Monday, December 20, 2010

DRUG PUSHING


I’ve written here before (see the April 23, 2010 entry) about pharmaceutical companies paying medical school faculty members to promote their drugs to other doctors. You might think that when this shoddy practice is exposed it would dry up, but no such luck.

The journalism website ProPublica (http://www.propublica.org/article/medical-schools-policies-on-faculty-and-drug-company-speaking-circuit) today revealed that this chicanery is as robust as ever. In 2009 and early 2010, medical school faculty members in my state alone, California, were paid $28.5 million to peddle their patrons’ products to colleagues.

Some institutions, like Stanford University, clamped down. In 2006 Stanford evicted drug company reps from its halls, stopped the free lunches and trinkets emblazoned with drug names, and forbade its physicians from giving paid promotional talks for pharmaceutical companies. Just one problem, though: it forgot about enforcement. ProPublica found that more than a dozen of the school’s doctors had continued on as paid speakers in violation of the policy, two of them earning six figures since last year.  

What’s wrong with this, after all? Aren’t these talks truly educational? Don’t physicians need to keep current with pharmaceutical advances?

No argument with that, but we already know that when we go to buy a car, the Ford salesperson wants to sell us a Ford. Plenty of independent sources, such as The Medical Letter (http://secure.medicalletter.org/), offer unbiased analyses.

But there’s a more crucial issue. The relentless, ubiquitous pushing of drugs creates the atmosphere that healthcare is about drugs, period. That’s the way most physicians come to see their work, especially younger ones who’ve had no contact with the family medicine style of a half-century ago. Despite abundant recent research showing the impressive therapeutic effect of non-drug treatments—diet, meditation, support, and exercise, for example—docs and patients continue to reach first for drugs.

I’ll know things are changing when a meditation school offers us docs a free lunch of stir-fried tofu and brown rice.

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