Dean prescribes cure for health crisis

by Elise Waxenberg | 11/17/04 6:00am

Dartmouth Medical School Dean Stephen Spielberg prescribed remedies for the country's pharmaceutical crisis during an inaugural lecture Tuesday night by a new healthcare awareness group on campus.

Drawing on his background as a clinical pharmacologist, Spielberg advocated individualizing both the process of producing drugs and the selection of treatment options for patients in his address, titled "Angst at the Interface of the Professional and Pecuniary Worlds."

Spielberg began by providing background on the evolution of pharmaceuticals and then went on to emphasize the complexity of the problems currently facing the medical profession as the field becomes more driven by financial constraints.

"This is not simple," he said. "Banner headlines do not tell you what this is all about."

Spielberg observed that in the face of mounting obstacles, many of his colleagues are growing discouraged by the issues plaguing today's healthcare system.

"Half the reason that I took this job was the recognition that a lot of my fellow physicians in Philadelphia were discouraging their own children from becoming physicians. That's despair," he said.

Spielberg suggested that innovation in drug development is being impeded by the bottom line. Drug companies are racing to find drugs that will rake in the most profits rather than making high-risk investments in drugs critical to smaller patient pools.

Spielberg cited this year's flu vaccine shortage as one example of the "embarrassing" problems the medical community has recently encountered.

He also said he was ashamed of the spates of drug recalls and the support some of his colleagues give to drug companies that misrepresent medicines.

"This isn't easy stuff," he said gravely. "Those who want to make political hay for it are going to get lots of headlines, but it isn't easy stuff."

The dean went on to analyze the hot issue of soaring prescription drug prices. He noted that the brand-name drug Nexium, "the purple pill" used to treat heartburn, is cheaper in Canada than in the United States. By contrast, the generic version of the drug sells for less in the states than it does in Canada. Spielberg concluded that some of the problems patients encounter with climbing prices could be cured by first asking which drugs are appropriate for each patient on a more individualized, personal basis.

"We do not have to write prescriptions for Nexium," he said. "We can indeed inform, discuss with our patients what the right choice of medicine is."

In his closing, Spielberg stressed that the opportunity to solve today's problems is riper than ever.

"We cannot allow the sciences of human biology and healthcare delivery to continue in isolation," he said.

Spielberg's address, held in 105 Dartmouth Hall, was the first event organized by the newly-established Dartmouth Healthcare Action Group. According to the group's founder and president Justin Altschuler '06, the group's aim is to raise awareness about current problems facing the healthcare awareness system.