4 ms·

Imagine the little perverse incentives that companies offer to leave a Yelp rating (rate us and get some free breadsticks! or whatever), but with pharmaceutical

Imagine the little perverse incentives that companies offer to leave a Yelp rating (rate us and get some free breadsticks! or whatever), but with pharmaceuticals (leave us a five star rating and get a new car, or a new medical device, or whatever). That sounds really, really bad, and it would require a lot of regulation and oversight to make sure ratings weren't being manipulated. I suspect those two things will be in short supply in the incoming administration.

smitherfield 10y ago
Doctors, like lawyers, accountants, pharmacists and so on have professional associations with existing and quite strict ethics regulations about this sort of thing.
- FreakyT 10y ago
  That hasn't stopped "buying expensive stuff for doctors to sway them" from being a thing, even now! http://www.wsj.com/articles/SB10001424127887324695104578414530096553710 http://www.wsj.com/articles/SB100014241278873246951045784145...
  - smitherfield 10y ago
    I didn't say the existing rules were perfect, I'm just noting they exist. You can also say that a "Yelp for drugs" wouldn't change the existing incentives. FWIW, the doctors I know take ethics very seriously; they take great pains not to be seen as accepting gifts, they treat pharma company claims with a great deal of reasonable skepticism, they always prefer non-drug and OTC treatment to prescriptions, and generics to branded drugs. A few bad apples do not spoil the tree.
- anigbrowl 10y ago
  Then why do we regularly see stories about doctors engaging in epically fraudulent billing practices, taking illegal kickbacks from drug manufacturers, prescribing unneeded drugs and so on? Have you heard of the opiate crisis? Because if so you cannot but be aware of how much of it is driven by prescription rather than black market drug sales. Not to put too fine a point on it, the drug market in the US is a total shitshow, and taking your comment at face value requires ignoring a mountain of evidence. Please don't insult our intelligence with your argument from ignorance. If you actually believe what you wrote above, then you are massively under-informed and should pay more attention to the news.
  - smitherfield 10y ago
    You seem to be a very angry person. We see stories about that because we are a country of 330 million people and there will be some subset of any [group of people] who do bad things in such a large population. The vast majority of doctors are highly ethical. As for opiates, I'm afraid I don't quite fit into your strawman; I think doctors should be banned from prescribing them on an outpatient basis to anyone but patients with a terminal prognosis. Chronic pain is awful, but opiate addiction is still worse. Since the action (and addictive mechanism) of opiates causes the pain to worsen over time, it's not an appropriate treatment. The main reason for overprescription of opiates is not some evil doctor conspiracy, it's because doctors, like everyone, have a very hard time telling people "no." And there's no group of people more skilled at emotional manipulation than junkies.
    - anigbrowl 10y ago
      Nice going, starting out with ad hominem and accusing me of a straw man argument as a way to launch several of your own. We're done here.
      - smitherfield 10y ago
        You might want to take a walk outside and then read your and my comments out loud to yourself, once you've calmed down.
    - detaro 10y ago
      Overprescription of opiates is also a cause for "junkies", not just a consequence of their skills in emotional manipulation.
      - smitherfield 10y ago
        It's a feedback loop. I suspect the ur-cause of the current epidemic is higher rates of depression related to an aging population and chronic un- and underemployment.
    - 10y ago
jeremyt 10y ago
You think FDA employees are immune from this type of thing? How do we go about finding the angels needed to staff this agency?
- anigbrowl 10y ago
  No, but those elaborate FDA approval procedures are designed to reduce the risk of corrupting human influence much like any other scientific protocol that aspires to reproducibility.

smitherfield 10y ago

Doctors, like lawyers, accountants, pharmacists and so on have professional associations with existing and quite strict ethics regulations about this sort of thing.

FreakyT 10y ago
That hasn't stopped "buying expensive stuff for doctors to sway them" from being a thing, even now! http://www.wsj.com/articles/SB10001424127887324695104578414530096553710 http://www.wsj.com/articles/SB100014241278873246951045784145...
- smitherfield 10y ago
  I didn't say the existing rules were perfect, I'm just noting they exist. You can also say that a "Yelp for drugs" wouldn't change the existing incentives. FWIW, the doctors I know take ethics very seriously; they take great pains not to be seen as accepting gifts, they treat pharma company claims with a great deal of reasonable skepticism, they always prefer non-drug and OTC treatment to prescriptions, and generics to branded drugs. A few bad apples do not spoil the tree.
anigbrowl 10y ago
Then why do we regularly see stories about doctors engaging in epically fraudulent billing practices, taking illegal kickbacks from drug manufacturers, prescribing unneeded drugs and so on? Have you heard of the opiate crisis? Because if so you cannot but be aware of how much of it is driven by prescription rather than black market drug sales. Not to put too fine a point on it, the drug market in the US is a total shitshow, and taking your comment at face value requires ignoring a mountain of evidence. Please don't insult our intelligence with your argument from ignorance. If you actually believe what you wrote above, then you are massively under-informed and should pay more attention to the news.
- smitherfield 10y ago
  You seem to be a very angry person. We see stories about that because we are a country of 330 million people and there will be some subset of any [group of people] who do bad things in such a large population. The vast majority of doctors are highly ethical. As for opiates, I'm afraid I don't quite fit into your strawman; I think doctors should be banned from prescribing them on an outpatient basis to anyone but patients with a terminal prognosis. Chronic pain is awful, but opiate addiction is still worse. Since the action (and addictive mechanism) of opiates causes the pain to worsen over time, it's not an appropriate treatment. The main reason for overprescription of opiates is not some evil doctor conspiracy, it's because doctors, like everyone, have a very hard time telling people "no." And there's no group of people more skilled at emotional manipulation than junkies.
  - anigbrowl 10y ago
    Nice going, starting out with ad hominem and accusing me of a straw man argument as a way to launch several of your own. We're done here.
    - smitherfield 10y ago
      You might want to take a walk outside and then read your and my comments out loud to yourself, once you've calmed down.
  - detaro 10y ago
    Overprescription of opiates is also a cause for "junkies", not just a consequence of their skills in emotional manipulation.
    - smitherfield 10y ago
      It's a feedback loop. I suspect the ur-cause of the current epidemic is higher rates of depression related to an aging population and chronic un- and underemployment.
  - 10y ago

jeremyt 10y ago

You think FDA employees are immune from this type of thing? How do we go about finding the angels needed to staff this agency?

anigbrowl 10y ago
No, but those elaborate FDA approval procedures are designed to reduce the risk of corrupting human influence much like any other scientific protocol that aspires to reproducibility.