4 ms·

Pharma gives gifts to physicians because giving gifts works to sell pharma's products. When I was in medical school and residency, it was a standard thing that

by logjam 14y ago

Pharma gives gifts to physicians because giving gifts works to sell pharma's products. When I was in medical school and residency, it was a standard thing that lunches were all sponsored by pharma. These were usually nice catered meals brought in by some pharm rep. The price was at least listening to a sponsored (biased) speaker, or a five minute sales pitch. Sometimes an office's or deparment's prescribing numbers for a particular drug were actually tracked and discussed, as if we were in a sales meeting and we were or were not meeting the pharmaceutical reps quota for sales. Dinners were even more elaborate, commonly held at some swank restaurant, with a paid physician (shill) brought in to present "research" about that company's drugs. My attendings were offered tickets to desirable sporting events, or paid travel to medical conferences that just happened to be in Tahiti. There was that wink and nudge: of course you would be using your own clinical judgment about the effectiveness of the drug being pushed. Of course the freebies had no effect on your judgement. Of course the published positive results reported at sponsored conferences and in sponsored journals constituted all the data and all the trials of that particular drug. If you had qualms about big gifts or even meals, a pharma rep was always ready to give you a gift of the latest textbook (embossed with the name of a drug and/or pharma company) or maybe a sponsorship to the latest conference: after all, augmenting your education would only benefit your patients, right? What could possibly be wrong with that? Physicians are increasingly and rightfully refusing to accept gifts of any kind from pharma. It was unethical then and remains unethical now. Many med schools and residencies have now rightfully banned pharma reps from any contact. We need more and better regulation, not less. Ask your doctor if he or she accepts gifts. If they do, or if you see product advertisements of any kind in the office (to include pens, notepads, pharma-labelled equipment, drug/product brochures), find yourself another doctor.

cloverich 14y ago
I'd also argue we need better education. My pharm. class followed the typical academic exercise in memorizing information which was 80% useless to modern medical practice. The heavy focus on biochemistry and mechanisms of action were interesting but mostly irrelevant, because they didn't help us answer questions most relevant to clinical practice; we don't typically choose drug A over B because of a biochemical property, but because there's evidence that one works better than the other, is more cost effective, has a better response rate in a particular population, etc. Shifting pharm. education to focus more on those types of things - how do we choose the right drug; how can we use evidence to critically choose when a new, more expensive drug, is actually better? Or marginally better but cost-effective? This type of teaching is relegated to one-off class' and side-topics. Its not center stage. The methods of big Pharma can definitely be unethical, but I think the real problem is our physicians are fundamentally unprepared to ask the right questions and make the best decisions.
- joshAg 14y ago
  did you take that as part of a pharmD. or MD?
  - cloverich 14y ago
    MD
    - joshAg 14y ago
      perhaps it might be better to have doctors prescribe for a specific issue (eg: needs something for allergies) and then leave it up to the pharmacist to decide which specific pill and dosage level as opposed to prescribing the specific pill themself (eg allegra). I mean, it's not like the pharmacist isn't going to already look over the prescribed medication to make sure it won't negatively interact with the patient's other medications of course, that's assuming that the doctor and the pharmacist will be able to see each other's notes and that egos won't get in the way. but it's not like doctors don't alredy farm certain tasks out to specialists (eg radiologists for reading x-rays or neurologists for reading ct scans).
- ars 14y ago
  This isn't going to happen because it turns doctors into technicians: You have this illness? Click click click - OK it says this drug is best. Doctors like the thought that they are evaluating each case based on first principles. Right now there is: Dr. -> Urgent Care -> Emergency Room We need something below Dr., for the really routine stuff. In some countries certain drugs are not over the counter, but are prescribed by pharmacists. (Obviously there is a very important place for proper diagnosis. I'm talking about the really obvious stuff.)
  - orta 14y ago
    In the UK its quite common to see a nurse for routine things that you're talking about here, personally I've not seen a doctor in years because of this.

by logjam 14y ago

cloverich 14y ago

I'd also argue we need better education. My pharm. class followed the typical academic exercise in memorizing information which was 80% useless to modern medical practice. The heavy focus on biochemistry and mechanisms of action were interesting but mostly irrelevant, because they didn't help us answer questions most relevant to clinical practice; we don't typically choose drug A over B because of a biochemical property, but because there's evidence that one works better than the other, is more cost effective, has a better response rate in a particular population, etc. Shifting pharm. education to focus more on those types of things - how do we choose the right drug; how can we use evidence to critically choose when a new, more expensive drug, is actually better? Or marginally better but cost-effective? This type of teaching is relegated to one-off class' and side-topics. Its not center stage. The methods of big Pharma can definitely be unethical, but I think the real problem is our physicians are fundamentally unprepared to ask the right questions and make the best decisions.

joshAg 14y ago
did you take that as part of a pharmD. or MD?
- cloverich 14y ago
  MD
  - joshAg 14y ago
    perhaps it might be better to have doctors prescribe for a specific issue (eg: needs something for allergies) and then leave it up to the pharmacist to decide which specific pill and dosage level as opposed to prescribing the specific pill themself (eg allegra). I mean, it's not like the pharmacist isn't going to already look over the prescribed medication to make sure it won't negatively interact with the patient's other medications of course, that's assuming that the doctor and the pharmacist will be able to see each other's notes and that egos won't get in the way. but it's not like doctors don't alredy farm certain tasks out to specialists (eg radiologists for reading x-rays or neurologists for reading ct scans).
ars 14y ago
This isn't going to happen because it turns doctors into technicians: You have this illness? Click click click - OK it says this drug is best. Doctors like the thought that they are evaluating each case based on first principles. Right now there is: Dr. -> Urgent Care -> Emergency Room We need something below Dr., for the really routine stuff. In some countries certain drugs are not over the counter, but are prescribed by pharmacists. (Obviously there is a very important place for proper diagnosis. I'm talking about the really obvious stuff.)
- orta 14y ago
  In the UK its quite common to see a nurse for routine things that you're talking about here, personally I've not seen a doctor in years because of this.