An open response to Anonymous commentary

So I was surprised to find that I had 2 comments moderate yesterday.  Both by anonymous strangers.  And apparently one of them by someone familiar with the subject of a previous post.  This represents the first time I have received a critical comment as opposed to the friendly kudos I usually get from my friends.  Funny thing, I was curious about how this happened.  Then I googled "jon marshall hydroxycut" and my blog appears at the end of the first page.  In this post-hydroxycut-recall world, its not so far fetched that someone might punch that in and find McBrandon's Blog For Profit.  I promised to address the comment, so here it is. 

"There seems to be a full blown attack on Dr. Marshall"

I'm not attacking him, I merely implied that you are a sell-out if you use your degree to appear as an authority on something you are not.  I will graduate from medical school in two weeks, and although it would be tempting to take $100,000 from Extenze to claim their product works, I would not feel that I was qualified to sign off on whatever data they present to me since it would be clearly biased.  Oh and, Hydroxycut and Extenze are food in the eyes of the government, so why should I put my reputation on the line for something that does not meet the current standards of medical care.


"What does this mean for the Physicians who wrote Rx's for Celebrex, Lipitor or verbally recommended Tylenol?"


I'm not sure it means anything new.  Adverse drug reactions occur daily, drugs that are found to be more dangerous than helpful are weeded out of the market.  As long as the prescribing physician is acting within the standard of care and monitoring side effects, it is reasonable to expect now and again some patients will be unlucky.  At least, a certain amount of efficacy and safety has to be demonstrated by drugs before they are brought to market.  Although there have been rare reports of Lipitor causing fatal idiosyncratic drug reactions including liver failure in 1/1,000,000 patients.  The number of premature deaths delayed by Lipitor outweighs the minute number of fatal reactions.   This is based on good peer-reviewed data.  The FDA specifically does not evaluate the claims of Hydroxycut to cure or treat any disease.  So if you ask, would I go on TV and endorse Lipitor? Maybe if I was a cardiologist with experience in patients who benefited from the drug.  Would I go on TV and hawk Hydroxycut after reading ten pages of "research" prepared by the manufacture and taking some free samples, no. 

"Are we punishing the prescribing physicians for the pt's inability to read warning labels or understand that if you 'Are' suffering from multiple illness ... that taking any drug non-prescribed (or prescribed) would result in a negative outcome."




No, but there is a significant amount of litigation against pharmaceutical corporations involving previously approved prescription drugs that result in bad outcomes, I'm thinking Vioxx.  If a physician prescribes a drug for a non-approved indication, or uses it in someone who has a contraindication to that drug, they are then vulnerable to the threat of malpractice litigation.  I'll make it clear though, I have never met an actual real life doctor who prescribes drugs as part of their practice, recommend Hydroxycut.

"Is the issue really that Dr. Marshall endorsed a product ... Or is it that he is an attractive physician that intelligently spoke on the data he was provided?"

You don't need to go to medical school to know that if the clown from Hydroxycut offer you studies to prove their food is safe and works that it is probably not first rate science.  I would not call reading a script saying that simply that a product "works," is intelligent analysis of data.  It takes hundreds of millions of dollars to get a new drug approved for market via the FDA, whatever Hydroxycut did I'm certain it was cheaper.  He exploited his doctor status and appeal for money, I don't know him, but, I doubt he did it because of an altruistic need to endorse something he really thought was helpful.  The real issue, is that the manufacture manipulated the public into thinking that some kid freshly minted from medical school is an authority on anything.  When I consider what drugs to prescribe, my influences are generally board certified physicians in a specialty pertaining to the disease I am treating.  I am very skeptical of advertising, the way marketing is used against people's judgement is at times insulting. 





"Seriosly ... How intelligent does ANY physician sound in a time of recall where they are guilty of prescribing the drug?"






You bring up an important point, you have to keep your patients trusting that you have both the knowledge, skill, and intention to do what it is best for them.  However, generally when drugs get recalled now, it is due to post-marketing surveillance that reveals harmful reactions that happen over a longer amount of time when prescribed to a larger group of people than done in FDA trials.  However, Jon Marshall was not endorsing a product that had been cleared by the FDA.  He was endorsing food.  If Hydroxycut was such a great idea, how come this relatively inexperienced physician was the only doctor on television endorsing it.  I didn't see Sanjay Gupta telling people to take it.  

Medicine is a profession and thus, it is important to protect the integrity of our profession.  Leave the endorsement of infomercial products to Chuck Norris, Susan Lucci, and Chef Tony. 

"Just asking .............."

Just saying......