Monday, May 17, 2004

Trust us, we're doctors: most people think of doctors as objective, rational, and kind people whose utmost concern is to help you get well.

They're wrong.

I am not saying that doctors are evil and malicious. I am saying that doctors have interests which are quite often divergent from the interests of their patients and that it is foolish for people to be unaware of this.

In the US, for example, it is in the interest of doctors to prescribe drugs. Pharmaceutical companies give all kinds of kickbacks to doctors that frequently prescribe their medications. These most often include lavish gifts and free vacations:

Disgusted by how the free gifts and trips add to the high price of medicine, and moved by the plight of patients forced to skip needed medication, Mueller agreed to provide Primetime with a rare glimpse of the astounding number of drug company freebies he was offered by various drug companies in a four-month period.

He was presented with an estimated $10,000 worth, including an all-expenses-paid trip to a resort in Florida, dinner cruises, hockey game tickets, a ski trip for the family, Omaha steaks, a day at a spa and free computer equipment.

"It changes your prescribing behavior. You just sort of get caught up in it," said Mueller, who said he was offered a cash payment of $2,000 for putting four patients on the latest drug for high cholesterol. The company called this a clinical study; Mueller called it a bounty...

Though Mueller normally declines the offers, he agreed to attend a dinner, which Primetime secretly taped. Not only were the doctors wined and dined, but each was also offered a payment of $150 for just showing up to listen to a pitch for a new asthma treatment for children.

The company called it "an honorarium," but Mueller saw it differently. "Again, it's bribery," he said. "This is very effective marketing."

From experience, I can testify that it is not difficult at all to get medication prescribed for you. At one point during my undergraduate career, a physician enthusiastically prescribed Adderall to me after I complained of not being able to pay attention; the whole session sounded suspiciously like a sales pitch for the drug. Did I know that adderall is also going to help me lose weight? Did I know that it would help me stay up all night before exams? Adderall, by the way, is the leading treatment of ADD and is actually just speed in small doses; it happens to be the most abused drugs in the US.

Is this really the way to do medecine?

Update: An article in the Chicago Tribune on the gift culture in medecine describes a case that actually went to trial:

In the trial of 11 current or former sales staffers of TAP Pharmaceutical Products Inc., prosecutors and witnesses have said that physicians extracted gifts by threatening to switch patients from TAP's Lupron--a prostate cancer drug that costs more than $400 a dose--to a rival drug, Zoladex, that was $100 a dose cheaper and just as effective.

At least one doctor, according to testimony, wrote out a list of what he wanted.

Cleveland urologist Dr. Kalish Kedia allegedly provided TAP's sales staff with a list of perks he wanted during the mid to late 1990s. Prosecutors said Kedia, who prosecutors claim purchased nearly $1 million of Lupron annually, demanded company-paid airline tickets and trips to resorts.

He also charged more than $7,000 to the credit card of a TAP sales representative for dinners for himself and his physician friends, prosecutors said.

"He was a doctor who always had his hand out," said Susan Winkler, an assistant U.S. attorney in Boston. "He kept threatening to switch to Zoladex. He always wanted something."


At 6:33 AM, Blogger jon said...

Looking at asthma symptom info online today while my son coughs I came across this post. Does anyone know a good asthma symptom site to help?



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