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The number of U.S. physicians who say they are suffering "burnout" has jumped to more than half of doctors as the practice of medicine becomes more complicated and millions more Americans gain health coverage under the Affordable Care Act...An analysis from researchers at the Mayo Clinic and the American Medical Association say doctors’ work-life balance is worsening, with the percentage of physicians who say they are suffering burnout rising to 54% in 2014 from 45% in 2011..."disturbing trend"..."Burnout and satisfaction with work-life balance among U.S. physicians are getting worse,"..."American medicine appears to be at a tipping point with more than half of U.S. physicians experiencing professional burnout...has effects on quality of care, patient satisfaction, turnover, and patient safety, these findings have important implications for society at large."

In an ideal world, doctors avoid outside influence and commit to ethical practice. However, they are also huge influencers in a for-profit pharmaceutical industry. This creates a breeding ground for potential conflicts of interest…In order to make relationships between health care providers and pharmaceutical companies more transparent, the Physician Payments Sunshine Act was enacted into law…Open Payments is the program that collects this information…Within this data, a pattern emerges: doctors who prescribe a lot of drugs tend to get more money from pharmaceutical companies…this data…identifies doctor and pharma relationships, it still does not determine causation. It only brings up certain questions: Are doctors prescribing specific drugs more because a pharmaceutical company is paying them? Or do pharma companies pay certain doctors because they prescribe a lot of their drugs? Further complicating the analysis is the knowledge that some physicians prescribe certain drugs in high volumes simply because they’re the best for their patients…While some argue that physicians should have nothing to do with drug marketing, others believe that collaboration between doctors and pharmaceutical companies is critical to improving the health and quality of life for patients. Not all doctors work simultaneously as drug prescribers and drug marketers, but those who do must strike a careful balance.

New data show the staggering reach of the prescription drug epidemic...Doctors wrote 259 million opioid prescriptions for Americans in 2012, enough to medicate every adult in the country. Drug overdoses are eclipsing car crashes as a leading cause of accidental death for American adults…A poll out today from the Kaiser Family Foundation adds a troubling new number to the accounting: 27 percent of Americans report that they either have been addicted to prescription painkillers or have a family member or close friend who has…That's roughly 66 million U.S. adults for whom the opioid crisis has become intensely personal…Prescription drug addiction and a related heroin epidemic have proven a stubborn public health crisis since painkiller abuse began rising more than a decade ago…Kaiser's poll found strong majorities in support of policy solutions, including drug treatment, tighter scrutiny of prescribers, and "good samaritan" laws that protect drug users from being charged if they call for help when addicts overdose.

…Americans overdose and die after taking opioid painkillers...people abuse or misuse the drugs…addictions and deaths mount…authorities are struggling to cope…State lawmakers are introducing bills to restrict prescribing…Food and Drug Administration is pushing pharmaceutical companies to develop more tamper-resistant products…the most sweeping initiative comes from the Centers for Disease Control and Prevention, which has prepared preliminary prescribing guidelines for primary care physicians…call on doctors to prescribe opioids only after other therapies have failed…there is considerable opposition to the guidelines…critics…say the CDC guideline process was flawed and, as a result, some patients will be denied much-needed pain relief.

Imagine if simply typing “password123” into a computer did not open your email account, but an internet-connected medical device responsible for feeding you drugs or monitoring your blood oxygen or insulin levels...It may sound like the nightmare stuff of fiction, but the lack of basic cyber security on hospital equipment is attracting hackers who want to use them as a way to enter medical networks...Experts say that while they have not yet seen someone die as a result of hacking, the risks are growing...Motives for attacks could range from wanting to harvest patient information or stealing intellectual property from medical trials to simply wanting to create chaos...Devices with default passwords that are left unchanged, and outdated operating systems that are connected to the network, such as medical databases, are all too common in healthcare...Each provider needs to carefully examine for themselves what types of risk are being brought in by new devices. They will have to give careful consideration to making sure they are kept up to date, behind firewalls and in networks segmented off from key medical and personnel data…

Doctors who entered data into computerized health records during patients' appointments did less positive communicating, and patients rated their care excellent less often…Many clinicians worry that electronic health records keep them from connecting with their patients…doctors who used the computer more also spent more time correcting or disagreeing with patients…Doctors who spent more time using the computer spent less time making eye contact with patients and tended to engage in more “negative rapport building,” correcting patients about their medical history or drugs they’ve taken based on information in the electronic record…That’s not necessarily a bad thing…Doctors who spend most of the time looking at the computer may miss out on an emotional connection with the patient…When people are paying attention to the same thing at the same time, you get the best transmission of information… Electronic health records need to be more usable so clinicians with varying computer proficiency can use them without struggling and diverting focus from patients…

All clinicians should prescribe generic medications whenever possible as a way to improve adherence to therapy and clinical outcomes while containing costs, “While the use of generic drugs has increased over time, clinicians often prescribe more expensive brand name drugs when equally effective, well proven, and less expensive generic versions are available,”…“The use of generic drugs is a High Value Care way to improve health, avoid harms, and eliminate wasteful practices.”… “ACP (American College of Physicians) recognizes that there are situations where generic substitution is not possible and the use of brand name drugs is clinically appropriate,”…Some of the underuse of generic medications is likely the result of patient and physician perceptions about the safety and a perceived lack of efficacy of the lower cost options. Patients may also associate the lower price of generics with lower levels of effectiveness… Public awareness and advertising campaigns similar to those used for brand name drugs might help to alter patient perceptions about generics…

On May 19, 1983, Boots aired the first broadcast television commercial in the United States for a prescription drug, the pain reliever Rufen...Within 48 hours of the ad’s airing, the federal government told the company to take it down. And more than 30 years later, the fight over marketing prescription drugs directly to the public is still raging...Now, the American Medical Association, the largest doctors group in the United States, wants to stop direct-to-consumer advertising for prescription drugs in the belief that the ads encourage patients to seek medicines unnecessarily. But the effort to have drug ads banned alongside tobacco ads will face plenty of obstacles, none bigger than the First Amendment. Perhaps the most unusual thing about this decades-long saga is that it’s an issue at all...The United States is one of only two countries in the world to allow these ads. How did this little-noted example of American exceptionalism come to be?...It started with Boots.

Medications won't work if patients don't take them…A national association of doctors this week urged physicians to order generic drugs whenever possible because patients are more likely to fill their prescriptions…Southern Nevada doctors and pharmacists say the report in the Annals of Internal Medicine reinforces what they've seen in their practices over the years…"Cost has a role, clearly, in this lack of adherence," said Dr. Scott Stolte, dean of the College of Pharmacy and a professor of pharmacy practice at Roseman University of Health Sciences…"Most of the time the generic drugs are just as effective as the trademark drugs," said Dr. James Anthony, a family practitioner and member of the Nevada State Board of Osteopathic Medicine. "They're more accepted than…they were 10 years ago."…Doctors say they prefer generic drugs because of the data showing patient outcomes improve, and the cost savings are an added benefit…"Not only are prescription-by-prescription costs going to be lower, but also the overall health care costs are going to be lower,"…

American Medical Association is calling for a ban on advertising prescription drugs and medical devices directly to consumers. The move…is largely symbolic, because any ban would have to be authorized by Congress…The new AMA policy comes after years of complaints by physicians…some ads too often encourage patients to seek medicines unnecessarily. They also resent the pressure the ads place on them to write prescriptions out of concern patients will switch physicians…Another rationale for the ban, however, is the rising cost of drugs…many of the ads aimed directly at consumers promote more expensive medicines…the Pharmaceutical Research and Manufacturers of America…“Providing scientifically accurate information to patients so that they are better informed about their health care and treatment options is the goal of direct-to-consumer pharmaceutical advertising...“Beyond increasing patient awareness of disease and available treatments, DTC advertising has been found to…encourages patients to visit their doctors’ offices for important doctor-patient conversations about health that might otherwise not take place.”...