Physicians in opera--reflection of medical history and public perception -- Willich 333 (7582): 1333 -- BMJ

Physicians in opera--reflection of medical history and public perception -- Willich 333 (7582): 1333 -- BMJ
Music plays an increasingly important part in medicine, such as in specific care for performing artists.1 But what about the representation of medicine in music?
A systematic search in theatrical reference books yielded 40 operas from three centuries in which physicians appear on stage (see table on bmj.com). I selected several operas as specific examples in the history of opera. I analysed the role and function of the physician in different categories including the character and importance of his role, his function and basis of knowledge, and his social status. I also looked at the historical context.
Eighteenth century
Opera developed in the late Renaissance and early Baroque.2 There are no doctors in the operas of Monteverdi, Gluck, or Handel, partly because the stories are often based on material from mythology or antiquity. In the 18th century, however, our colleagues enter the stage.
Le Nozze di Figaro (The Marriage of Figaro, premiered 1786) is one of Mozart's great operas. Among the secondary characters is Dr Bartolo, a physician who does not appear in his role as a healer. He is angry with Figaro and threatens to take revenge on him for having once helped to abduct his ward Rosina, who Bartolo wanted to marry. Towards the end of the opera, however, Dr Bartolo sides with Figaro after finding out by chance that Figaro is his lost son who had been abducted as a baby. /.../

What stays constant at the heart of medicine -- Cook 333 (7582): 1281 -- BMJ

What stays constant at the heart of medicine -- Cook 333 (7582): 1281 -- BMJ: "There is no one division of medicine by which we know and another by which we act

The expression 'the science and art of medicine' is much misunderstood. Too often the parts of medicine termed as its 'art' seem to amount to no more than good communication skills or to what was once called a good bedside manner. No doubt patients feel better, and perhaps even do better, when they think their doctor cares about them. But stories also abound of well dressed doctors with smooth manners but little knowledge who have gained—and sometimes abused—the trust of their patients.

While the historical record is replete with such examples, and almost every practitioner will be able to call others to mind, it is the fictional creations of writers such as Molière, Shaw, and Cronin that have most amused and scandalised us. To provide a counterweight to such social frauds, all kinds of programmes and regulations have been introduced to make competence and knowledge more important to professional advancement than manners, social graces, and public regard.

But to identify the art of medicine with 'artfulness' is to fall into a set of modern confusions. It is now common to think of art as something done by artists and the arts as a different field of activity than science, sometimes even "

Scientist charged in ethics case - baltimoresun.com

Scientist charged in ethics case - baltimoresun.com: "A senior government scientist working in Alzheimer's disease research was charged by federal prosecutors yesterday with accepting $285,000 in consulting fees and travel expenses from the world's largest drug manufacturer without proper approval from his bosses.

The criminal case emerged as a rare example of a top leader in the sciences being accused of breaking the law over a breach of professional ethics.

Leaders at the National Institutes of Health and their overseers in Congress have described the private financial arrangements between drug companies and publicly employed scientists as the worst scandal in the history of the agency.

Pearson 'Trey' Sunderland III, chief of the geriatric psychiatry branch of the National Institute of Mental Health, which is part of the NIH, was charged yesterday with conflict of interest. He is accused of accepting payments from Pfizer Inc. without authorization from his superiors and ethics watchdogs. The misdemeanor charge was filed by criminal /.../"

Educating Health Professionals about Drug and Device Promotion: Advocates' Recommendations

PLoS Medicine - Educating Health Professionals about Drug and Device Promotion: Advocates' Recommendations: "This Health in Action provides recommendations for improving education for health professionals about pharmaceutical and device promotion, which includes any activity that can increase sales of pharmaceuticals or devices. The recommendations were produced by an iterative E-mail discussion among representatives of four organizations: the American Medical Student Association, Healthy Skepticism Inc., No Free Lunch, and PharmAware (Box 1).
We hope these recommendations will inform, stimulate, and support educators of health professionals to develop improved education about pharmaceutical and device promotion. We will survey educators to seek their views on these recommendations.
Background
In the promotion of rofecoxib (Vioxx), “drug marketing got well ahead of the science” [1]. The successful hormone-replacement-therapy marketing campaign “convinced physicians that so called HRT [hormone-replacement therapy] prevented cardiovascular disease before one single clinical trial with cardiovascular disease end points had ever been done” [2]. These are just two examples of how misleading promotion can be a major threat to health [1,2].
There were an estimated 88,000–140,000 excess cases of serious coronary artery disease attributable to rofecoxib in the United States alone [3]. The number of women harmed by severe adverse effects of hormone-replacement therapy, including breast cancer, may have been even larger because hormone-replacement therapy was used for longer, but we are not aware of any reliable estimate. Reforms are needed to reduce the risk of similar events occurring again [4].
The US Accreditation Council for Continuing Medical Education states that “residents must learn how promotional activities can influence judgment in prescribing decisions and research activities through specific instructional activities” [5]. World Health Assembly resolution 52.19 urges member states to “integrate the rational use of drugs and information on commercial marketing strategies into training for health practitioners at all levels.” However, a recent worldwide survey of education about pharmaceutical promotion in medical and pharmacy schools found that “in most cases … students devoted one half day or less to this topic during their professional training; in nearly one third of cases, medical faculties devoted only 1–2 hours” [6]. That survey also found wide variations in objectives, ranging from aiming to “increase students' ability to extract beneficial information from drug promotion” to aiming to “increase students' use of independent information sources."