Recent Newspaper & Online Columns by Kate Scannell MD

Medicine under the influence -- Abbott's off-label drug promotions

May 27, 2012

Tags: off-label drug promotion, Abbott, Depakote, conflicts of interest in medicine, ethics, evidence based medicine

By Dr. Kate Scannell, Syndicated Columnist; First published in print: 05/27/2012

When I was a young girl, I watched my mother use a small amount of carbonated cola to successfully remove a rusty stain from our kitchen sink. I was amazed -- and a bit worried -- that a beverage I regularly consumed could also serve as a powerful stain remover.

Inspired by my mother's wizardry, I wondered what else the cola might do. Let's just say that experimentation allowed me to discover that the cola could not remove freckles from my little sister's face. And it failed as fuel for my father's cigarette lighter.

Obviously, the cola manufacturer made no marketing claims about its beverage other than encouraging its use as a tasty thirst quencher. My mother and I had freely chosen to use the cola for wholly unapproved uses -- notably, with both success and failure.

After becoming a physician, I discovered that we doctors often prescribed medications for unproven and unapproved uses. We would speculate how a drug proven useful by research to treat a specific illness might work for other diseases as well. That ostensible leap of faith into "the art of medicine" usually entailed a dollop of scientific hypothesis and a dash of hope, and it was generally taken only when a known cure for a patient's disease did not exist. Notably, both remarkable successes and lamentable failures ensued.

There is much talk today about "evidence-based medicine" providing the great corrective to drug-prescribing and medical practice guided by hunch and hope. In theory, evidence-based medicine operates on the assumption that judicious analysis of all the published evidence concerning a particular treatment will lead to an accurate assessment of that treatment's true effects. (more…)

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Prescription--Take two clowns, call me in the morning

May 13, 2012

Tags: medical clowns, hospital clowns, therapeutic clowns, McGill, infertility, laughter in medicine, Scannell

Dr. Kate Scannell, Syndicated columnist; First published in print: 05/12/2012

It was a dark and stormy day. I sat in an overlit hallway of a sprawling urban hospital, anxiously waiting to be ushered into a conference room filled with doctors and administrators. Under considerable stress, I looked down at the notes in my hands, reviewing them one final time in preparation for my presentation. That's when three clowns approached me -- and, no, they were not members of the hospital staff.

I looked up and stared into their painted faces. One clown withdrew a squeaky rubber pen from her enormous pocket and, with dramatic flourish, made two giant check marks on a pink card. After her clown colleagues nodded approval, she handed the "ticket" to me and said: "We're citing you on two counts."

To be frank, I hesitated about engaging with these clowns. After all, I was a serious doctor on a serious mission, preparing for a tense interaction, and I didn't have time for, well, clowning around. Still, I was surrounded by three clowns, and the last thing I needed before my meeting was a lapel-flower squirt of water in my face.

So I smiled politely and read aloud the charges on my citation: "Feet are not big enough" and "Gathering too much dust." (more…)

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