visit doctor

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Health Topics
• Drugs & Supplements
• Medical Tests
• Medical Encyclopedia
• About MedlinePlus
• Customer Support

Make the most of your doctor visit

A visit with your health care provider is a good time to share health concerns and ask questions. Preparing ahead for your appointment can help you get the most from your time together.

When you see your provider, be honest about your symptoms and lifestyle habits . Ask questions to make sure you understand. Taking an active role in your health can help you get the best care possible.

How to Prepare

Before your visit, jot down your questions and concerns. You may want to ask things like:

• Am I due for any screening tests?
• Should I keep taking this medicine?
• What could be causing my symptoms?
• Do I have other treatment options?
• Should I worry about my family medical history?

Also be sure to write down all medicines, vitamins, and supplements you take. Include over-the-counter medicines and herbal supplements as well. Bring this list with you to your appointment.

If you are having symptoms, write down details before the visit.

• Describe your symptoms
• Describe when and where they appear
• Explain how long you have had symptoms and if they have changed

Put the notes in your purse or wallet so that you do not forget to bring them. You can also put the notes in your phone or in an email to your provider. Writing things down makes it easier to remember details at the time of your visit.

If you need support, invite a friend or family member to come with you. They can help you understand and remember what you need to do.

Make sure to have your insurance card with you at the time of your visit. Tell the office if your insurance has changed.

What to Share and ask

What you do and how you feel can affect your health. Here are some things you want to share.

Life changes. These may include:

• Job changes
• Family changes, such as death, divorce, or adoption
• Threat or acts of violence
• Planned trips outside of the country (in case you need shots)
• New activities or sports

Medical history. Go over any past or current health conditions or surgeries. Tell your provider about any family history of disease.

Allergies. Tell your provider about any past or current allergies or any new allergy symptoms.

Medicines and supplements. Share your list at your appointment. Tell your provider if you are having any side effects from your medicines. Ask about special instructions for the medicines you take:

• Are there possible interactions or side effects?
• What is each medicine supposed to do?

Lifestyle habits. Be honest about your habits, your provider will not judge you. Alcohol and drugs can interfere with medicines or cause certain symptoms. Tobacco use puts you at risk for a number of health problems. Your provider needs to know about all of your habits in order to best treat you.

Symptoms. Share your notes about your symptoms. Ask your provider:

• Which tests might help to find the problem?
• What are the benefits and risks of tests and treatment options?
• When should you call your provider if your symptoms do not improve?

Prevention. Ask if there are screening tests or vaccines you should have. Are there any lifestyle changes you should make? What can you expect for results?

Follow-up. Ask your provider when you should schedule more appointments.

After Your Visit

Your provider may want you to:

• See a specialist
• Have a test
• Take a new medicine
• Schedule more visits

For the best results, follow your provider's instructions. Take medicines as directed, and go to any follow-up appointments.

Write down any new questions about your health, medicines, or treatment. Continue to keep a record of any symptoms and all of your medicines.

When to Call the Doctor

You should contact your provider when:

• You have side effects from medicines or treatments
• You have new, unexplained symptoms
• Your symptoms get worse
• You are given new prescriptions from another provider
• You want the results of a test
• You have questions or concerns

Agency for Healthcare Research and Quality (AHRQ) website. Before your appointment: questions are the answer. www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/questions-before-appointment.html . Reviewed December 2020. Accessed August 8, 2022.

Centers for Disease Control and Prevention website. See a doctor before you travel. wwwnc.cdc.gov/travel/page/see-doctor . Updated January 28, 2022. Accessed August 8, 2022.

National Institute of Health website. Talking to your doctor. www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/talking-your-doctor . Updated April 25, 2020. Accessed August 8, 2022.

Review Date 8/11/2022

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Talking With Your Doctor

Doctor Visits

Regular Checkups

Screening Tests

Vaccines (Shots)

Talking with the Doctor

The office of disease prevention and health promotion (odphp) cannot attest to the accuracy of a non-federal website..

Linking to a non-federal website does not constitute an endorsement by ODPHP or any of its employees of the sponsors or the information and products presented on the website.

You will be subject to the destination website's privacy policy when you follow the link.

Americans' Primary Care Experiences and Preferences: 2024 Survey Report

U.S. News & World Report surveyed 2,000 U.S. adults about health care issues, including why and how often they go to the doctor, how they choose their doctors and why they choose to (or don't) follow the advice of their doctors.

Americans' Primary Care Experiences

People don’t typically think about their health until they get sick. At that point, they might visit an urgent care center or emergency room rather than seeing a primary care provider , or PCP. However, a trip to the ER for a common ailment is, on average, 12 times more expensive than getting care at a physician’s office, according to an analysis from UnitedHealth Group.

In addition to vast cost savings, having a consistent primary care provider for health ailments and regular screenings can improve a patient's experience and help prevent medical issues from becoming critical emergencies. Most health insurance companies and Medicare plans will cover an annual preventative wellness visit to a PCP.

Health care costs have been on the rise for years; and for many Americans, it’s an obstacle to getting timely and dependable health care. According to the Kaiser Family Foundation, one in four American adults say they have skipped or postponed getting medical care because of costs, and 41% of adults report having medical or dental care debt.

To better understand Americans’ health care preferences and attitudes, U.S. News & World Report surveyed 2,000 U.S. adults about a number of health care issues, including why and how often they go to the doctor, how they choose their doctors and why they choose to follow the advice of their doctors – or not.

Here are the top insights from that survey.

How Often Americans Go to the Doctor

Nearly three in four (73%) of respondents had their last annual physical in either 2023 or 2024.

It seems the COVID pandemic has shifted many Americans’ attitudes on wellness and preventative health. Of the respondents who had gone in recently for an annual physical, 29% said that since the COVID pandemic, they now visit their PCP more regularly. And more than two in three (68%) surveyed adults said they plan to have an annual physical this year.

Why Some Americans Won’t Go to the Doctor

While a majority of adults surveyed have recently seen a primary care provider, many people aren’t getting the preventative health screenings and checkups they need. In fact, 12% of the surveyed adults said they were unsure of when they would go in for their next annual physical.

Of those who haven’t had an annual physical recently, people had different reasons for not visiting a doctor or other health care provider:

• 32% said they can’t fit an appointment into their schedule or keep forgetting to make an appointment. 
• 25% said they don’t like going to the doctor. 
• 12% said they just haven’t found a PCP they like. 
• 10% said they have felt shamed or judged by doctors in the past. 
• 10% said they’re afraid of getting sick from others during a PCP visit.

Scheduling issues and poor experiences can be difficult obstacles to overcome. The relationship with a primary care physician is an important one, and some patients might be seeing a PCP who simply isn’t a good fit for them.

Finding the right primary care provider is the first step a patient can take. And it’s easier than ever to find a doctor by using U.S. News & World Report’s doctor finder tool , which allows patients to search for a doctor by specialty and areas of expertise, location, insurance accepted and many more details to ensure patients choose a doctor that will be a good fit for them. The doctor finder tool also shows patient ratings of individual doctors.

How Americans Choose Their Primary Care Providers

Establishing care with a PCP seems to make people more likely to have regular visits: 81% of people who had a recent annual physical visited a PCP that they’d seen previously. Seeing the same PCP year after year and creating that continuity of care (vs. a one-off urgent care visit) can improve the quality of care a patient receives because that PCP will be more familiar with them and their medical history.

How people find their PCPs varies. About one quarter (24%) found their PCP through their insurance provider’s directory of providers that are in-network.

Types of Doctors

Adults in the U.S. can choose to see different types of doctors :

• Family medicine specialists treat people from childhood through adulthood.
• Internal medicine doctors , or internists, only treat adults. 
• Children may see pediatricians through the age of 18 to 21, depending on the practice.
• Older adults may choose to see a geriatrician .
• Doctors for women, including OB/GYNs, provide important additional preventative care, including mammograms and PAP smears.
• Gastroenterologists also provide important preventative screenings, like colonoscopies .
• Some men may see a urologist for conditions such as an enlarged prostrate or prostate cancer.

What to Look For in a Doctor

Aside from the type of doctor, people surveyed considered the following characteristics when choosing a doctor:

• Nearly 30% (28%) of U.S. adults are looking for their doctor to have experience and expertise in a specific area of care, possibly one related to a health condition they have. 
• 24% are looking for providers with positive patient reviews.
• 13% look for a PCP who is the same sex, gender or race as them. 
• 13% look for a PCP who is associated with a highly-rated hospital . 
• Only 9% look for whether the PCP went to a top medical school or residency program. 

COVID precautions

It's been four years since the beginning of the COVID pandemic, and most Americans still value providers who follow COVID-related precautions: 66% are more likely to make an appointment if masks are required, and three quarters of those surveyed (75%) would be more likely to make an appointment if the office offers COVID vaccines and boosters.

What Americans Think Makes a Great Doctor

People may want to consider certain c haracteristics when looking for a doctor that is a good fit for them. For example, they may think about whether the doctor communicates with an open and empathetic dialogue, shows compassion and fosters trust.

The good news is that of the respondents who had their last annual physical in 2023 or 2024, an overwhelming majority feel comfortable with and trust their doctor, at 96% and 95%, respectively.

Additionally, of the 2,000 survey respondents:

• 35% felt heard and understood by their PCP during their last annual physical exam.
• 26% said their PCP eased their nerves during their last annual physical exam. 

Of those who felt heard and understood by their PCP:

• 56% said their PCP asked questions in a nonjudgmental way. 
• 38% reported that their PCP said they would follow up with next steps or answers to their questions . 

Of those who felt that their PCP eased their nerves:

• 50% said their PCP was compassionate.
• 48% said their PCP asked questions in a nonjudgmental way.
• 22% said their PCP clearly explained next steps in their care. 

Online Patient Portals

Respondents were also asked to select up to three choices from a set of options about what features they’d like to be able to use with an online patient portal for their PCP.

The most popular options chosen:

• Ability to review test results within the online portal. More than half (57%) of adults want this option.
• Request medication refills. 47% would prioritize being able to request medication refills.
• Schedule an appointment. 47% of respondents chose this option. 
• Message with their PCP or staff. 42% want the ability to communicate with their PCP via an online portal.

What Americans Do – And Don’t – Want to Know About Their Doctor

When people visit their doctor, they aren’t just looking for answers about their health. There are things that they do - and don’t - want to know about their doctor.

For this question, respondents were able to select up to three options that they’d like to know about their doctor. These were the most common things patients want to know about their doctor:

• Beliefs about alternative medicine. 46% of respondents said they would like to know their provider’s beliefs about alternative medicine.
• Stance on vaccination. 42% of respondents wanted to know their provider’s stance on COVID vaccines, and 22% wanted to know their PCP’s stance on vaccinations for infants and children.
• Opinion on cannabis. 20% of respondents said they would like to know their PCP’s opinion on cannabis. 
• Perspective on ethnic disparities in healthcare. 20% of respondents said they’d like to know more about their PCP’s perspective on ethnic disparities in healthcare. 

What patients are less interested in knowing about their doctor:

• Stance on abortion. Only 13% of U.S. adults surveyed want to know their PCP’s stance on abortion.
• Political affiliation. Additionally, most respondents (73%) said they would prefer not to know their PCP’s political affiliation. 

When Americans Don’t Follow Their Doctor’s Advice – and Why

When Americans visit their PCP, they generally follow the advice that the PCP gives them. Four in five (81%) say they usually or always follow their PCP’s health advice.

When people don’t follow their PCP’s advice, they say it’s because:

• The advice is difficult to implement in daily life (43% of the time).
• They cannot afford what their PCP recommends (34% of the time). 

While treatments are often covered by a person’s medical insurance, doctors may sometimes recommend things like vitamins and supplements, over-the-counter medications , ongoing physical therapy or new medical equipment that insurers don’t always cover.

Bottom Line

PCPs can be a valuable part of a person’s medical journey – both to prevent health emergencies as well as to effectively manage ongoing health conditions. These health professionals can see and treat a person throughout their life, tracking medical issues over the course of years or decades, and puzzling together pieces of medical information to understand a full picture of a patient’s health.

While many Americans have a PCP whom they see regularly and report positive experiences with, there are still millions of people who do not see a PCP on a regular basis for a variety of reasons, from time constraints to trust issues and poor prior experiences.

Methodology

In February of 2024, 2,000 U.S. adults were surveyed about their experiences with primary care. 44% identified as male and 56% identified as female at the time of the survey. After collecting responses through a third-party survey platform, responses were weighted to reflect the current U.S. population by achieving equal distribution with known population characteristics. According to Census.gov , as of July 2023, the population of those 18 years of age and older in the United States was 262,083,034 and thus the margin of error for this survey is 3% at a 95% confidence level.

Citation Guidelines

Should you reference any data from this report elsewhere, please include a source link to https://health.usnews.com/health-care/top-doctors/articles/primary-care-experiences-survey-report .

Routine Health Screenings Everyone Needs

Tags: patients , patient safety , doctors , patient advice , surveys

Most Popular

health disclaimer »

Disclaimer and a note about your health », you may also like, key medicare enrollment deadlines.

Joanne Kaldy and Vanessa Caceres April 26, 2024

LASIK Eye Surgery

Mariya Greeley and Elaine K. Howley April 26, 2024

What Makes a Good Doctor?

Paul Wynn April 25, 2024

Does Medicare Cover Cataract Surgery?

Elaine K. Howley April 24, 2024

RSV Vaccines: Who Should Have One?

Stacey Colino April 22, 2024

Your Guide to Hip Replacement Surgery

Lisa Esposito and Elaine K. Howley April 22, 2024

Find a Primary Care Doctor Near You

Payton Sy April 18, 2024

Streamlined Maternity Services Survey

Jennifer Winston, Ph.D. , Xinyan Zhou and Kaylan Ware April 17, 2024

Major Food Allergens

Claire Wolters April 15, 2024

What to Know About Creatinine Levels

Christine Comizio April 12, 2024

• Rules/Help/FAQ Help/FAQ
• Members Current visitors
• Interface Language

Follow along with the video below to see how to install our site as a web app on your home screen.

Note: This feature may not be available in some browsers.

• English Only

"To see a doctor" vs "to visit a doctor"

• Thread starter Nicknamed
• Start date Jun 20, 2020

Senior Member

• Jun 20, 2020

Hello to everybody, what's the difference between the 2 following sentences? 1) You should visit a doctor. 2) You should see a doctor. The context is someone who feels sick. Thanks  

Keith Bradford

No difference in meaning. There's also "you should consult a doctor".  

I don't think I've heard people using "visit a doctor" in BE. I'd expect most people to use "see".  

Moderato con anima (English Only)

Yes, 'visit a doctor' sounds a bit strange to me. Quite often people say, 'You should go and see a doctor.'  

I agree with Andygc and Natkretep. See: Google Ngram Viewer  

Expedia Rewards is now One Key™

Elektrostal, visit elektrostal, check elektrostal hotel availability, popular places to visit.

• Electrostal History and Art Museum

You can spend time exploring the galleries in Electrostal History and Art Museum in Elektrostal. Take in the museums while you're in the area.

• Cities near Elektrostal

• Places of interest
• Yuri Gagarin Cosmonaut Training Center
• Peter the Great Military Academy
• Central Museum of the Air Forces at Monino
• History of Russian Scarfs and Shawls Museum
• Balashikha Arena
• Balashikha Museum of History and Local Lore
• Bykovo Manor
• Pekhorka Park
• Ramenskii History and Art Museum
• Malenky Puppet Theater
• Drama Theatre BOOM
• Likino Dulevo Museum of Local Lore
• Noginsk Museum and Exhibition Center
• Pavlovsky Posad Museum of Art and History
• Saturn Stadium
• Fairy Tale Children's Model Puppet Theater
• Fifth House Gallery
• Church of Vladimir
• Malakhovka Museum of History and Culture
• Orekhovo Zuevsky City Exhibition Hall

OUR MINISTER

Dr. Joseph Lozovyy was born into a Christian family in Elektrostal, Moscow Region, and was raised in a pastor’s home. From the age of fifteen, he began actively participating in the music ministry of the Baptist Church in Mytishchi, where his father served as a pastor, and also played in the orchestra of the Central Moscow Baptist Church. From 1989, he participated in various evangelistic events in different cities of Moscow Region and beyond. From 1989 to 1992, as a member of the choir and orchestra “LOGOS,” he participated in evangelistic and charitable concerts, repeatedly performing on the stages of the Moscow State Conservatory, the Bolshoi Theatre, and other concert halls in Russia and abroad. In 1992, his family moved to the United States. In 2007, after completing a full course of spiritual and academic preparation, Joseph moved to Dallas, Texas, to engage in church ministry. In 2008, he founded the Russian Bible Church to preach to the Russian-speaking population living in Dallas, Texas.

– Bachelor of Arts in Music (viola) from the Third Moscow Music School named after Scriabin, Russia (1987-1991)

– Master of Theology (Th.M); Dallas Theological Seminary, Texas (1999-2003);

– Doctor of Philosophy (Ph.D) Hebrew Bible (Books of Samuel): University of Edinburgh, Scotland, United Kingdom (2007).

– Doctoral research (2004-2005) Tübingen, Germany.

– Author of a theological work published in English: Saul, Doeg, Nabal and the “Son of Jesse: Readings in 1 Samuel 16-25, LHBOTS 497 [T&T Clark/Continuum: Bloomsbury Publishing]).

https://www.bloomsbury.com/us/saul-doeg-nabal-and-the-son-of-jesse-9780567027535/

Joseph and his wife Violetta and their son Nathanael live in the northern part of Dallas.

Saul, Doeg, Nabal, and the “Son of Jesse”: Readings in 1 Samuel 16-25: The Library of Hebrew Bible/Old Testament Studies Joseph Lozovyy T&T Clark (bloomsbury.com)

Joseph, his wife Violetta and their son Nathaniel live in North Dallas, Texas where he continues ministering to Russian-speaking Christians and his independent accademic research.

Published Work

1. bloomsbury:, 2. buy at christian book distributors:, 3. buy on amazon:.

Study record managers: refer to the Data Element Definitions if submitting registration or results information.

Search for terms

• Advanced Search
• See Studies by Topic
• See Studies on Map
• How to Search
• How to Use Search Results
• How to Find Results of Studies
• How to Read a Study Record

• Learn About Studies
• Other Sites About Studies
• Glossary of Common Site Terms

• Submit Studies to ClinicalTrials.gov PRS
• Why Should I Register and Submit Results?
• FDAAA 801 and the Final Rule
• How to Apply for a PRS Account
• How to Register Your Study
• How to Edit Your Study Record
• How to Submit Your Results
• Frequently Asked Questions
• Support Materials
• Training Materials

• Selected Publications
• Clinical Alerts and Advisories
• Trends, Charts, and Maps
• Downloading Content for Analysis

• ClinicalTrials.gov Background
• About the Results Database
• History, Policies, and Laws
• ClinicalTrials.gov Modernization
• Media/Press Resources
• Linking to This Site
• Terms and Conditions
• Search Results
• Study Record Detail

An Open Comparative Study of the Effectiveness and Incomparable Study of the Immunogenicity and Safety of the Vaccine (CoviVac) for Adults Aged 60 Years and Older

• Study Details
• Tabular View
• No Results Posted

Inclusion Criteria:

Volunteers must meet the following inclusion criteria:

Type of participants

• Healthy volunteers or volunteers with a history of stable diseases that do not meet any of the criteria for non-inclusion in the study.

Other inclusion criteria

• Written informed consent of volunteers to participate in a clinical trial
• Volunteers who are able to fulfill the Protocol requirements (i.e., fill out a self-observation Diary, come to control visits).

Exclusion Criteria:

SARS-CoV-2 infection • A case of established COVID-19 disease confirmed by PCR and/or ELISA in the last 6 months.

Diseases or medical conditions

• Serious post-vaccination reaction (temperature above 40 C, hyperemia or edema more than 8 cm in diameter) or complication (collapse or shock-like condition that developed within 48 hours after vaccination; convulsions, accompanied or not accompanied by a feverish state) to any previous vaccination.
• Burdened allergic history (anaphylactic shock, Quincke's edema, polymorphic exudative eczema, serum sickness in the anamnesis, hypersensitivity or allergic reactions to the introduction of any vaccines in the anamnesis, known allergic reactions to vaccine components, etc.).
• Guillain-Barre syndrome (acute polyradiculitis) in the anamnesis.
• The axillary temperature at the time of vaccination is more than 37.0 ° C.
• Acute infectious diseases (recovery earlier than 4 weeks before vaccination) according to anamnesis.
• Donation of blood or plasma (in the amount of 450 ml or more) less than 2 months before inclusion in the study.
• Severe and/or uncontrolled diseases of the cardiovascular, bronchopulmonary, neuroendocrine systems, gastrointestinal tract, liver, kidneys, hematopoietic, immune systems.
• Is registered at the dispensary for tuberculosis, leukemia, oncological diseases, autoimmune diseases.
• Any confirmed or suspected immunosuppressive or immunodeficiency condition in the anamnesis.
• Splenectomy in the anamnesis.
• Neutropenia (decrease in the absolute number of neutrophils less than 1000/mm3), agranulocytosis, significant blood loss, severe anemia (hemoglobin less than 80 g/l) according to anamnesis.
• Anorexia according to anamnesis.

Prior or concomitant therapy

• Vaccination with any vaccine carried out within 30 days before vaccination / the first dose of the studied vaccine or planned administration within 30 days after vaccination / the last dose of the studied vaccine.
• Prior vaccination with an experimental or registered vaccine that may affect the interpretation of the study data (any coronavirus or SARS vaccines).
• Long-term use (more than 14 days) of immunosuppressants or other immunomodulatory drugs (immunoregulatory peptides, cytokines, interferons, immune system effector proteins (immunoglobulins), interferon inducers (cycloferon) during the six months preceding the study, according to anamnesis.
• Treatment with systemic glucocorticosteroids (≥ 20 mg of prednisone, or an analog, for more than 15 days during the last month).
• Volunteers who received immunoglobulin preparations or blood transfusion during the last 3 months prior to the start of the study according to anamnesis.

Other non-inclusion criteria

• Participation in any other clinical trial within the last 3 months.

Exclusion criteria:

• Withdrawal of Informed consent by a volunteer;
• The volunteer was included in violation of the inclusion/non-inclusion criteria of the Protocol;
• Any condition of a volunteer that requires, in the reasoned opinion of a medical researcher, the withdrawal of a volunteer from the study;
• Taking unauthorized medications (see section 6.2);
• The volunteer refuses to cooperate or is undisciplined (for example, failure to attend a scheduled visit without warning the researcher and/or loss of communication with the volunteer), or dropped out of observation;
• For administrative reasons (termination of the study by the Sponsor or regulatory authorities), as well as in case of gross violations of the Protocol that may affect the results of the study.
• For Patients and Families
• For Researchers
• For Study Record Managers
• Customer Support
• Accessibility
• Viewers and Players
• Freedom of Information Act
• HHS Vulnerability Disclosure
• U.S. National Library of Medicine
• U.S. National Institutes of Health
• U.S. Department of Health and Human Services

• Skip to main content
• Keyboard shortcuts for audio player

• Your Health
• Treatments & Tests

Health Inc.

• Public Health

Oncologists' meetings with drug reps don't help cancer patients live longer

Sydney Lupkin

Drug companies often do one-on-one outreach to doctors. A new study finds these meetings with drug reps lead to more prescriptions for cancer patients, but not longer survival. Chris Hondros/Getty Images hide caption

Drug companies often do one-on-one outreach to doctors. A new study finds these meetings with drug reps lead to more prescriptions for cancer patients, but not longer survival.

Pharmaceutical company reps have been visiting doctors for decades to tell them about the latest drugs. But how does the practice affect patients? A group of economists tried to answer that question.

When drug company reps visit doctors, it usually includes lunch or dinner and a conversation about a new drug. These direct-to-physician marketing interactions are tracked as payments in a public database, and a new study shows the meetings work. That is, doctors prescribe about five percent more oncology drugs following a visit from a pharmaceutical representative, according to the new study published by the National Bureau of Economic Research this month.

But the researchers also found that the practice doesn't make cancer patients live longer.

"It does not seem that this payment induces physicians to switch to drugs with a mortality benefit relative to the drug the patient would have gotten otherwise," says study author Colleen Carey , an assistant professor of economics and public policy at Cornell University.

For their research, she and her colleagues used Medicare claims data and the Open Payments database , which tracks drug company payments to doctors.

While the patients being prescribed these new cancer drugs didn't live longer, Carey also points out that they didn't live shorter lives either. It was about equal.

The pharmaceutical industry trade group, which is known as PhRMA, has a code of conduct for how sales reps should interact with doctors. The code was most recently updated in 2022, says Jocelyn Ulrich, the group's vice president of policy and research .

"We're ensuring that there is a constant attention from the industry and ensuring that these are very meaningful and important interactions and that they're compliant," she explains.

The code says that if drug reps are buying doctors a meal, it must be modest and can't be part of an entertainment or recreational event. The goal should be education.

Ulrich also points out that cancer deaths in the U.S. have declined by 33 percent since the 1990s , and new medicines are a part of that.

A Chronicle of Current Events

For human rights & freedom of expression in the ussr, the podrabinek case, dec 1977 to feb 1978 (48.7).

<<No 48 : 14 March 1978>>

On 1 December 1977, the brothers Alexander and Kirill PODRABINEK (CCE 47) and their father Pinkhos Abramovich PODRABINEK were summoned for a chat by Yu.S. Belov, chief of a department at the Moscow City and Regional KGB. Alexander refused to appear.

“On behalf of the Committee for State Security ” (Belov told Kirill and his father Pinkhos Podrabinek)

“I suggest that you and your families leave the Soviet Union and go abroad via Israel within 20 days. There is enough material against you, Kirill Pinkhosovich, to institute criminal proceedings. You, Pinkhos Abramovich, are also known to us for your anti-social activities. An act of humanity is being offered to you both. I advise you to make use of it.”

Alexander (b. 1953) and Kirill Podrabinek (b. 1952)

The same evening Alexander Podrabinek was arrested on the street and taken to the KGB. Belov presented him, too, with an ultimatum: all three must leave the country, otherwise criminal proceedings would be instituted against both brothers.

Belov let it be understood that the absence of an invitation and difficulties with money would not be obstacles. Belov stressed that they could only leave all together.

HOSTAGE-TAKING

Many painful disputes have sprung up around the moral problems arising from KGB’s ultimatums and blackmail. The Chronicle cannot present the arguments but at least it can accurately convey the stance of participants in such events by reproducing all their statements in sufficient detail.

On 6 December 1977, there was a press conference at Andrei Sakharov ’s flat. Pinkhos PODRABINEK read out a “Statement for the Belgrade Conference [note 1] and the Press”:

“A distinctive feature of this case is the KGB’s use of the hostage system. Not one of us can determine his own fate independently, and a decision about the fate of three people has been placed by the KGB on Alexander Podrabinek alone, in whose departure the authorities are most of all interested. “We categorically refuse to accept such conditions and insist on our right to make our choices independently…”

Then Alexander PODRABINEK read out his “Reply” to the KGB’s proposal:

“I would like to draw the attention of the world public to my brother’s painful position and to the dirty tactics of the KGB — tactics of intimidation and terror. The whole world condemns the hijacking of aeroplanes and the taking of passengers as hostages, yet the KGB is using the very same method with regard to my brother, a method commonly used by terrorists. In the situation that has arisen the most painful thing for me is my brother’s fate. “At the KGB they insistently advised me to take advantage of this ‘humane act of the Soviet government’, as they expressed it. I regard this proposal as unconcealed blackmail by the KGB. “They have given me four days to reflect. On 5 December I have to give my reply. A reply that means a great deal to me. “This is my reply.

“I do not wish to go to prison. I value even the semblance of freedom which I possess now. I know that I would be able to live freely in the West and at last receive a real education. I know that there I would not have four agents at my heels, threatening to beat me up or push me under a train.

“Over there, I know, they will not put me in a concentration camp or a psychiatric hospital for attempting to defend people who are denied their rights and oppressed. Over there, I know, one breathes easily. While here one does so with difficulty, and they stop your mouth and stifle you if you speak too loudly. I know that our country is unhappy and doomed to suffering.

“And that is why I am staying.

“I do not want to go to prison, but neither do I fear a camp. I value my own freedom as I value my brother’s, but I am not bargaining for it. I will not give in to any blackmail.

“A clear conscience is dearer to me than material well-being. I was born in Russia. This is my country, and I must remain here, however hard it may be and however easy in the West. As far as I am able, I will go on defending those whose rights are being so brazenly trampled on in our country.

“That is my reply. I am staying.”

After this Alexander Podrabinek added that he would agree to leave the country only if Kirill were to ask him to do so.

On 7 December 1977, Kirill PODRABINEK made a statement:

KGB Blackmail

1. The KGB is using the hostage-taking method. They are basically blackmailing my brother Alexander, while I am the hostage. 2. The very formulation of the question: ‘leave or we will put you in prison’, is contrary to the law. If a man has committed a crime he must be prosecuted. However, in this case the KGB does not want to stage a new political trial but prefers to dispatch us abroad. The KGB has employed a well-calculated device — to exploit the insolubility of a situation with a hostage. All this blackmail is patently a consequence of the public stand taken by our family … “If any one of the three of us is arrested and any charge whatsoever brought against him, it can only be viewed as an act of revenge by the KGB and not as a requirement of justice.”

On 12 December 1977, Kirill Podrabinek informed Belov that he had decided to leave. Belov replied that Kirill could hand in his emigration documents, and on the same day Kirill did so. On 14 December Kirill Podrabinek made an addition to his previous statement:

“On 12 December, I telephoned investigator Belov at the KGB. Permission to go abroad has been granted; there was no mention of my only being able to leave only with my brother. Does this mean that the KGB has given up its hostage-taking and will really allow me to leave? In the very near future this will become clear … In view of all the circumstances, and fearing for my life” (see CCE 47) “I have taken the decision to leave.” *

KIRILL PODRABINEK (b. 1952)

On 27 December 1977, the police in Elektrostal (Moscow Region) brought charges against Kirill Podrabinek under Article 215 (RSFSR Criminal Code: “Illegal possession of arms, ammunition” etc). Kirill refused to sign the record of this charge. Investigator Radygin obtained his written undertaking not to leave town but said he would not need Kirill before the middle of January and, if need be, he could go to Moscow.

When Kirill Podrabinek came out of the Elektrostal police station he was met at the door by KGB Investigator Belov, who had arrived from Moscow. The condition of Kirill’s departure remained unchanged, Belov said, and gave him three days in which to persuade his brother to agree to leave.

From that day onwards, KGB employees began trailing Kirill Podrabinek . (His brother Alexander had been under a similar “escort” since 10 October 1977, see below). The same day 22 Muscovites issued a statement:

“Wishing to force Alexander Podrabinek to leave the country, the KGB is openly blackmailing him with his brother’s fate. A method of hostage-taking used thus far only by irresponsible criminal-terrorists is in the present case being adopted as a weapon by the official representatives of a powerful State. This blackmail clearly demonstrates the value of the charges brought against Kirill Podrabinek. “We call upon our fellow countrymen and world public opinion to protest against the use of hostage-taking, unprecedented in the practice of civilized states. We call upon our fellow countrymen and world public opinion to follow attentively the fate of the Podrabinek family.”

On 28 December Kirill Podrabinek made a statement:

State Terrorism

“… The KGB has resorted to hostage-taking. My brother Alexander has made a statement for the press saying that he does not wish to leave, but he will leave if I so demand. “Under no circumstances will I make this demand of Alexander. In the first place, that would mean becoming a blind instrument of blackmail in the hands of the KGB, exploiting a situation created by them for my own sake. In the second place, it is impossible for me to even ask, let alone demand such a thing. “However, I have resolved to pursue my chosen line of action and try to obtain permission to leave.”

On the evening of 29 December 1977, Kirill Podrabinek was arrested.

On the day of his arrest, he declared a hunger strike. After a few days he was transferred from Elektrostal to Moscow, to the MVD’s detention centre on Matrosskaya Tishina Street.

The first response to Kirill’s arrest was “The Christmas ‘Feat’ of the KGB”, a short article by Victor Nekipelov [note 2]:

“… The arrest of Kirill Podrabinek is an act of deliberate, demonstrative revenge. The authorities know full well that they are thereby dealing the severest blow to both Alexander Podrabinek – Take that for not accepting our offer! – and to his father — While you didn’t steer your sons to a compromise!”

On 1 January 1978, Yevgeny Nikolayev (see “In the Psychiatric Hospitals”, CCE 48.12 ) sent a letter to the RSFSR Procurator’s Office, protesting against the arrest of Kirill Podrabinek.

On 4 January 1978, Alexander and Pinkhos Podrabinek asked Belov for a meeting with Kirill.

Belov refused but promised to pass Kirill a note from them, “if there are no objections on the part of the investigator”. In the note Alexander and his father asked Kirill: “Do you agree to leave if there is no need to ask Alexander to do the same?”

On the same day, at 11.30 pm, Belov came to Elektrostal to see Pinkhos Podrabinek . He informed him that the investigator “had not allowed” the note to be passed to Kirill. If Alexander handed in his application to emigrate within three days, however, all three could leave the USSR. Otherwise, Alexander  would also be arrested. Belov suggested that P.A. Podrabinek go at once to Moscow and persuade Alexander to change his mind: he even gave Pinkhos Abramovich a lift back to Moscow in his car.

On 5 January 1978, Alexander Podrabinek appealed in an open letter to Amnesty International, calling on the organisation to speak out in Kirill’s defence.

On 9 January Alexander Podrabinek telephoned Belov at the KGB. When Belov asked if he intended to leave, Alexander replied that he could only decide this matter together with his brother.

On 15 January 1978, the Christian Committee for the Defence of Believers’ Rights in the USSR called upon “world public opinion” to speak out in defence of Kirill Podrabinek and condemn the policy of hostage-taking.

At the beginning of February 1978, the Podrabineks were summoned to Elektrostal for interrogation in connection with Kirill’s case.

Pinkhos Podrabinek replied to questions about Kirill but refused to sign a record of the interrogation. Alexander declined to answer questions, stating that the case was inspired by the KGB and was being conducted with violations of norms laid down in the Code of Criminal Procedure.

ALEXANDER PODRABINEK (b. 1953)

From 10 October 1977, Alexander Podrabinek was under constant KGB surveillance. Round the clock he was pursued by two cars carrying seven or eight employees of the security services.

Whenever he was inside a building the cars stood in front of the doorway. Whenever he walked along the street or travelled in public transport there were always several agents at his side. They threatened Alexander’s acquaintances and took photographs of them. Sometimes they interfered more actively with the life of their charge: on Sunday 18 December the escort prohibited Alexander from going skiing with friends in the Orekhovo-Borisovo district [Moscow Region]. Podrabinek wrote about this incident to [KGB chairman] Andropov:

“… Since 10 October of this year I have been under the continuous and unconcealed observation of our glorious Chekists. Defending the State’s security, I understand, it is essential for the KGB to search my home, call me as a witness in the case of Yury Orlov, suggest that I leave the USSR, blackmail me, make an attempt on my brother’s life, and do much else to ensure that I do not, accidentally, undermine the foundations of the Soviet political and social system. All this I understand. “I am not even particularly annoyed when one of the eight officers who perpetually watch over me swears he will break my legs or push me under a train. I understand the full difficulty of this highly complex, responsible and dangerous work and do not get angry with these heroic young people who, performing their civic duty, freeze on cold December nights outside the entrance to my house or squeeze after me onto a city bus in the rush-hour. I am enraptured by their daring, their persistence and their indifference to the cold … “Citizen Andropov! On behalf of myself and six of my friends I beg you: Provide your employees with skis and toboggans and, please, teach them how to use them, if they do not know. Then I shall be able to enjoy my on Sundays and the KGB will be able to work normally and not violate the Soviet Constitution. This can only enhance the reputation of our valiant organs and promote their physical development.”

From January 1978, the constant “escort” was replaced from time to time by ‘ordinary’ shadowing.

The security services are trying by any means to prevent Alexander Podrabinek from continuing his activities on the Working Commission (to Investigate the Use of Psychiatry for Political Purposes). In particular, they are hampering him from meeting, in the flats of his Moscow friends, people who have been subjected to “psychiatric persecution” and their relatives. Podrabinek and his friend Dmitry Leontyev , in whose flat he was living, were fined for violating the city residence regulations. Podrabinek was forbidden to continue residing at the flat.

Alexander Podrabinek was warned that he was liable to be charged with “parasitism”. In February 1978, having given his shadow the slip, he managed to get a job as a medical orderly (he is a qualified paramedic).

The pre-trial investigation of Kirill Podrabinek ’s case was completed in February 1978.

=======================

[1] Representatives of all 35 member-States of the Conference on Security and Cooperation in Europe (CSCE) assembed in the Yugoslav capital Belgrade to discuss the implementation of the 1975 Helsinki Accords five years on.

[2] Victor Nekipelov

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)
• Click to share on LinkedIn (Opens in new window)

• Already have a WordPress.com account? Log in now.
• Subscribe Subscribed
• Copy shortlink
• Report this content
• View post in Reader
• Manage subscriptions
• Collapse this bar

Ontario scrapping sick notes to cut down on doctors' paperwork

Province also expanding ai pilot project in bid to ease administrative burden on family doctors.

Social Sharing

Ontario says it will force employers to scrap requirements for sick notes as part of an effort to cut down on paperwork for family physicians.

The change will be part of new legislation tabled by the minister of labour in coming weeks, a government official says. The amendments would eliminate the need for a doctor's note from employees who want to use part or all of their three days of provincially-mandated annual sick leave.

Employers will retain the right to require another form of evidence that an employee is ill, which could include self-attestations or a receipt for over-the-counter medication, the official said.

The change is part of a host of measures announced by Health Minister Sylvia Jones Wednesday intended to help free primary care physicians for more direct patient care.

The province is also expanding a pilot program that will see family doctors use artificial intelligence technology to transcribe and summarize patient visits.

Some 150 primary care clinics will participate in the project, which is being administered and evaluated by OntarioMD, a subsidiary of the Ontario Medical Association (OMA).

Hopes to reduce paperwork

The AI software is called Scribe. It can summarize conversations with patients who consent to its use into electronic medical records, Jones said.

The province says it will also digitize more referral and consultation forms and is working to improve the eForms platform.

"Together these changes put patients before paperwork, allowing clinicians to spend more time with their patients, resulting in a more connected and convenient patient care experience," Jones said.

• Is it time to ditch sick note requirements? Doctors and patients are tired of them
• Want more family doctors in Ontario? Pay them better, say physicians

According to an accompanying news release, research in other jurisdictions suggests AI software can reduce the time doctors spend on after-hours paperwork by up to 50 per cent and allow them to see more patients.

OMA President Dr. Andrew Park said the "burden of unnecessary administration" takes up about 19 hours per week for primary care doctors, preventing them from seeing more patients and achieving a healthy work-life balance.

The OMA estimates roughly four of those total hours are spent on writing sick notes and completing government medical forms.

Checks and balances

Liberal MPP Adil Shamji, who has also worked as an emergency room doctor, told reporters Wednesday that "the devil is in the details and the execution," and AI systems would need to be carefully implemented.

"If this proves to be an avenue that we actually decide to pursue beyond a pilot project, there will need to be a series of checks and balances to make sure that there is accuracy, to make sure that patient confidentiality is preserved," he said.

• Fewer medical school graduates choosing family medicine, Ontario doctors warn

Roughly 2.3 million Ontarians do not have a family doctor, a figure that is expected to double in the coming two to three years, Park said. 

The OMA warned earlier this week that fewer medical students are choosing to pursue family medicine , partly due to the time primary care physicians spend doing unpaid paperwork.

As part of Wednesday's announcement, the OMA said it is also working with the health ministry to streamline and simplify 12 key government medical forms that are burdensome and time-consuming for family doctors.

Kathleen Wynne's Liberal government actually  banned employers from demanding sick notes,  effective Jan. 1, 2018. Then, the Doug Ford government  repealed that ban shortly after taking office , allowing employers to demand a doctor's note for even minor illnesses, as part of its changes to provincial labour law.

With files from The Canadian Press, Lucas Powers and Mike Crawley

Related Stories

Orphaned by an airstrike and saved from her dead mother’s womb, baby Sabreen has died

Sabreen Alrouh Joudeh was born an orphan. And her life, however hopeful, has proved brief.

During a barrage of intense Israeli airstrikes on the southern Gaza city of Rafah this weekend, one blast hit the family home into which Sabreen would have been welcomed, according to local health officials, hospital staff and family members. The blast killed her mother, Sabreen Sakani — who was 30 weeks pregnant with her at the time — as well as her father, Shukri Joudeh, and her 3-year-old sister she never got to meet, Malak.

The family was declared dead at the city’s Kuwaiti Hospital on Saturday, but NBC News’ cameras captured the moment doctors were able to perform a posthumous cesarean section and rescue Sabreen from her mother’s lifeless body. 

Limp and lifeless at first, the vernix-covered newborn weighing just over 3 pounds was taken in a golden fabric blanket and rushed to an upstairs room. There, doctors tried for more than two minutes to resuscitate her by pumping air into her mouth and tapping her chest. They were finally, somehow, successful.

From there, she was immediately rushed by ambulance through the night to an intensive care unit incubator at the nearby Emirati Hospital, audibly whimpering on arrival. It was there that her paternal grandmother and uncle paid her an emotional visit, accompanied by NBC News, on Monday.

“I don’t know if we should be happy that she came to life or sad,” said her uncle Rami Joudeh, 25, weighing what should have been the joy of Sabreen’s arrival with the deaths of his brother and sister-in-law, who were just 29 and 27 years old. “Our lives are messy.”

The newborn’s grandmother Alham Al-Kurdi, 55, wept as she reached into the incubator. 

“You are my soul, my heart. You are my heart, baby,” she said, tears rolling over her freckled cheeks, her wrinkled hand caressing the infant’s tissue-paper skin as machines chirped around her. “You are my beloved one. God willing, God willing. She is inside my heart.”

It was difficult to get a clear view of Sabreen’s tiny, preterm form through the thick plastic of the incubator keeping her alive. As she was lying swaddled in tubes and wires, those lifelines provided oxygen to her underdeveloped lungs and monitored her fragile pulse. Beneath the technology keeping her alive — a rarity in Gaza where many hospitals have been destroyed by six months of war — her ribs continued to rise and fall.

Though a remarkable vignette, this family has been devastated like so many others in the enclave.

More than 34,000 people, including some 13,000 children, have been killed since Israel launched its military campaign following the Hamas-led attack on Oct. 7 , according to the Palestinian enclave’s Health Ministry. That toll only looks set to rise as Israel focuses its military might on Rafah, Gaza’s southernmost city that sits on the border with Egypt.

It’s here where some 1.5 million Palestinians have fled, now sheltering in tents and on the streets.

Nevertheless, Israel says it must strike Rafah because Hamas leaders and units are hiding out there. The United States and others have warned Israel against a long telegraphed, full-scale ground assault of the city, given the already desperate civilian population that has been caught up in the fighting.

Bombing this weekend alone killed 26 children across three families in the city, according to Health Ministry figures compiled by NBC News. Palestinians say that so-called safe zones designated by Israel are a myth, with people directed to move into areas that have been subsequently bombed anyway.

“There are no safe places at all, they are liars, liars,” Rami Joudeh said. “There is no safe place in Gaza. We are all living under the menace of death.”

Asked for comment on the strike that killed Sabreen’s family, the Israel Defense Forces said in a statement, “At given times, the IDF struck several military targets of the terrorist organizations in Gaza including military compounds, launch posts and armed terrorists.”

The hospital that treated the newborn is only one of three still providing maternal care for Gaza’s 2.3 million population, and 180 women a day are giving birth in “inhumane, unimaginable conditions,” according to an update from the United Nations Population Fund last week.

“Every day we have a sad story; every day we have a horrible story,” said  Dr. Muhammad Salama, head of the emergency neonatal department in the Emirati Hospital, who is treating baby Sabreen.

He gestures to other infants under his care. “This baby right here, his father has died. This baby’s mother has died. Another two babies in the ICU, one of them came and we cannot know, sadly, if his mother or father is alive.”

This takes its toll not just on the families, but also on the medical workers themselves. 

“All medical staff are really tired from these cases, which take a lot of energy physically and psychologically, because we are dealing with babies who were born without mothers and fathers,” Salama said. “We are exhausted and, physically, we cannot take any more like this.”

At the time, Sabreen, at least, was getting stronger every day, he said. But she was by no means safe.

Because she was born almost two months prematurely, her lungs had not formed properly and she arrived with something called respiratory distress syndrome.

And in the end, Dr. Salama said, it was difficult for her lungs to absorb oxygen. On Thursday, less than a week after her birth, Sabreen died.

Alexander Smith is a senior reporter for NBC News Digital based in London.