Going through a year’s worth of junk faxes…

When my secretary goes through our incoming faxes each day, she is quite proficient at sorting through what is relevant, and what I would consider complete junk. She drags those junk documents into a specified folder on her desktop which I check periodically.

Recently, “periodically” became “Oh shoot, I haven’t checked that folder since last summer”.

Now typically I hate going through this folder of useless correspondence. There’s a reason I go months without checking it. None of these faxes ever provide me information that benefits my clinical, personal, or professional life.

But I found it surprisingly interesting to sift through hundreds of items of complete trash. Some patterns emerged. Some were concerning. Some were hilarious. Some just made me shake my head.

1) I don’t want to brag, but I was invited to join the exclusive group of “Leading Physicians of the World”. I couldn’t believe it! For a mere $950, they would feature my biography in their prestigious registry. Plus another $35 a month for registry maintenance. And they would give me a shiny certificate to hang on my wall! (They have yet to respond to my inquiry for whether I could get additional copies for my parents and grandparents.) Of course most of us with a sliver of common sense would see this as a complete scam, but I know of at least one local physician who hangs his certificate proudly in his office. I wish I were joking.

2) There are a shocking number of conferences/summits/presentations that focus on cardiovascular risk factor management, with the same presenters focusing on the same messages of looking at surrogate markers. I won’t name any names, but we all know who our provincial usual suspects are.

3) Along the same lines, it appears to be the same general topics that come up time and time again in industry-funded CME. Atrial fibrillation, overactive bladder, COPD/asthma, hypertension, diabetes, rosacea, and more recently LDL targets (think PDSK9 inhibitors) have been disproportionately represented in CME over the past year. Unrestricted financial grants still influence the content of CME, let’s not kid ourselves. If you are relying on industry-funded CME for the majority of your yearly CME, you are missing out on entire swaths of relevant aspects of medicine. Let this be my reminder to you to diversify your sources of CME.

4) I can’t help but be concerned about the proliferation of companies in Ontario that are advertising for putting holter monitors in family physicians’ offices. Essentially if the physician feels their patients require a holter monitor, they put it on the patient for the desired duration, then mail it to the company who will have a cardiologist read it. The family physician is paid a portion of the technical fee for their time, usually around $50.

There are two major problems with this arrangement. First, it is not outrageous to assert that a physician may be more likely to order a holter when it is easily accessible in their office. I won’t go as far as to claim that a physician would order the holter strictly for financial gain, but I am always uncomfortable when any health professional stands to benefit financially by a specific clinical decision that they make themselves.

Second, many of these companies only offer holter monitors for 72 hours or more. The total cost to OHIP for a 48-hour holter is $188.65, and a 72-hour holter is $265.60. So will a physician, who only requires a brief monitoring period for a patient, refer their patient to a local cardiologist who does 48-hour holter monitoring, or will they set up the 72-hour holter in their office and claim their fee? I would like to believe they would choose the former in the name of stewardship for our publicly-funded system, but we can’t be completely naive here.

 

So the bottom line? I can probably go another entire year without checking my junk fax folder. Evidently I didn’t miss a single important thing.

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