To see or not to see? That is the question for physicians

The Hospitalist hosts a debate on whether or not doctors should interact with and accept gifts from pharmaceutical reps.

On the “con” side, Dr. O’Neil Pyke argues that samples and free lunches affect physician decisions:

Let’s not kid ourselves: There is a good reason the pharmaceutical industry spends more than $12 billion per year on marketing to doctors. In 2006, Rep. Henry Waxman (D-Calif.) said, “It is obvious that drug companies provide these free lunches so their sales reps can get the doctor’s ear and influence the prescribing practices.” Most doctors would never admit any such influence. It would be, however, disingenuous for any practicing physician to say there is none.

On the “pro” side, Dr. Dawn Brezina says:

Although pharmaceutical representatives brief physicians on new medications in an effort to encourage the use of their brand-name products, they also provide substantive information on the drugs that serves an educational purpose.

The Aristotelian Golden Mean is superior to extreme positions, and I submit that the best road is the center. Listen to what the drug company representatives have to say, just like you listen to a car salesman: You can learn from both—as long as you research the data and form your own opinion.

I see the merit of both arguments but tend somewhat toward the “con.” On the “con” side it’s certainly the case that drug companies successfully influence physician behavior. Physicians also underestimate or dismiss the extent that they are influenced, including by small gifts.

On the “pro” side I agree that reps may have something to offer and that it’s safe to consume if docs do their own research. Unfortunately it’s too easy not to bother.

My proposal is as follows: physicians should take a course in how drug companies establish their sales and marketing budgets, how they evaluate the success of their spending, and how they compensate their reps. After that they should feel free to see reps if they still think it’s a good idea.

October 8, 2010

3 thoughts on “To see or not to see? That is the question for physicians”

  1. This is true and I support this because tes Physicains can be very misleading at most times and somtimes forbid them selves from doing their jobs corectly and accuratly so I support the idea.

  2. With so much of the drug information education and other CME sponsored by Pharma, shouldn’t we be looking for new models for funding CME? Same is true to an even larger extent for patient education.

  3. There are plenty of sources of relatively unbiased information, and evidence-based evaluation of pharmaceuticals easily accessible by physicians.

    Common sense, plus some vivid anecdotal evidence suggests that pharmaceutical representatives offer biased information, with plenty of psychological manipulation thrown in. For example, see: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040150

    So explain why the benefits of seeing drug reps outweigh the harms?

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