JAMA editoral argues against preemption

JAMA published an editorial in the October issue in urging the US Supreme Court not to endorse preemption and argues for patients' right to sue drugmakers in state court for harms caused by defective drugs that were approved by FDA.

The editorial states that " ......if the court rules in favors of Wyeth, endorsing preemption, patients will lose an irreplaceable method for seeking remedies for injuries resulting from pharmaceutical agents that were approved by FDA."

American legislation states that federal regulation preempts state law - this means that patients have no legal right to sue drugmakers in state court for injuries caused by FDA-approved drugs.

Source: Catherine D. DeAngelis, Phil B. Fontanarosa Prescription Drugs, Products Liability, and Preemption of Tort Litigation JAMA 2008;300(16) :1939-1941 ( f/t via Athens)

America low in primary care physicians

In a study "Diagnostic scope of and exposure to primary care physicians in Australia, new Zealand and the United States : cross sectional analysis of results from three national surveys" published in the BMJ 2007; 334:1261 ( 16 June), Bindman and colleagues compared the mix of patients, scope of practice and duration of visit in primary care physicians in Australia, New Zealand and the US using data from national surveys of primary care physicians in each of these countries. ( You can read the full text if you have an Athens password).

Findigns showed that length of consultation in the US is about half the average of New Zealand and one-third of Australia. The author concluded that such severe shortfall of duration of visits might be one of the reasons why the US does not achieve health outcomes that correspond to its high costs in healthcare.

Read the press release and other findings :

• Australia has the highest number of primary care physicians per 100,000 population and 56% trained in primary care while the US has 36%


• range of problems dealt with in primary care is narrower in the US than the other 2 countries due to greater proportion of specialists in the US healthcare system


• average duration of a visit was about 16.5 mins in the US, 15 mins in New Zealand and 14.9 mins in Australia, but the Americans had fewer visits.