The recent verdict of Glasco Smith Kline really should mean little to me. After all, I have never taken payment from them. There might be the occasional lunch so they could pitch their product to me, but I finished residency after the first set of Pharm D laws were passed. Actually I think that I might have been in medical school when they were passed, but in residency when they went into effect. What does this mean? Well, I have never taken a trip to Hawaii on a drug company, I have never gotten a membership at a fancy golf course, nor did I ever accept any money from them.
In the interest of full disclosure, I believe that either Merck or Pfizer paid for my graduation from residency (It has been 7 years, and the program was responsible for details) I have received numerous meals, and pens, and writing tablets. Did these items influence me? Maybe, if I am writing a blood pressure medication, and the pen that I was writing with was for a blood pressure medication. But I would have to believe that it was effective. I wouldn’t write Norvasc (amlodipine) for a patient in heart failure for example, because they already have problems with swelling. But most of the time, I didn’t even think about the pen in my handle. Mostly because it is a stylus that only works on a computer and is black without label. I rarely use a pen except to sign the few prescriptions that I cannot send electronically.
As for samples, yes I utilize them. Before the antidepressants started going generic, it was nice to be able to give a patient a two week supply to see if a certain medication was going to work, prior to putting out cash for a high dollar prescription. Now that there are generics, well that is typically the first choice I write for. If the generics don’t work, well then I make my next selection with what I can give the patient a sample for, because it is nice to try a medication without spending an ungodly amount, only to find that it doesn’t work.
Now why the verdict means something to me. With the announcement the Dr Drew Pinsky took at least $275,000 to “provide services for Wellbutrin” (whatever that means) the internet has lit up with claims that this is what physicians do. They are all on the till for Big Pharma. Slate online discusses Dr Drew and then implies that most doctors collect checks from Big Pharma. Lew Rockwell (the founder of the Mises Institute) actually says on his blog “Here is much of the medical profession in a nutshell, since most doctors are in the pay of Big Pharm from medical school onwards. They get commissions for all those drugs they tell you to buy.” I guess my check is still coming, since I have yet to see one, yet.
Now it is easy to blow off the likes of Lew Rockwell, since I don’t know if there is a conspiracy that he doesn’t believe (that is my opinion) but his large following is where the problems come in. He has some of the most rabid of followers and even helps to continue the vaccines cause autism fallacy. But he is only one of many that are helping to spread the idea that all doctors accept payment from Big Pharma.
Why Dr Drew accepted money from GSK to promote Wellbutrin should even register is beyond me. He is one of a growing number of charlatans who have traded their respect for media fame. Dr Drew is worse than most, in that he has also traded on the fame of his patients who are struggling with addiction to create television. The man let’s face it appears to be a media whore. I don’t know where in the Hippocratic Oath the statement of except in the case of a television show comes in, but apparently it is there.
I don’t have a problem exposing those that do take commissions, maybe we should be more transparent. I don’t mind discussing with patients why certain medications would work better for that patient than others. It is part of my job. But there are times that the generic is not the best choice for the patient, or maybe there is not a generic equivalent, but this should be a conversation that I have with the patient because it is for the good of the patient, not because some blogger without a medical degree has decided that the whole profession is suspect just because there are a few (alright more than a few, but no where near the majority) corrupt practitioners. Based on the blogs I have seen on the issue, I have been convicted merely because I hold a medical degree.
Few physicians receive payments from the pharmaceutical companies. An occasional meal for listening to a drug lecture or spiel but rarely anymore than that. In fact, I don’t know the last time I accepted a dinner from a drug rep due to preferring to spend my evenings with my children and running them to their activities. As for those who are paid to promote their drugs, there is supposed to be disclosure for doing so, both in lectures at Continuing Medical Education events. And believe me, every rep tells me their drug is better than their competitors and all of the generics, I have a medical degree, I think I can figure out that they are in my office to sell their product.