Now More Than Ever, Even More...

Guest Blog:
Jerry Avorn, M.D.,  Professor of Medicine, Harvard Medical School, Co-founder & Special Adviser, NaRCAD

It’s a time of loss for many of us. Programs to which people devoted years of their lives have been slashed or eliminated altogether. Principles and values that guided our work for years are being thrown under the bus, whether they relate to efficacy (“Vaccines are optional and don't work so well anyway,” “Leucovorin treats autism”) or safety (“Mifepristone is dangerous,” “Tylenol causes autism”). Governmental agencies we relied on for decades have been shredded. It goes beyond CDC and FDA.

AHRQ, the Agency for Healthcare Research and Quality, funded my first study in 1979 to get the whole academic detailing concept off the ground; now it barely exists anymore. I wonder how many Young Jerry’s of today will have odd new ideas that they won’t be able to launch because of that. And then a terrible blow will fall in a few months when millions of Medicaid patients will have their coverage taken away thanks to the ironically named "One Big Beautiful Bill” passed last summer.

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Many of us feel the need to hunker down in a defensive crouch, hoping that the bad times will eventually blow over. But here’s where the "Now More Than Ever” part comes in: The more the parasite of medication mistruths keeps expanding like some kind of informational Cyclospora spreading nationally from its source, the more vital our evidence-based educational outreach becomes.

Its hallmark interactivity is especially useful when distortions and deceptions infect the decisions of clinicians and patients alike – to assess perceptions, understand biases, and provide just the right knowledge to best address a particular person’s informational (and attitudinal) needs.

The more limited the resources for delivering medical care become, the more we need to help decision-makers arrive at choices that are the most effective, and represent the best use of our increasingly limited healthcare funds.

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So the worse things get, the more important our work becomes.

And each of us needs that special sauce of interactivity ourselves in these times: to learn from one another, to ventilate, to talk to each other about what’s working and what isn’t. As we know from our academic detailing work, this is best done in person whenever possible – not through memos, emails, or Zooms. That’s another reason I’ll be happy (if we can still use that word these days) to meet in person with people throughout our academic detailing community at the upcoming November conference. Yes, there will also be an excellent, interactive virtual component, but if you can come to Boston, you'll reap the rewards of interpersonal connection.

So I hope as many of you as possible can make it to Boston for the Annual Conference in November, or join in for the virtual conference if you can’t. Until then, here are three thigs to tide you over:

• Seminar: I recently participated in a one-hour seminar on the clinical and ethical aspects of medication use and affordability, hosted by the Harvard Program in Bioethics. View the recording.

 

• Reading Guide: The Arnold Gold Foundation is creating a program on Humanism and Prescribing that’s offering a Reading Guide to accompany my book, Rethinking Medications, for students and faculty in the health professions. They’ll be making the book and Reading Guide available at no cost while supplies last. 

 

• Substack: I’ve started a new Substack to offer relevant insights on medications, policy, and the meaning of life. 

Hang in there; I hope I’ll get to see you one way or the other to talk about all this in November.
-Jerry

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