Sunday, March 25, 2007

Health Care Renewal: More on Financial Entanglements of Physicians and Health Care Academics

Health Care Renewal: More on Financial Entanglements of Physicians and Health Care Academics

This post explains in detail how academic physicians are used by the pharmaceutical companies. In my 27 years of experience in a psychiatry department, I can count on one hand the number of physicians WHO DID NOT TAKE DRUG MONEY. In fact, when one of the NON-taking MDs was leaving, they gave her a whole box of pens from drug companies, because in her 30 years at the hospital, she would not even take a pen!

Here are the forms of money that I have seen - it is not as black and white as it seems:

1. Doctors who sit on best practices committees DO INDEED run studies that use the treatments that they are paid to promote, thru distributing their "research results."

2. Doctors receive poorly "grants" based on single letters of intention to do "research" using their drug of choice. The up side to this is that they hire a staff of young minds who want to enter research and try to earn a living wage.

3. They provide breakfast for the resident diadactics every week for most departments. This is a nice breakfast, but how nice, depends on how much you can actually USE their products.

4. In our single hospital, on a given day, a drug rep is providing a nice lunch for most departments. There are new laws about this, but I still see it happen at least twice a week in our department.

5. Drug companies take MDs to very expensive restaurants, for "CMEs" on their drug of sale.

6. Drug companies pay doctors to give lots of talks. Most of the doctors are only in their offices several days a week. The rest of the days, they are flown around the country to give talks on drug company monies.

7. Drug companies sponsor special speakers, with nice lunches. These are called grand rounds.

8. Drug reps pop up to bring all sorts of sweets for the secretaries that can get them appointments with the doctors.

9. Drug reps give out coffee cards.

10. Drug reps pay for residents to go to conferences.

11. Drug companies hold conferences that appear to be for the consumer and clinicians, but the real point of the conferences is the big halls of drug exhibits and the drug funded "free" luncheons, breakfast buffets and incredible dinners in huge rented facilities that usually involve alot of open bars. Drug companies also host poster sessions, with alot of booze and food and self promotion.

The bottom line is, for years now, ethical doctors have been complaining against this practice and nothing changes at all. Laws are passed by individual institutions, but they seem to dissolve when one follows funding sources for all of the above.

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