Canadian medical journals world leaders in drug ads: study
The Montreal Gazette reports the Quebec College of Physicians issued the decree after two University of Montreal ethics specialists were alerted by school staff to separate incidents involving the matter. Imagine a doctor who does a gynecological examination with the sole purpose of … it goes beyond the imagination. And its degrading to women, Charles Bernard, president of the College des medecins, told The Gazette. The Quebec College of Physicians is, among other things, responsible for dispensing ethical guidance on medical issues for its many member physicians. The Gazette writes University of Montreal ethicists were contacted by a clinic nurse after a young woman asked the health professional during a routine medical exam whether, she was still marriageable. But by then, it seems the ethicists were already grappling with the issue. Two weeks prior, the same researchers reportedly fielded a call concerning an adolescent whose family had forced her to undergo a chastity test at a local clinic. The girl subsequently told her school nurse, who then contacted the university. We got the impression that the physician was pressured by the family in the emergency room. The father was very insistent about having the certificate, and to get rid of the problem, the doctor did it, University of Montreal researcher Marie-Eve Bouthillier reportedly said. The Gazette writes Canadian officials have focused on the issue of late, or since the bodies of four women of Afghan descent were discovered in Ontario in 2009. They were reportedly murdered by relatives in so-called honor killings.
and Britain looked at the number of ads in six highly read journals from the three countries over a six-year period. Pharmaceutical ads took up almost as much space as peer-reviewed editorial content in the two Canadian publications the Canadian Medical Association Journal (CMJ) and Canadian Family Physician, they concluded in the online journal Plos One . That was several-fold more than the ratio of ads to articles in the U.K.s British Medical Journal and Lancet, and the U.S.-based New England Journal of Medicine and Journal of the American Medical Association, they said. At most, advertising in the non-Canadian journals represented about 20% of the space taken up by editorial content. Everyone was surprised by that finding, said Dr. Persaud. It did not come as a surprise, though, to Dr. John Fletcher, editor-in-chief of the CMAJ. Canadian journals have traditionally relied more on advertising than their counterparts in Britain and the U.S., even though the volume of ads has been declining, he said. The edited content of journals provides information about medications, which makes you wonder why we also needs ads Some of the added revenue also stemmed from a previous requirement that pharmaceutical companies include detailed prescribing information with their ads, which could sometimes occupy two or three pages at the back of the journal, said Dr. Fletcher. That government requirement was recently lifted, though. The CMAJ has mechanisms in place to ensure its independence, he said, but acknowledged that changing the funding model is a discussion worth having.
The Canadian contribution to the US physician workforce
1 The growth of the family physician workforce was aided by an 11.9% increase in the number of international medical graduates practising in Canada and by a 5.1% increase in graduates from Canadian medical schools between 2000 and 2004. 1 Unlike people in the United States, nearly all Canadians (97%) have a family physician; however, nearly 1 in 3 Canadians surveyed in 2002 reported difficulty finding a regular family physician or seeing their family physician when needed. 2 Over half of Canadians surveyed in 2002 said it was very or somewhat difficult to see a specialist: 2 Access problems are worse for rural Canadians. 3 By the early 1980s, concern about medical care costs led Canada’s provincial and federal governments to regard physicians as independent cost centres. This perception and a report in 1991 stating that there was a physician surplus led to physician-workforce reduction policies. 4 , 5 These policies restricted the entry of international medical graduates into Canada and reduced the size of classes in Canadian medical schools by 13.4% between 1991 and 2000. 6 A series of new policies in the late 1980s and early 1990s controlled health care spending, discontinued rotating internships (increasing training time and specialty training), limited interprovincial migration of new physicians and financially penalized, or threatened to penalize, new physicians practising in overserviced areas. 6 The early 1990s also saw a wave of retirement by doctors who came to Canada in the 1950s and 1960s and a deliberate increase in the ratio of specialist to family medicine training positions. 6 All of these factors are blamed for a relative shortage of physicians in Canada in nearly all specialties. Changes in the emigration patterns of Canadian-educated physicians are not believed to have had a profound effect on workforce reduction; however, this view usually compares yearly emigration with the total physician workforce. 6 , 7 Between 1981 and 2004, Canada had an annual net loss of Canadian-educated physicians, in large part due to immigration to the United States. 1 , 4 The Association of American Medical Colleges recently pronounced an impending physician shortage in the United States and called for a 30% expansion in medical school enrolment over the next decade and similar expansion in residency training programs. 8 Given the porous nature of the CanadaUS border for physician migration and pronouncements by both countries of a physician-workforce shortage, we chose to study the effects of migration on the Canadian and US physician workforces.
click over here http://www.cmaj.ca/content/176/8/1083.full