Pharma

Today I went to a Makerere Medical School "Grand Rounds". It was different from what I expected because it seemed that mostly residents presented topics that were directed at a medical student level of understanding. The topic was on Peptic Ulcer Disease, Osteoarthritis, and the use of NSAIDs. I thought the topics presented were thoroughly covered.. to the point of repetition. It was interesting that they mentioned things like blood transfusion with a hgb <7.0 and ICU admission for certain patients.. when on the wards our group routinely sees patients with hgb of 4-5 who aren't receiving transfusion and patients we feel who warrant ICU admission who are on a regular medicine floor. One of the presenters even admitted that they wouldn't have endoscopy machines available for a few years. It's nice to know that if there was a better infrastructure or more resources these things might get done in the same way that we manage them back home.

At the beginning of grand rounds the physician leading discussion introduced two pharmaceutical reps from AstraZeneca sitting in the back. He explained that they had provided cokes for all of us during the lecture and they passed around cards about Nexium in the use of PUD. At the end of grand rounds he even said "I hope you all feel confident in prescribing Nexium in the future". Thousands of miles away from the US, here it was, Pharma. Pharma advertising at a medical student lecture, none-the-less. I guess in a country with few resources there is still money to be made...? Furthermore it was odd that the professor was endorsing it so strongly.. it was quite the contrast to Dr. Neely's adamant disapproval of pharmaceutical involvement in medical care.