I will go first.
There was a time when I assumed my role was to write the words I was hired to write. Nothing to see here folks--If the client had a phase III drug about to be approved, the words should plant a fertile field for the industry client to harvest all the spoils.
Well, shortly thereafter I realized what I was sowing was carefully edited manure. You could smell it a mile away but what was an independent medical writer to do? I started noticing the data. I was lucky. Numerous stats courses and an ability to learn a little bit of SQL and Python opened many doors to how the data sausage was made.
I decided I needed my own platform. Like-minded professionals can gravitate toward or away. As Seth Godin would infer, This is what I made--It might not be for you...
Around this time, I attended my first Lown Conference. John Ioannidis presented and my suspicions were confirmed. All was not well in evidence-based medicine. I wrote about his prescient articles numerous times. What follows is a quick summary of what grabbed my attention from Lown 2018--my 3rd Lown conference.
A big differentiator at Lown is the audience. A robust mix of writers, analysts, policy experts, patients, providers, and a variety of stakeholders with a passion and deep concern for US healthcare--and most importantly--for the patients we are supposed to be serving.
Shannon Brownlee's book Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer was published in 2008. I think she must be some kind of soothsayer because it is hauntingly predictive and timely.
Good healthcare can not be separated from social correlates of health. We should be asking about our values before creating a brand like "value-based care."
Powerful discussions from the podium and highlighted in panel sessions emphasize the need for multi-national coalitions to redefine the medical industrial complex for humanity--not profit. A sobering but salient comment, "Prince Edward Island is no match for Pfizer" reminds us that individually--country by country the best efforts will be no match for large power wielding global pharmaceutical companies. Driving what they have branded "innovation" that is in reality, patent protection and share holder investments.
In closing, Dr Martin reminded us that Canadian Medicare is narrow but deep--good for what it covers but more is needed. Civic engagement is not about patients but democracy.
The colorized image represents the close-up of what that quadrant will look like when we describe key resources and activities, attributes of a competitive value proposition, the role of the customer and their relationships, revenue generation, cost structure re-alignment, and identification of partnerships to maximize drug effectiveness in this new model.
For perspective on what 1 trillion looks like--think of it as time:
How Long Ago Is a Trillion Seconds?If you count backward, then:
1 million seconds = 12 days ago
1 billion seconds = 31 years ago
1 trillion seconds = 30,000 B.C.
(give or take a decade or two)
I am also waiting for Dr. Vinay Prasad's latest article. If you are active in the healthcare sphere on twitter--you likely know Vinay. It should be published soon and a graphic shared at Lown describing false positives in immune-oncology trials and costs and profits associated with randomized controlled trials will continue to illuminate the lagging results in huge oncology pipelines.
Dr. Prasad's work has demonstrated that many medical practices, promoted and advocated for decades, are ultimately shown not to work. These reversals typically occur when we adopt new therapies based on incomplete or inadequate studies. Dr. Prasad has also demonstrated that the high cost of cancer drugs is not explained by rational factors, that media coverage of medical articles preferentially covers lower levels of evidence, that industry sponsored randomized trials have substantial bias, and that many current medical practices have no convincing proof of efficacy (e.g. IVC filters).
Thank you again to my sustaining donors! I could not do it without you.