academics. I seriously doubt that my local Family Physician or Internist is pulling down such income numbers. In my opinion this whole series is nothing more than muckraking.
Your article implies that Big Pharma's speakers in some way hypnotize the physicians during the lecture who then immediately walk out of the lecture in mass blank eyed, automatically writing new prescriptions for that company's drug. Nothing can be farther from the truth. Physicians prescribe medications based on what they read in medical articles about the success and effectiveness rate of mediations. They read independent publications such as The Medical Letter. They consider the opinion of colleagues. They take note of how their own patients respond to a particular medication.
The real entity that governs what physicians prescribe is not Big Pharma but Pharmaceutical Benefit Programs. If a patient's Pharmacy Benefit Program does not cover a drug then the doctor cannot prescribe it; no matter how deeply he may have been hypnotized by a Big Pharma lecturer. Over the past several years Pharmacy Benefit Programs have been increasing the number of drugs that physicians have to obtain prior authorizations for. Such an action forceably directs the physicians prescription writing to certain drugs that are financially advantageous to the Pharmacy Benefit Program. Where is Pro Publica in reporting on this issue??
@J. Preston:
I don't think you really understand how your physician operates, based on your comments. Also, even when a drug is not approved under your health insurance plan, your doc will have a handy coupon for the drug. Your statements are also contradictory: if physicians are too busy with their practices to attend these seminars (which, by they way, from first hand knowledge, they are not), then they are certainly too busy to swim through mounds of medical literature about various new drugs coming out.
Some physicians are academics, but the vast majority are not. And, even the few that are academics are not a substitute for a researcher in biochemistry, biophysics, or molecular biology. In fact, their actual knowledge about biochemistry pales in comparison.
And, I've seen a drug rep in my doc's office every other visit. The perfect marketing/messaging is to get consumer's to become proponents, and when they enter the doc's office and name the drug, the doc then says,"Oh yeah, I've heard of that. Yes, that might help you."
This article is not frivolous. It should go farther to show the big picture and show the context of these programs with regard to patient care.
First of all can any of you name one product that isn't "marketed" whether it be Coca-Cola or the Democrat Party? I didn't think so! Drugs are no different.
Next, the reason physicians who speak on behalf of pharmaceutical companies use company slides, is called GOVERNMENT REGULATION! The federal government agencies (FDA, OIG, CMS etc) highly regulate EVERYTHING the ethical pharmaceutical industry does. Those slides are required to be approved by the government before a presentation is given. (There was a day that physicians could make their own slides on their own topics to educate, unfortunately, government regulation ruined that practice.).
Next, after the many years of research, and billions spent on R&D, in identifying potential therapeutic candidates to help allieve and cure human suffering and disease, is the reason drugs are expensive, not the small marketing budgets. The average new product takes greater than 10 years and over $2 billion dollars to bring it to market. I think it's important for folks to educate themselves before they believe the lies told by the political class (and the clueless liberals) who spew their vitriolic lies solely for political gain and regulatory control of an industry. I guess lies sell well to the ignorant and low-information voters.
@ Jon Publius
"the ethical pharmaceutical industry"? LOL. How much is Eli Lilly paying you? And what the hell do liberals have to do with "doctors" being paid shills for big pharma?
@Jon Publius:
Thanks for equivocating . Drugs are very different from Coca Cola and the Democratic Party. When did Coca Cola promise to cure your ailments? That is a much more powerful allure than bubbly, fizzy, tastes great. People buy these drugs because they have serious health problems, or have health issues they feel serious about. To have the doctor-patient relationship compromised to change a doctor into a pusher of a drug company is irresponsible and unethical, plain and simple. If given the choice, would you seriously start taking your medical advice from someone who works for Phizer or Merck?
"[S]mall marketing budgets"? How much do you think it costs for ad time to assail you with Cialis commercials? If you add up all those commercials, it's not a "small marketing" budget. Not to mention the thousands of sales reps pushing this stuff, what is spent on marketing isn't chump change. But, why should doctors be allowed to participate in their advertising schemes? Don't they have enough advertising? Shouldn't somebody be left to speak on behalf of the patient's health?
@ Sam in Texas
You must be time traveling your opinions in from the 1950's. In the 21st century drug companies have been firing pharmaceutical field reps by the thousands. Big Pharma decided 10 years go that it was no longer economical to market drugs directly to physicians.
How did you obtain your "first hand knowledge" on seminar attendance??? According to this series, the only individuals who are invited to the lectures have MD behind their name. Based on the views you have voiced I doubt that you are a MD and so doubt your claim.
In regards to your comment "When did Coca Cola promise to cure your ailments" such claims were indeed made by the pharmacist who originally developed the beverage in 1886. Coca-Cola originally contained the extract of coca leaves which by the way are used in producing cocaine. This is where "Coca" portion of the name comes from. Original marketing claims included headache relief and a tonic for the brain and nerves. You need to become a better historian.
Why do you and Pro Publica want to begrudge US physicians a decent return on their educational investments?? It takes from 11 to 16 years of college, medical school, residency training and fellowship training to become a practicing physician. This is a long time to put one's life and earning potential on hold. Those who choose to become physicians spend much more money than they earn during their educational years on tuition, lab fees, books, living and travel expenses. You and Pro Publica (and Medicare and the Managed Care Industry) seem to imply that physicians should only earn minimum wage. Comparing the low reimbursement rates physicians are now being paid against the high dollar education loans that medical students have to take out and later pay back, it has become cost prohibitive for anyone to entertain the notion of becoming a doctor.
Your reference to physician's lack of knowledge about biochemistry is irrelevant. There is a big difference between the theory of a subject and the actual daily practice of that subject. That is why it is called "the practice of medicine". It takes more than just knowledge of the theory of biochemistry to treat a patient's disease. A physician has to be knowledgeable about physiology, anatomy, pathology, pharmacology, microbiology to name a few as well as the limitations of the healthcare market he works in, in order to develop a treatment plan for a patient's illness.
This series, by its own admission sights 22 physicians that it says are MD's who has "earned at least $500,000 since 2009". According to the Kaiser Family Foundation (http://www.statehealthfacts.org/profileind.jsp?ind=934&cat=8&rgn=1&cmprgn=2), in November 2012 there were a total of 834,769 "Total Professionally Active Physicians" in the USA. According to my calculations the 22 physicians that this bogus ProPublica series sites represent 0.0026% of this total. I have a hard time believing that 0.0026% of the physicians in the US have any direct influence over the prescribing habits of the remaining 99.9974 %.
@J. Preston:
I guess you're the time traveler, since you decided to pull advertising from the 1800s, before there was any FDA or regulation of any kind, and before modern medicine. I am quite familiar with the history of Coca Cola, and I saw the same documentary on the History channel.
You got me. I am not an M.D., and neither are you, but I have several friends who are M.D.s, and they continually get invited to these conferences. The ones in private practice get regular visits from pharma reps. In fact, some of their practices have gone to the lengths to adopt the Mayo Clinic protocols on dealing with reps, and the gripe from the M.D.s is they won't get as many free dinners now.
No one is saying doctors should earn a minimum wage, and that's really a dramatic argument not based in any sort of reality. Going to school for 16 years is a choice, and a choice I would hope based on one's desire to heal people. But, of course, having been around a lot of pre-meds, this isn't the case, and thus the refrain. And, if being a doctor is such a tough gig, why are there still droves of them going to med school and going into practice? It's because doctors still make a very comfortable living. But, while paying off hefty med school loans might be a good argument, why should doctors be entitled to a lavish life style?
With regard to your statement that biochemistry expertise is irrelevant, you simply don't know what you're talking about when it comes to pharmaceuticals, and most doctors don't either. Drug interactions are very specific, and, one would hope, designed to target a specific problem. This is a biochemistry problem, pure and simple, thus very relevant. Nothing to do with diagnosis or checking for other diseases. It would follow, then, that a person with actual expertise in the biochemical reaction of the drug is better suited to talk about its efficacy. Yes, docs deal with all sorts of problems, and have a great cursory knowledge about a great many things, but they are not experts in the science behind the medicine by any stretch. Ask your doctor about the signal receptors that your prescription drugs interact with the next time you see him or her. They won't have a good answer.
Finally, your comment on the database seems to completely pretend that the database is not a work in progress. This information is not readily available to the public, and Propublica is doing a service in attempting to gather this information. Your calculations are irrelevant.
I am a pain management physician, and have been to many medical talks over the years. I went to one recently, where we had a nice dinner, and had an expert in the field discuss new techniques to inject knees with Synvisc. It was wonderful. I learned alot. My patients have benefitted from these injection techniques. Do I use Synvisc? Sometimes. Usually, I use the generic equivalent.
I also went to one put on by the makers of Seraquel XR. We spent an hour discussing mental illness. It was also excellent. I learned all about the medication, and will try it my patients that have failed conventional therapy.
Where else am I going to learn about cutting edge techniques and new medications? There are hundreds of new medications that come out every year. I try to attend conferences whenever I can. The dinner meetings allow me to interact with collegues, and and find out about new treatments and therapies. Do we talk about the medication that sponsored the dinner? Yes, but it is part of a larger discussion, such at ways to treat depression or pain.
The speakers I have met are doctors that are experts in their field. This gives us a chance to interact with them one on, asking questions that no textbook answers.
One of the doctors in my office refuses to see the pharmaceutical reps. I truly feel sorry for him. He is years behind the rest of us in knowledge about current treatment for pain.
Dr. Matt,
There are plenty of resources that your partner who never sees drug reps can use for the latest treatments. UpToDate is an excellent example of an evidence based approach to illness that is constantly updated to reflect the latest research. MedScape CME is another free resource that keeps physicians up to date on the latest treatments.
On the other hand, your drug rep is paid to tell you about their medications using research that has been paid for and often written by the company he or she works for. They are not as well educated as you and certainly don't have the interest you do in helping their patients.
I stopped seeing drug reps 25 years ago when I found out that they were tracking my prescriptions and focusing in on the drugs I was not prescribing. The studies are very clear that any physician who is a "thought leader" (i.e. paid to speak) will significantly increase his or her use of the drug(s) that he is paid to tout. Most of them will say that the money has no effect on their prescribing practices, but the pharmacy monitoring shows differently in every study ever done.
You may be a case in point. You state that you learned that you could use Seorquel XR and "will try it my patients that have failed conventional therapy" in an hour session. Would it not be more efficient to send your patients to a psychiatrist who knows a lot more about mental illness and medications than you do? Also, Seroquel XR is a long acting Quetiapine (which has a half life of 12 hours counting the active metabolite) and is much more expensive than the generic which can be taken BID. It also has significant side effects that you might not be aware of from an hour lecture.
You are probably not aware that AstraSeneca paid a $520 million fine for falsely marketing the drug or that it is abused significantly intranasally especially in prisons where it is known as "Q-Ball." I doubt that your rep told you these things either.
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Dollars for Doctors: How Industry Money Reaches Physicians
ProPublica is tracking the financial ties between doctors and medical companies.
The Story So Far
ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.
Latest Stories in this Project
- With Drug Reps Kept At Bay, Doctors Prescribe More Judiciously
- Pharma Money Reaches Guideline Writers, Patient Groups, Even Doctors on Twitter
- We've Updated Dollars for Docs. Here's What's New.
- Illinois Sues Controversial Drug Maker Over Deceptive Marketing Practices
- Drug and Device Makers Pay Thousands of Docs with Disciplinary Records