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Thursday, December 14th 2006

Lucky Bastard Promises To Keep Taking Stuff

I’ve had my share of free lunches working in doctors offices (and all I did was put charts away and take fundus photos), and I’ve been around physicians my entire life. But these are the most extreme examples of pharma gifts I’ve ever heard of,

[S]oon I hit the harder stuff: a trip to Italy in exchange for attending a symposium, tickets to a Mets game for my sons and me (and a chatty drug rep). Et cetera. There’s a moment when each of us knows we have gone over the edge. For me, it was a trip to California where I met with a pharmacist for 30 minutes to talk about antifungal medication.

I’m not saying that isn’t “common,” but certainly not common enough for me to have run into it; even growing up with physicians as parents, and working through high school and college in multiple private surgical subspecialty offices. Tickets to a Mets game?

The thing is, there are no apologies in the article.

I don’t feel that much shame for my former behavior, at least the money-grubbing part. I just don’t think that the financial hanky-panky between drug companies and doctors constitutes the central crisis in American medicine or, for that matter, the most corrosive aspect of the entire messy doctor-drug relationship. They need us; we need them. We do the studies they can’t do because they aren’t doctors. They invent the drugs that we can’t invent because we aren’t chemists. It’s pretty straightforward, really. A symbiosis.

No, the real problem is…well, the physician kind’ve gets lost defining the real problem. But this is all light hearted so I won’t take him to task.

[Doctors] feel unappreciated by our patients and by the public. The way we see it, we’re just a bunch of blue-collar Joes with a degree, traveling through rain and sleet and snow trying to keep people healthy. Like the president, we think it’s hard work and, also like Mr. Bush, we are genuinely shocked that everyone doesn’t love us.

Enter the drug reps. Those guys love me; they really love me. I have my own personal troupe of professional grovelers who are paid to laugh at my jokes. You should join me when a few are in my office. It is a laugh riot. And you should hear the compliments I get after giving a paid lecture. My back is patted. I receive countless business cards and compliments.

So the problem isn’t the freebies or the drug reps. It is the physician ego. But not really because…

It’s not our fault, really. We’ve been working in a drug-company haze for far too long.

Ah, we’ve made a circle in our reasoning. Still, I’m not shy saying while I have a personal problem with pharma gifts, I do not think it is something that needs, nor should get, regulation.

I’m trying not to be hypocritical here. Let people pitch their products. Physicians, or many of them, don’t take pharma reps to task on a large scale. The same can’t be said about medical students and the younger crowd, who doth protest in greater numbers (they just haven’t been flown to Italy yet). Certainly, the drug rep-physician relationship draws less vocal calls for reform than say Direct To Consumer advertising.

At least that is my observation.

But the similarities between the two are there. Let’s protect the right to speech…even for apparently soulless corporations.

You don’t want to see pharm reps, don’t see them. You don’t want to give your patient a script for that blue pill he saw on television, have the gall to tell him. And yeah…I know – “you don’t have the time,” “they’ll just go to someone else,” etc. Those sound an awful lot like assholes excuses. Everyone has one.

A beautiful example of the just teeny-weeny hypocrisy of such positions is found at Mexico Medical Student’s blog as he discusses both issues. I’m not picking on him, it was just too good an example (and I found it while I was writing…I didn’t write these comments because of the post) to pass up.

And Yeah, If I Had My Way Joe Could Still Be On TV…
…I Await The Response Where Every Small Cell Carcinoma Is My Fault For That Position