Letters to the Editor - May 2, 2005

Concern over suicide law should be about access to best end-of-life care -- not few psychiatric consults - Deny prescribing privileges to doctors who are paid to tout drugs - Low pay, lack of respect explains why fewer doctors want to be FPs

Concern over suicide law should be about access to best end-of-life care -- not few psychiatric consults

Regarding "Oregon sees fewer numbers of physician-assisted suicides" (Article, April 4): I found the article on physician assisted suicide in Oregon very helpful. I expect that the concern over the lack of psychiatric consultations is unwarranted and that the real concern (and therefore a focus of data collection) should be on referral to a palliative care specialist and hospice program.

I looked over the list of reasons people requested physician-assisted suicide (less able to engage in activities that make life enjoyable; losing autonomy; loss of dignity; losing control of bodily functions; burden on family, friends, caregivers; inadequate pain control or concern about pain; and financial implications of treatment) and they all strike me as areas of intervention for hospice and palliative care professionals, not psychiatrists.

So it seems to me that perhaps the focus in Oregon and the rest of the states should be on making excellent end-of-life care a higher priority, rather than just condemning those who are making terribly difficult decisions under terribly difficult circumstances. We physicians have to make ourselves better at providing excellent care for these patients.

--Christopher M. Hughes, MD, Pittsburgh

Deny prescribing privileges to doctors who are paid to tout drugs

Regarding "Drug company gifts not proper, whether sterling silver or stethoscope" (Letters, March 28): The drug companies pay lots of money to physician speakers, along with gourmet dinners in expensive restaurants for the attendees, to pitch their products. Too many of these speakers have no reputable clinical or research background and use company-provided slides for presentation.

Physicians are exclusively privileged to choose between available drugs and medical devices. Accepting money from competing product makers is deceit. Medicare and state licensure boards can stop this by denying prescription privileges to industry-affiliated physicians except for bona fide research work.

--Mohinder Partap, MD, St. Louis

Low pay, lack of respect explains why fewer doctors want to be FPs

Regarding "Family medicine sees 8th consecutive year of Match losses" (Article, April 4): There is no question that the main reason for continued Match losses of family physicians is money. While working longer hours, the yearly income continues to be at the lowest level of all other groups of physicians.

Then, add the disparaging attitude of medical school professors and many specialists toward the lowly FP, and the reason becomes more evident.

Intelligent people become physicians and they head toward the more rewarding areas. The way to correct this drift away from family practice is simple.

--Walter H. Daniels, MD, Morgan City, La.