臨床医学に環境・労働の観点を

・ＡＣＰ（The American College of Physicians）という団体が、 In the News for the Weekというニュースを出していますが、以下のようなものを見つけました。（私が、こだわっている、医師とメーカーの関係です）

http://www.acpinternist.org/weekly/archives/2010/6/29/index.html#free 

Industry interactions

Most physicians think free lunches, small gifts OK

Physicians of all specialties, but especially surgeons, continue to see gifts from the pharmaceutical and device industries in a positive light, according to a recent survey.

Almost 600 physicians and medical students in the Mount Sinai School of Medicine consortium were asked about their attitudes toward industry interaction. A majority of the respondents favored the use of samples as well as industry sponsorship of lunches, educational materials and medical school and residency programs. More than half also thought it was acceptable to receive dinner at a modest restaurant if an educational component was included and to have industry pay for travel expenses to a conference.

Just less than half of the survey participants found it appropriate to accept a small gift (less than $50) from a company, and only a quarter thought it was OK to take a larger gift. The surveyed physicians also thought that they personally were less likely to be affected by free food or gifts than their colleagues: Only about 35% said it would affect their prescribing, while 52% said their colleagues would be influenced. The study was published in the June Archives of Surgery.

Surgeons, trainees and respondents who weren’t familiar with their own institution’s guidelines on the subject were more likely to have a positive attitude toward pharma interactions and gifts. This may be because less attention has been paid to this issue by surgical journals and societies, according to the study authors. A critique that accompanied the article also noted the importance of distinguishing between types of interactions with industry; development of new surgical techniques requires collaboration between clinicians and device makers, but the benefit of a free pen or sandwich does not outweigh the risk of influence, the critique said.

Based on the survey’s results, one can conclude that physicians generally may be out of synch with public thinking about industry interactions, the study authors said. Despite changes in medical school policies and governmental concern about the issue, physician attitudes are similar to those found in studies going back to 2001. Physician attitudes are not likely to change until the entire culture of medicine rejects industry influences more thoroughly, the authors concluded.

・赤字の所が結論ですが、なんだか、情けないですね。それは、さておき青字のところは、笑ってしまいました。自分（Ａ）は、メーカーからの贈り物の影響を受けない。でも、同僚は受けていると考えるわけです。では、その人の同僚（Ｂ）はといえば、同様に考えているので、Ａはメーカーの影響をうけていると。ただ、３５％の医師は、メーカーの贈り物の影響を受けていると考えています。正直ですね。３５％って、大きいですよ。・・・何が問題か？いっぱいあるけど、医学界がＥＢＭと声だかに叫ぶけど、処方は、贈り物できまるという現実。

以下日記

・本日は7時30分前に病院にいって、回診。午前外来。午後は会議が二つ、その合間に回診と事務作業。最近本当に着かれていると分かります。指標が二つ、一つは、人に批判がとてもこたえる。二つ目は、怒りっぽくというか、普通ならそのような言動はしないはずなのに、してしまう。あと4日我慢すれば私の夏休み。リフレッシュしたいですね。

・本日、「家出していた」妻子が帰ってきました。東京の状況を聞いたら、行列に並んでいたと。コンサートで並び、その他イベントで並び。（三女と配偶者が嵐のコンサートに行っており、その間長女、次女はショッピング）配偶者は、三女がいろんなことでフテたのに怒っており、もう、連れて行かんと言っておりました。私へのお土産はときいたら、ナン＆カレーでした。まあ、なんやかんや言っても楽しんできただろうし、無事帰ってきてめでたしめでたし。次は、わしが好き勝手やらしてもらうで。

・本日の夕食は、久々に個食ではありませんでした。なぜかナン＆カレーとチリとり鍋。ビールの後に、同僚のDr.Ｎ（彼は、私のオヤジギャグを理解する貴重な存在）にもらった『球泉洞』という球磨焼酎（熊本産）を飲みましたが、結構おいしく飲みやすかったです。これは、危険な酒です。つい飲み過ぎてしまいます。ほどほどにして、これから、寝床で『石田徹也遺作集』を見ながら、眠りに着こうと思います。（21時前で、早すぎ）