Why do doctors interact with pharma reps
It is all about money
Based on the Congressional
testimony of Michael Wilkes, M.D., Ph.D. Vice Dean, Medical
Education Professor of Medicine and Public Health, University of
California, Davis in front of the Committee on Government Reform
with respect to safety of Vioxx.
|There are three reasons: 1) free food and perks, 2) doctors feel they deserve such gifts,
and 3) reps often fill a perceived educational need.
The power of free food is not to be overlooked. Doctors and trainees work long
hours and often skip lunch. In community hospitals, academic medical centers, Veterans
Hospitals and clinics drug reps bring free food. They also hand out promotional material
and schmooze with the doctors. Sometimes the drug reps give a 15-minute presentation.
Companies often invite doctors to lavish restaurants to hear these presentations.
held such events often to promote their cox-2 inhibitor Vioxx and when asked about the
cardiovascular dangers of the drug they downplayed any harm.
Doctors often perceive that they “deserve” these benefits since they are, after all,
working long hard hours on behalf of their patients. Little thought is given to the huge
cost that patients incur in paying for these meals and gifts that of course are part of the
patients’ high drug prices.
A recent study in the
Annals of Internal Medicine (Feb 2005) explains why older
physicians are less likely to deliver high-quality care. Medical advances occur
frequently, and the explicit knowledge that physicians possess may easily become out of
date. Therefore, although it is generally assumed that the tacit knowledge and skills
accumulated by physicians during years of practice lead to superior clinical abilities, it
has been shown that physicians with more experience may paradoxically be less likely to
provide technically appropriate care. This applies most particularly to prescribing drugs.
Doctors are aware that they quickly become out of date and seek easy ways to keep up to
date. Pharma seeks to provide “a feel good” approach to learning about new medicines.
Unfortunately, the information they provide is insufficient to educate a doctor.
Comparisons between new and existing drugs are rare, and information is spun so as to
make newer drugs sound far superior and safe. In fact, only a very small percentage of
new drugs offer any substantial benefit over existing drugs.
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