For Sale: My Soul
As you might imagine, not one of these questions was answered (and that last one wasn't even addressed...but it's so true.). In fact, our group spent so much time just trying to define a set of rules that allowed us to receive some gifts and allow some drug rep influence but reject others, that we never really got to any heart-of-the-matter concerns. I walked away from that meeting dissatisfied, yearning for some guidance on how to proceed with the big drug companies hovering over my shoulder like a dark shadow leading me into night. Was that dramatic enough? Anyways, I thought I would explore this topic here, because I think it would be useful for you all to see how easy it is to judge doctors with respect to this topic, but how hard it is to actually deal with the challenge at hand if you're in this position.
Like I mentioned above, finding some sort of middle ground in dealing with drug companies and their attempts to brainwash us into using their products was a pretty futile affair. Our group got so bogged down in different scenarios, with each of us harboring our own opinions, that it was evident no clear-cut rule was to come of this. Given that, it is clear to me that doctors really only have two options, and I'd like to take each option seriously (or as seriously as I can):
(1) Reject any and all efforts by the drug companies to buy us out - By adhering to this philosophy, you must reject any gestures by drug companies to influence your decision-making. This means no free lunches, no free pens, no informative brochures, no funding for drug research to be carried out at academic institutions and, most importantly, no harmless flirting with the female drug reps. Now, any non-medical professionals out there might think this is a reasonable goal to strive for, because after all, we are there for the patients and not anyone else (and, after all, this notion of not accepting gifts works so well in other facets of modern life, like our government). However, even though I've only been in the chaos that is your average hospital for a few months now, I realize how daunting of a task this is to actually achieve. Lets take the "no pens" rule as an example. No pens. Seriously, this seems so easy a retard could do it (wait, what was that thing about sensitivity I was talking about? Oh, whatever.) Seems easy, but picture this scenario (which actually happened): You're the attending physician in a ritzy urology practice. You just finished interviewing a patient, but realized you have no nice pen to document the encounter. Just then, a ridiculously hot woman arrives, rolling a small suitcase full of Levitra goodness behind her. She gives you a kiss on the cheek and offers to skip her pitch because she knows you are really busy. You then realize you are completely out of pens, and kindly ask if you can have one of hers. She offers you the Levitra pen, so futuristically designed that when you press a button, the pen literally mimics a penis going from the flaccid to erect state while revealing the ink dispenser (yes, they actually have these pens). You take the pen, write your note, and mindlessly shove the pen in your pocket, only to find yourself prescribing Levitra over other equal drugs at a later date without even thinking about it. Congratulations, you have just been claimed as sucker #23478925782398547, and you didn't even notice. What point am I trying to make here? You're about as likely to make it through an entire career in ANY medical profession (doctors, nurses, techs, etc.) and be able to withstand even the slightest drug company pressure as I am of convincing a few of my newfound readers that I'm not actually a pervert and that I don't go around giggling, pointing, and screaming "FISH TACO!" every time I see a vagina in an ob/gyn clinic. So this extreme is, quite simply, not a viable option.
(2) Throw yourself at the mercy of the drug companies, latching onto every free piece of crap that you can find - Now we're talking! By adhering to this philosophy, you accept the fact that drug companies are pervasive in their marketing and will not just go away, so the only way you can combat that is by accepting EVERYONE'S crap and ensuring that you can't be biased towards any particular drug because you took free stuff from everyone. Hold onto every Levitra penis pen around. Take every free trip they'll give you. Soak up all the commercials you can*. Hell, you could be even more subversive: take everything you can, and then prescribe no drugs at all ever! (OK maybe that's going a little too far, but as one reader pointed out to me, it's very true that US doctors seem to rely too heavily on pills and less on non-pharmaceutical methods of healing.) Sounds good, right? Wrong. Lets take this a little farther, because you all know this is going to happen eventually as we teeter down this extreme path. Soon the companies catch on that you're just taking their stuff and not actually giving their drugs to your patients over he other company's drugs. So what do they do? Make you look even more ridiculous. I'm talking automated drug reps in patient waiting rooms. Drug logos emblazened all over your white coat, NASCAR-style. And just imagine the day you sink low enough to where you have to start saying stuff like this:
"Please lower your pants and I'll perform the rectal examination. I would like to remind you that this rectal exam is sponsored by the good folks at ExtremeRestraints.com, makers of quality anoscopes used by hospitals and anal fetish proponents worldwide. If you would like to purchase a home anoscope device, please talk to our receptionist outside. I will now insert my finger into your rectum."
Anyways, I hope you are starting to appreciate the bind we're in as medical professionals. I realize that, as patients, you probably still don't care so long as you get the best medical treatment you can without the sense that your doctor has been bought out by some random drug company. But please at least think about these issues, and if you have any bright ideas on how to pursue an even path, let me know. And if you're a drug rep for those erectile dysfunction drugs, I'd just love to hear from you (and hear about your drugs blah blah blah).
*Except for that goddamn Celebrex commercial. I swear every time I hear that jingle I want to break something. Crap, just thinking about it has that song in my head. Nice move.