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How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine

The ongoing epidemic of narcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies' aggressive promotion of these drugs which minimized their substantial risk. A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing. Background: Impunity of Top Leaders of Big Health Care Organizations For years, we have railed against the impunity of top leaders of health care organizations.  We have noted that despite numerous legal settlements made by health care organizations of alllegations like fraud , bribery , and kickbacks , almost never do top leaders who presided over these actions face any negative consequences.  Lack of deterrence caused by such impunity appears to be a major cause of  the epidemic of continuing unethical behavior, crime and corruption on the part of large health car

Health Care and Endocrinology

You may have heard the word Endocrinology used in a sentence by a health care professional, like your family physician or someone that has had to visit an endocrinologist, but not really know what it is or what part of your body is the primary focus for this type of medical need. is a specialty of medicine; some would say a sub-specialty of internal medicine, which deals with the diagnosis and treatment of diseases related to hormones.

Endocrinology also focuses on the endocrine glands and tissues that secrete hormones, and it is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones.

From a clinical and research perspective, the Endocrine Society (100 years old this year) does a significant amount of scientific study about this particular field of medicine. The Society offers scientific statements to educate basic scientists, clinical scientists, and clinicians on the scientific basis of disease and its application to the practice of medicine with regard to both prevention and management.

Scientific statements provide an overview of basic and clinical science content on topics of emerging importance. Content is evidence-based to the extent possible but also identifies areas of basic or clinical knowledge that require additional research. Topics are selected on the basis of their emerging scientific impact on disease and broad clinical relevance to the general population. Much more detailed material is located at this website: http://www.endocrine.org/about-us.

According to the Society for Endocrinology, at its simplest, a hormone is a chemical messenger from one cell (or group of cells) to another. Hormones are released in the body and have an effect on other parts of the body. The effect is to communicate with other distant parts of the body. So for example, the adrenal glands may secrete adrenalin, which has an effect on several different organs. An endocrine gland is a gland which secretes hormones. Not all glands are classified as endocrine glands. For example, sweat glands or lymph glands are not endocrine glands).

Hormones are found in all organisms with more than one cell, and so they are found in plants and animals. They influence or control a wide range of physiological activities, such as growth, development, puberty, level of alertness, sugar regulation and appetite, bone growth and other bodily functions. You also find that problems with hormones and the way they work contribute to some of the major diseases of mankind; for example, diabetes, thyroid conditions, pituitary conditions, some sexual problems, some neurological problems, appetite and obesity, bone problems, cancer, and more. Additional info is found at this site: http://www.endocrinology.org/.

The Journal of Endocrinology is a leading global journal, available through the Society of Endocrinology, that publishes original research articles, reviews and science guidelines. Its focus is on endocrine physiology and metabolism, including hormone secretion; hormone action; biological effects. The journal publishes basic and translational studies at the organ, tissue and whole organism level. You can find more information at this site: http://joe.endocrinology-journals.org/ 

The American Association of Clinical Endocrinologists (AACE), founded in 1991, now has over 7,000 members who work together as a professional community of physicians specializing in endocrinology, diabetes, and metabolism committed to enhancing the ability of its members to provide the highest quality of patient care. Their website has significant information on the study of endocrinology and provides a detailed list of definitions for anyone seeking to know more about this type of medicine. More info can be found at this website: https://www.aace.com/about/mission.

On a more detailed basis, according to the American College of Physicians, endocrinologists are frequently involved with the diagnosis and management of these health care problems:
·         Hypothalamic disorders (abnormal sodium and water balance)
·         Pituitary diseases (tumors, over- or underproduction of pituitary hormones)
·         Parathyroid abnormalities (hypercalcemia, hypocalcemia)
·         Thyroid diseases (hyperthyroidism, hypothyroidism, goiter, nodules)
·         Adrenal cortex dysfunction (mineralcorticoid, glucocorticoid, sex hormone abnormalities)
·         Gonadal disease (hypogonadism and reproductive disorders)
·         Pancreatic endocrine disease (diabetes mellitus)
·         Bone metabolism (osteoporosis)
·         Lipid metabolism
·         Iatrogenic effect of glucocorticoids

Training in endocrinology includes two years of additional training following successful completion of a basic internal medicine residency training program. More details are found at this website: https://www.acponline.org/about-acp/about-internal-medicine/internal-medicine-subspecialties/endocrinology-diabetes-and-metabolism.

An additional materials resource is this site: http://www.nature.com/nrendo/index.html, where you can find detailed scholarly journals and research information about endocrinology. And, Healio online has some very good materials about this type of medicine: http://www.healio.com/endocrinology.

There are many good hospitals and health care organizations in the US that have special sections and staff allocated to the study of endocrinology. One of them is Children’s Hospital of Dallas, and you can find more details about their treatment options at this site: https://www.childrens.com/specialties-services/specialty-centers-and-programs/endocrinology.

Another great location for treatment, especially for adults who need specialty care, is located at the University of Chicago Department of Medicine. Their 3-fold mission: (1) to provide excellence in patient care; (2) to perform cutting-edge basic, clinical and translational research in endocrine diseases, diabetes, obesity and hypertension; and (3) to provide outstanding educational opportunities for medical students, house staff and fellows. More information is located at this site: http://medicine.uchicago.edu/endo/index.html.

Hormones are a huge part of what makes your body tick. Endocrinologists are medical specialists that can help determine what may be out of whack if you are experiencing symptoms or medical issues that need more detailed study and care. Talk with your doctor or a medical professional who can assist you in getting the quality of care you need for any problems dealing with hormonal imbalances. It’s worth your time.


Until next time. 

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