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← An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 217 by Dr Benway

Interesting, hungarianelephant. I'm taking what you're saying about drug development oversight and thinking about the problem of oversight in medicine more generally.

Where to invest authority? And who polices the authority? And who polices the police? What is the cost of oversight verses the benefit?

I'm not happy with amatures in the police role. It's so time consuming, explaining yourself to someone who hasn't read the books, etc.

The third party oversight people have made my job nearly impossible. Private practice is going the way of the dinosaur. The administrative overhead is too much.

I hardly ever spend time with patients now. I'm on my ass looking at a glowing screen, making pretty book reports. This is a crazy, costly, inefficient way to do things.

Let me be the first to say that my colleages often do not impress me. Some oversight is good thing.

The tort system is one way to it. But it's so expensive. Lawyers aren't cheap. And any given trial will be about a case or set of cases apart from the background of public health. You don't get sued for ordering too many tests and bankrupting the community chest. The tort system has made doctors so risk adverse they're spending us into the poor house.

Further, courts resolve conflict but are no guarantee of justice or truth, in my humble experience.

Anyway, getting back to the vaccinophobes, the Autism Omnibus hearings have largely ruled against the vaccine-autism link. The Hannah Poling case is an exception, although that child has a mitochondiral disorder, not autism. Still, she's a poster child for the vaccine injury camp.

Governments have set aside funds for children injured due to required vaccinations, to reassure the drug companies they wouldn't be sued out of business, and perhaps to reassure the public. But attorneys after that pile of money in this country and the UK have been at the heart of the recent increase in anti-vax feeling. Note how many guys on the NVIC link I gave are lawyers.

Unintended consequences, I guess.

Wow, this rambles. And shit, I'm late for work.

Tue, 20 Oct 2009 14:17:00 UTC | #407011