KT,I like your post on PPHM going it alone. For years I have said that is a viable option if/when product is clearly better than competition, or fulfills an obvious need. No "sales" force is necessary. You were mostly right about doctors being in the driver's seat, but some huge caveats apply. Number one concern is family and self. We all want to keep our license to "practice" another day...to feed/clothe ourselves, etc., and therefore avoid being out in front of the crowd. We are bound by a legal concept, the "standard of care" which is a bit fuzzy, but the implication is clear. Can I prove that a prudent professional would administer this treatment choice vs. another more time-tested one? Oncologists are in the hotseat for malpractice suits, almost as much as radiologists and obstetricians, because a relatively higher percentage of their patients die, and they are dealing with remote and often greedy family members, and not the patient they have established a relationship with. So in the rare instance the patient is daring and the doctor is willing, what about the bereft family. Using standard of care, whether effective or not, is often preferable to trying a new approach with more promise.
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