Chinese labs modify deadly fentanyl to circumvent ban on sales to US

first_img Chinese laboratories are producing and openly selling a new form of deadly fentanyl to get around China’s recent export ban on the synthetic drug causing thousands of overdose deaths across the United States.The slightly tweaked version of fentanyl — called furanyl fentanyl — is so new that it is not on the US government’s list of controlled substances. That means the altered fentanyl, which was blamed for the March overdose of an Illinois man, is technically legal for drug dealers to sell.The US Drug Enforcement Agency told STAT Monday that it is moving quickly to ban street sales of the new fentanyl product. The agency plans within days to classify furanyl fentanyl  as an analog to fentanyl, which would mean the new drug would be treated in the same fashion as fentanyl, said DEA spokesman Russell Baer. He added that the producers of the new fentanyl are located in China and said the agency is planning similar action with other fentanyl analogs it has identified.advertisement By David Armstrong April 26, 2016 Reprints Leave this field empty if you’re human: In many areas of the United States and Canada, fentanyl is now causing more fatal overdoses than heroin. The drug is up to 100 times more potent than morphine and many times stronger than heroin. In some cases, fentanyl is being sold in pill form, often made to look like other prescription painkillers that fetch a higher price on the street. Fentanyl is also being added to heroin. Users are often unaware they are snorting or injecting the more powerful fentanyl. Tags ChinaDEAfentanylopioidspolicy HealthChinese labs modify deadly fentanyl to circumvent ban on sales to US Once the ban was in place, furanyl fentanyl began to show up in the United States.“Laboratories are automatically tweaking the formula to come up with the next analog,” said Baer. “We will seek to put furanyl fentanyl on the list (of controlled substances), and then they will tweak one molecule, and in two months we will be discussing that one. It is a challenging process for us.”A laboratory company called Dharma Chemicals, or Dharmachem, that reports an address in a central China commercial district, recently told a STAT reporter by email that is was no longer selling the banned acetyl fentanyl, but that it “just added” furanyl fentanyl to “our catalogues.” The company said the drug was being sold for “laboratory research.”The company was previously accused in a World Health Organization report of selling acetyl fentanyl over the Internet.Furanyl fentanyl was recently identified as the cause of death in the fatal overdose of a 30-year-old man in Naperville, Ill., a suburb west of Chicago, according to an overdose database maintained by the Will County coroner. It appears to be the first public reporting of a case in which the new version of fentanyl caused a deadly overdose. Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. A company that lists its headquarters in the Chinese city of Wuhan is offering a new version of potent fentanyl to US buyers. Rex Features via AP US refuses to release records on Chinese companies linked to deadly fentanyl trade Privacy Policy Related: ‘Truly terrifying’: Chinese suppliers flood US and Canada with deadly fentanyl Read the most popular stories this hourThe chemical structure of the new drug, and its effect on the body’s central nervous central system, is nearly identical to that of fentanyl. China last fall banned more than 116 synthetic drugs, including other analogs of fentanyl. One of the most popular of those is called acetyl fentanyl. Fentanyl can be legally prescribed by physicians, often to treat chronic pain. Any other sale of the drug is illegal.The DEA is also working to place the new version of fentanyl on the permanent list of controlled substances, a move that requires review by the Food and Drug Administration, Baer said.advertisement Please enter a valid email address. Related:last_img read more

Female veterinarians can expect less pay — and that’s baked into this salary calculator

first_imgLeave this field empty if you’re human: Harvard Med narrows faculty gender gap, but slowly File this under “doggone it!”Seeking to help new veterinary graduates with their job hunt, the American Veterinary Medical Association last week distributed a starting salary calculator that instructed women to automatically deduct nearly $2,407 off the top.But the move backfired. Some members criticized the decision to include the deduction and interpreted it as a sign that the AVMA was, effectively, endorsing disparities in pay between men and women, since there was no explanation given for the deduction. In an email, one vet wrote to others that the calculator may reflect real-world data, but that was “not a reason” to use it as a guide for recent grads on starting their salary talks.advertisement Please enter a valid email address. The grousing put AVMA officials on the defensive.On Monday, Dr. Joseph Kinnarney, the association president, sought to dispel concerns by sending an email to AVMA members to explain the calculator does, indeed, reflect actual data, but is not a “value statement on what should be.” He added that “we absolutely agree there is no valid reason for this gender salary bias — and it is inherently unfair.”advertisement Ed Silverman Reed Saxon/AP [email protected] Newsletters Sign up for Pharmalot Your daily update on the drug industry. He went on to argue the AVMA has, for the past three years, attempted to highlight the gender gap and, by inserting the data into the calculator, he believes the organization is alerting vets to the issue. “If we are going to work on solutions, we must first openly acknowledge the problem exists,” he wrote. He added the AVMA is taking steps to equip students and new grads to deal with the problems by providing seminars on negotiating skills.“Illuminating this gender disparity in our Salary Calculator is an example of how, by highlighting an issue that is plaguing the profession, we are providing an opportunity to engage our membership and seek potential solutions,” he wrote. The association maintains that removing the gender factor from its calculator would not help identify or address the problem.However, there was no mention in his email of any steps the AVMA may be taking to influence those who do the hiring and convince them to close the gender pay gap. But an AVMA spokeswoman says the association sends reports to members that include information on salary gaps. She also noted that in instances when AVMA identified gender pay gaps, such female vets own their practices but typically make less than their male counterparts.center_img Privacy Policy Tags pay gapveterinarian Related: @Pharmalot By Ed Silverman May 25, 2016 Reprints BusinessFemale veterinarians can expect less pay — and that’s baked into this salary calculator Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. About the Author Reprintslast_img read more

5 health and medicine issues to watch for at the Democratic convention

first_img Clinton vs. Trump: A race between a policy wonk and a ‘black box’ Tags Hillary ClintonpolicyPresidential campaign Leave this field empty if you’re human: The other recent Democratic nominees have talked about health care in varying levels of detail, but they’ve all made it an important part of their speeches. Bill Clinton talked in 1992 about “an America in which health care is a right, not a privilege,” foreshadowing both Clintons’ ill-fated attempt to reform the health care system. In 2000, Al Gore promised to “find new medicines and new cures, not just for cancer, but for everything from diabetes to HIV/AIDS.”And in 2008, Barack Obama set the stage for the Affordable Care Act by calling for “affordable, accessible health care for every single American.” He also promised that “my plan will lower your premiums” for people who already had insurance — a promise that didn’t exactly come true. (Oops.)What will Kaine bring to the table?Clinton’s brand new running mate, Senator Tim Kaine of Virginia, is a reliable ally on issues like letting Medicare negotiate drug prices. But he’s also earned a unique reputation for focusing on prevention — keeping people healthy by heading off medical problems.So it will be worth watching to see if Kaine can make a case for preventive health care in his acceptance speech — an angle that would help round out Clinton’s health care platform.What about Obama’s medical research initiatives?While Clinton has talked about her own research priorities — including Alzheimer’s, autism, and HIV/AIDS — she has said less about the future of the programs President Obama has launched, including the Precision Medicine Initiative, the BRAIN Initiative, and Vice President Joe Biden’s cancer effort.The convention speech will give her a chance to do that. For Clinton, it’s a two-fer. Not only would it allow her to talk about her ideas for medical research — it also feeds into her view, which she has expressed in past speeches, that funding medical research is good for the economy because it helps create jobs.“Let’s fund the scientific and medical research that spawns innovative companies and creates entire new industries, just as the project to sequence the human genome did in the 1990s, and President Obama’s initiatives on precision medicine and brain research will do in the coming years,” Clinton said in a speech last year at the New School in New York.Will there be any surprises in the Trump attacks?So far, Clinton’s attacks on Trump’s health care proposals have been standard fare. She has gone after him for proposing to repeal Obamacare — saying that would allow insurance companies to go back to rejecting people with health problems — and she has accused him of wanting to “wipe out safe, legal abortion.” Privacy Policy By David Nather July 25, 2016 Reprints Hillary Clinton takes in big money from drug industry Matt Rourke/AP Related: WASHINGTON — Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads.So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. What she says about the future of medical research, public health, and the uninsured will give a valuable preview of what her priorities would be — and how far she’s willing to go to co-opt the ideas of her defeated rival, Bernie Sanders.Here are the five biggest things to watch in health and medicine:advertisementcenter_img Please enter a valid email address. Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. That package, worked out in detail between the Clinton and Sanders policy staffs, has helped to ease tensions between the two camps — so the Sanders campaign will be watching closely to see how much of it she mentions in her speech.“This deal is an extremely important initiative. It will save lives and ease suffering,” said Warren Gunnels, Sanders’s policy director. “We look forward to working with her to turn it into a reality.”Clinton and Sanders always saw eye to eye on the need to rein in prescription drug prices, but her acceptance speech will signal how enthusiastic she is about her new add-ons. She won’t talk about “Medicare for all,” as Sanders does — that was one of their biggest conflicts during the primaries. But she could embrace the goal of health care as “a fundamental right for every American,” as the Democratic platform says.Those who want single-payer health care, however, won’t have to wait long to hear about it — it’s virtually guaranteed to be in Sanders’ speech on Monday night. “You’ll never hear Senator Sanders stop talking about a Medicare for all, single-payer system,” Gunnels said.How wonky will Clinton be?Most convention speeches are broad and thematic, not laundry lists of policy proposals. But wonkiness is a big part of Clinton’s brand. And she has already spent much of her campaign putting out detailed proposals for reining in rising prescription drug costs, lowering out-of-pocket health care expenses, accelerating Alzheimer’s disease research, supporting people with autism, and fighting substance abuse.So health care and medical research groups will have a lot of reasons to tune into Clinton’s acceptance speech on Thursday night. Whether she mentions her proposals specifically — to contrast herself with the often vague Donald Trump — or just talks generally about the next steps in health care, her speech will send important signals about which issues would get the most attention in a Hillary Clinton administration. Both points are good bets to make their way into her speech, especially now that aggressive abortion opponent Mike Pence is on the GOP ticket. But the bigger question is whether Clinton —  or any of the other convention speakers —  will highlight Trump’s remarks and actions that have alarmed people in the medical research community, from tweeting about long-disproven theories about links between vaccines and autism to suggesting he might appoint a talk radio host as NIH director.If they do, it would mean Clinton has decided to make her support of medical research — and science generally — part of the broader case for her election, not just her work on the health care issues that are always popular with the Democratic base. Related: Politics5 health and medicine issues to watch for at the Democratic convention How much will Clinton channel Sanders?When she first got into the race, Clinton’s goals for building on Obamacare were relatively modest, and focused mainly on controlling health care costs.Now that she’s survived an unexpectedly tough nomination battle against Sanders — who wanted to keep expanding health care to reach the 29 million Americans who are still uninsured — she has gone farther. She now has proposals to let people 55 and older join Medicare, offer a “public option” health plan in every state as an alternative to private Obamacare plans, and doubling federal funding for community health centers for low-income people.advertisementlast_img read more

Amrit Chaudhuri: Part bio-socialite, part bioscientist, helping young companies scale up

first_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Log In | Learn More Biotech Correspondent Meghana covers biotech and contributes to The Readout newsletter. STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. About the Author Reprints Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Amrit Chaudhuri: Part bio-socialite, part bioscientist, helping young companies scale up What is it? GET STARTED Hyacinth Empinado/STATcenter_img Meghana Keshavan Biotech “In the Know” features conversations with the people and personalities in biopharma.If you want to spend the day talking biopharmaceutical investment and infrastructure, and then sneak into a rock ’n’ roll show at night — then Amrit Chaudhuri’s your guy. Tags STAT+ By Meghana Keshavan July 7, 2017 Reprints What’s included? [email protected] @megkesh last_img read more

Martin Shkreli’s bail revoked, he heads to jail after Facebook post on Clinton

first_img Associated Press Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. By Associated Press Sept. 13, 2017 Reprints What’s included? Martin Shkreli’s bail revoked, he heads to jail after Facebook post on Clinton Tags legalpharmaceuticals What is it? Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED Log In | Learn More NEW YORK  — Former pharmaceutical company CEO Martin Shkreli had his bail revoked and was headed to jail Wednesday while awaiting sentencing for a securities fraud conviction.A judge heard arguments about whether the provocative online antics of Shkreli, dubbed the Pharma Bro, were bad enough to put him behind bars and decided to have him taken into custody immediately. GET STARTED About the Author Reprints Pharma Martin Shkreli on the first day of his securities fraud trial in June. Kevin Hagen/Getty Imageslast_img read more

Sales of antibiotics used in food-producing livestock unexpectedly dropped

first_img In an unexpected development, sales of antibiotics used in food-producing livestock fell in the U.S. in 2016 although drawing any firm conclusions from the data is likely premature, since a new program designed to limit usage did not go into effect until this year.Last year, sales dropped 14 percent from 2015, the first time since data collection began in 2009 that there has been a year-over-year decrease in the sale of medically important antibiotics used in food-producing animals, according to a report from the Food and Drug Administration. “Medically important” refers to antibiotics that are also used to treat people. Sales of antibiotics used in food-producing livestock unexpectedly dropped Log In | Learn More Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED @Pharmalot GET STARTED Ed Silverman By Ed Silverman Dec. 11, 2017 Reprints About the Author Reprints Pharmalot center_img Nati Harnik/AP Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Tags antibioticsFDApharmaceuticalsSTAT+ What is it? [email protected] STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What’s included?last_img read more

LISTEN: The FDA’s cold shoulder, the latest CAR-T contender, and how Grindr relates to personal genetics

first_img What’s it like to be a biotech investor? Do you know where your genetic data are? And what does it mean when the FDA swipes left on your drug?We tackle all that and more on the latest episode of “The Readout LOUD,” STAT’s biotech podcast. Tune in for a recap of the lively chat about capitalism we had on Wednesday, a dive into the latest CAR-T upheaval, and a discussion of how the FDA’s quote-unquote flexibility might be a little more rigid than biotech thought. Also we talk about Grindr.For more on the topics we cover, here’s a story on the new CAR-T company; here’s the news on Alkermes and the FDA; and here’s the BuzzFeed News scoop on Grindr.advertisement [email protected] The Readout LOUDLISTEN: The FDA’s cold shoulder, the latest CAR-T contender, and how Grindr relates to personal genetics We’ll be back next Thursday evening — and every Thursday evening — so be sure to sign up on iTunes, Stitcher, Google Play, or wherever you get your podcasts.And if you have any feedback for us — topics to cover, guests to invite, vocal tics to cease — you can email [email protected] By Damian Garde , Rebecca Robbins, and Adam Feuerstein April 5, 2018 Reprints Damian Garde National Biotech Reporter Damian covers biotech, is a co-writer of The Readout newsletter, and a co-host of “The Readout LOUD” podcast. Adam Feuersteincenter_img Tags cancergeneticspodcastpolicy [email protected] @adamfeuerstein Senior Writer, Biotech Adam is STAT’s national biotech columnist, reporting on the intersection of biotech and Wall Street. He’s also a co-host of “The Readout LOUD” podcast. About the Authors Reprints @damiangarde last_img read more

Democrats offer a counterpoint to Trump’s drug pricing policy before major speech

first_img By Erin Mershon May 10, 2018 Reprints @eemershon GET STARTED [email protected] Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What’s included? Democrats offer a counterpoint to Trump’s drug pricing policy before major speech WASHINGTON — A coterie of the country’s most powerful and recognizable Democrats gathered Thursday to offer their early rebuttal to President Trump’s anticipated Friday address on drug prices.As one lawmaker put it, the group was “hopeful, but … not optimistic” that Trump would deliver on his early promises to lower prescription drug prices. What they want to see, however, is far broader than anything that top Trump administration officials have hinted at ahead of Trump’s Friday speech. Senate Minority Leader Chuck Schumer of New York AP Photo/Alex Brandon Senior News Editorcenter_img Log In | Learn More Unlock this article — plus daily intelligence on Capitol Hill and the life sciences industry — by subscribing to STAT+. First 30 days free. GET STARTED What is it? Erin Mershon About the Author Reprints STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Politics Tags Congressdrug pricinglast_img read more

Up and down the ladder: The latest comings and goings

first_img Up and down the ladder: The latest comings and goings By Ed Silverman July 27, 2018 Reprints [email protected] Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Alex Hogan/STAT @Pharmalot Pharmalot Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What is it? GET STARTEDcenter_img Log In | Learn More STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. About the Author Reprints Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Hired someone new and exciting? Promoting a rising star? Finally solved that hard-to-fill spot? Share the news with us, and we’ll share it with others. That’s right. Send us your changes, and we’ll find a home for them. Don’t be shy. Everyone wants to know who is coming and going.And here is our regular feature in which we highlight a different person each week. This time around, we note that Amgen (AMGN) named Murdo Gordon as executive vice president of global commercial operations, replacing Anthony Hooper, who will be retiring. Previously, Gordon worked at Bristol-Myers Squibb (BMY), where he was chief commercial officer. What’s included? Ed Silverman Tags jobspharmaceuticalsSTAT+last_img read more

We love primary care. Why are our trainees so discouraged by it?

first_imgFirst OpinionWe love primary care. Why are our trainees so discouraged by it? About the Authors Reprints Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. A third patient, a woman with severe depression and poorly controlled diabetes, arrived in the office with her log of blood sugars, finally engaging in self-managing her disease after consistent outreach by a dedicated and caring team, some of whom she has known for 30 years. These are not one-off visits to a walk-in clinic. Primary care at its core often requires a deep understanding of the patient and the development of trust over time. We feel honored by this trust and inspired to give our best to help.advertisement [email protected] Carl Court/Getty Images Leave this field empty if you’re human: A call to overhaul primary care and deconstruct it into newly “specialized” and more manageable pieces worries us as being potentially problematic for the health of the public, since ample evidence documents better health indicators and higher patient satisfaction in societies that have robust primary care systems.“Specializing” primary care does not guarantee freedom from debt, inefficiency, or burnout. We see other solutions:Address and solve some of the systems that overburden primary care providers.Support them with multidisciplinary teams to deal with the multitude of contextual factors that create poor health and complicate care.Train them differently so they see complex patients as deeply in need of their care and thus more rewarding to work with, and see systems obstacles as opportunities to innovate.Fixing primary care doesn’t lie in turning away from it, but rather in working together to create a system in which physicians can effectively lead interdisciplinary teams in providing high-value and equitable health care to the populations they serve.The dominant values of the environment in which medical students and residents learn medicine shape their experiences, the lessons they absorb, and the solutions they envision. We must train a cohort of young physicians who see themselves as change agents, and who embrace and advance the mission of primary care: to improve the health of the public through a continuous relationship with a caring provider who provides first access to care, coordinates treatment and preventive efforts, and advocates for patients in an often complex system.We must also clear away the obstacles, and ensure that residents learn and train in an environment that promotes, rather than undermines, a vibrant primary care system that is at the core of a rational and effective health system.Barbara Ogur, M.D., is a faculty member of the Center for Primary Care and an associate professor of medicine at Harvard Medical School, and a primary care physician at the Cambridge Health Alliance. Katherine Miller, M.D., leads the Harvard Home for Family Medicine is an assistant professor of medicine at Harvard Medical School, and is a primary care physician at the Cambridge Health Alliance. Russell Phillips, M.D., is the director of the Center for Primary Care and a professor of medicine at Harvard Medical School, and a primary care physician at Beth Israel Deaconess Medical Center. Related: So we are alarmed and confused when the residents we train choose to leave primary care. We agree wholeheartedly with a number of the issues they cite: the electronic medical record with its primary service to the billing department rather than the patient, the unfair reimbursement for non-procedural specialties, the overwhelming debt burden from medical training, the long hours, and the complex social and emotional contexts that complicate our patients’ care. These are undeniable barriers that sap the joy and satisfaction that come with providing the longitudinal coordination of care, advocacy, clinical reasoning, and caring that are the core of primary care.For us, and many others, the joy of primary care has not vanished. We recently surveyed students who graduated from Harvard Medical School between 1980 and 2016 and matched into residency programs that might lead to careers in primary care. Only 48% of the respondents continued on with primary care. Those who did that said they were highly satisfied with their choice. Despite the travails of the electronic medical record, the long hours, the complex patients, and the lower pay, they still found intense satisfaction in their generalist’s practices and their deep connections with patients. The intensely engaging core of the work is still there.Still, too many young doctors have lost faith that their ideals for primary care can be realized in today’s health care environment. We suspect it’s not just the electronic medical record, or even lifestyle issues. Practicing medicine has always been hard, and we know that our trainees are strong. We suggest that the root of their dissatisfaction is the corporatization and bureaucratization of medical practice, which impinges on our professional autonomy, leaving us less flexibility to do what needs to be done for each patient. Barbara Ogur Privacy Policycenter_img We have been primary care physicians for a combined total of 98 years. Every day we are reminded why we do it and why we love this type of medicine.Here are three examples from a single day in one of our practices that show how a trusting relationship built over time has been vital to providing good care. One patient was a young woman whose recurring sinus infections and refractory asthma were treated with single-contact visits with specialists for years. None of them identified the underlying immunological disease that was causing her problems. But by observing her clinical course over time, her primary care physician realized she needed to be seen by a specialist in vasculitis. She also needed ongoing rapid access to a doctor who knows her complicated history when new issues arise and can coordinate specialists so nothing falls between the cracks.Another patient was a middle-aged man with severe back pain due to lumbar disc disease who had been prescribed opioids for his pain when that was the standard of care. Over the next five years, his work took him out of the area, and he switched to heroin as prescription opioids became hard to find. Feeling consumed with guilt, he returned to his primary care provider, told her what was happening, and asked about buprenorphine treatment.advertisement [email protected] Please enter a valid email address. @HMSPrimaryCare Katherine Miller Tags educationphysicians Russell Phillips By Barbara Ogur, Katherine Miller, and Russell Phillips July 11, 2019 Reprints We were inspired to become primary care physicians. Now we’re reconsidering a field in crisis [email protected] last_img read more