Key stakeholders in urology must work to restore public's faith in doctors

First of all, I'd like to thank you for making Urology Times my number one source for keeping up with the entire field of urology. I know that I don't just speak for myself when I say that I read it cover to cover and look forward to next month's issue.

I'd like to call your attention to a disturbing trend I've noticed, which was most glaringly illustrated in October's issue, with the interview of Dr. Petrylak by Dr. Thrasher ("New PCa agents extend survival, address unmet needs," Oct. 2011). It was exceptionally complete and informative, but overshadowed by conflicts of interest. After spending five pages compulsively outlining all of the new advances in treating castration-resistant prostate cancer, with very little mention of the astounding costs of these new treatments, we find that Dr. Petrylak is an advisory board member and/or consultant for ten major pharmaceutical companies, including the manufacturers of many of the products named in the article.

And then there are the huge advertisements that occupy nearly one-third of the ad pages in the October issue of Urology Times: 3½ pages for Provenge, 2½ pages for ZYTIGA, and 4 pages for XGEVA.

It's time for organized medicine to realize that our interests are not the same as the pharmaceutical industry's, and while we appreciate all of the advances being made, we as a society cannot afford all of them. These are tough choices, but if organized medicine thinks that we can have it both ways, we are sadly mistaken. So far, the responses of organized medicine to the proposed changes have been 100% reactive, with virtually no proactive ideas. And the American people see us as part of the problem, not the solution.

It's high time for the AUA and the other organizations that theoretically represent us to educate the American people and elected officials and let them know that we are but a fraction of the problem. We need the AUA, along with the editorial boards of our publications, including Urology Times, to embrace cost-effectiveness studies and to work proactively to restore the faith of the American people in us as physicians. Otherwise, we will go down with the ship, and it's not going to be pretty.

Jonathan M. Vapnek, MDNew York