502.495.5040

News - 2018

Consistency is the Hobgoblin of Little Minds

Oct
16

“Consistency is the hobgoblin of little minds.”

~ Ralph Waldo Emerson, Self-Reliance

There was a recent publication from NPR concerning a study of physicians who treat with Seroquel (an antipsychotic drug). These physicians received letters from Medicare that gave a general warning that they were being “flagged/warned” as above-average prescribers of this medication. Guess what, two years later and without follow-up, the physicians’ usage of this drug dropped dramatically.

We have found that scientific peer-to-peer intervention with treating physicians is one of the most cost-effective techniques to improve outcomes. This is best handled by a professional, highly credentialed panel of providers who will engage treating physicians with data on the latest science and industry guidelines. Nothing is more rewarding and cost-effective than providers who are willing to listen and then voluntarily modify their protocols.

No attorneys. No regulators. No disputes. No appeals.

Just doctors who decide to do better and change their minds. Sometimes you need a hobgoblin to correct a wrong.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Fasten Your Seatbelts, It’s Going to be a Bumpy Ride

Oct
08

“Fasten your seatbelts, it’s going to be a bumpy ride.”

~ Bette Davis in All About Eve

I’m linking to a press release from the Food and Drug Administration, as well as a recent article by Jeffrey Singer in Cato At Liberty. The headline below tells me we might be in for a scientific royal rumble:

“New FDA Initiative Implies CDC
Opioid Guidelines Are Not Evidence-Based”

The Centers for Disease Control and Prevention (CDC) promulgated opioid prescribing guidelines in 2016. Some patient advocacy groups, as well as addiction/pain medicine specialists, have criticized these guidelines as not being evidence-based.

In light of these criticisms, the FDA has awarded a contract to the National Academies of Sciences, Engineering, and Medicine to more specifically develop guidelines relative to opioid prescribing. The FDA intends this study to be indication-specific and based on evidence drawn from clinical practice.

Buried in the press release is this nugget: “Our work could potentially inform drug labeling.”

Let the science and evidence speak. We’re fastened up and ready to do better.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

FDA Surrenders in TIRF War

Sep
18

Were you expecting TURF instead of TIRF? This is not a typo. TIRF stands for transmucosal immediate-release fentanyl.
We all know about these fentanyl sprays, tablets and lozenges, and that they are a risky narcotic 50 times stronger than heroin and up to 100 times stronger than morphine. Generally their label use is for cancer patients with high opioid tolerance.
Emily Baumgaertner, writing in The New York Times, explains how these drugs are being prescribed for back pain and migraines, and how the FDA did little to monitor or curb inappropriate use. Essentially, the FDA entrusted Big Pharma (that makes and sells the drugs) to provide the oversight.
Brandeis University opioid policy researcher Dr. Andrew Kolodny is quoted as follows: “They had the fox guarding the henhouse, people were getting hurt — and the FDA sat by and watched this happen.”
Gee, I wonder if the fact that a month’s worth of prescription can cost tens of thousands of dollars made a difference to the fox that was guarding the henhouse?
Big Pharma will not do better. Regulatory agencies are well-meaning, but…
…Pharmaceutical UR is the key.
Call us. We can do better.
William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

It’s Like Watching Sausage Being Made

Sep
04

A common saying for a distasteful process is that “it’s like watching sausage being made.” We can appreciate the end result, but we don’t necessarily want to see the inner workings.

I’ve had occasion recently to see the sausage being made as regulations are drafted for new Kentucky legislation:

  • Limiting medical benefits to 754 weeks in most cases;

  • Selecting and installing new treatment guidelines for medical providers to use in workers’ comp cases;

  • Installing a pharmaceutical formulary.

If this sounds like a lot to do in a short period of time, you would be correct.

All of these are mandated by statute and have different effective dates. Nevertheless, Commissioner Robert Swisher and Chief Administrative Law Judge Douglas Gott must act fast to get this accomplished. To assist them, they have formed two committees — one which will draft regulations, and the other which will advise on selection of treatment guidelines and drug formulary — and I was fortunate to sit in on their meetings yesterday. The committees include plaintiff and defense attorneys, various physicians, physical therapists, and claims and carrier representatives. All are well qualified to offer guidance germane to their areas of expertise, and Swisher and Gott are genuinely receptive to what they are hearing.

So, I have to tell you that watching this sausage being made isn’t so bad. With well intentioned, intelligent folks on all sides, this may work out after all.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Physicians’ Prerogative to Change Their Minds

Sep
04

Back in the Stone Age, popular culture claimed it was a woman’s privilege and prerogative to change her mind. I have NO COMMENT on this subject.
What I will comment on is a publication from NPR concerning a study of physicians who treat with Seroquel (an antipsychotic drug). These prescribers received letters from Medicare that gave a general warning to physicians that they were being “flagged/warned” as above-average prescribers of this medication. Guess what, two years later and without follow-up, the physicians’ usage of this drug dropped dramatically.
We have found that scientific peer-to-peer intervention with treating physicians is one of the most cost-effective techniques to improve outcomes. This is best handled by a professional, highly credentialed panel of providers who will engage treating physicians with data on the latest science and industry guidelines. Nothing is more rewarding and cost-effective than providers who are willing to listen and then voluntarily modify their protocols.
No attorneys. No regulators. No disputes or appeals.
Just doctors who decide to do better and change their minds.
Call us. We can do better.
William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz
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