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View Diary: Physician Payment and Drugs: a bit of clarity (22 comments)

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  •  My father (2+ / 0-)
    Recommended by:
    dogdad, Andrew F Cockburn

    was a physician for 40 years and he never got a free trip anywhere.  I've never heard of free trips for writing prescriptions.

    •  And I know physicians who made a living (2+ / 0-)
      Recommended by:
      cynndara, Oh Mary Oh

      from attending sales meetings, educational conferences, and being on speaker's bureaus. Thought leader physicians were overwhelmed with invitations in the 90's and it hasn't really slacked off. Now docs are recruited to be in "post marketing trials" where they get paid to prescribe medications to be in studies where they might have to fill out a 2 question protocol.

      I was in a position to influence the formulary at a larger hospital in Florida for 15 yrs, and I was offered trips to Martha's Vineyard, the Masters tournament, and since we were close, more Disney junkets for my family than I could have taken vacation days off to cover. And the physicians on the committee had to be kept confidential to keep the sales reps from camping in their office waiting rooms to offer them the same incentives.

      Watch "Love and Other Drugs"...pretty accurate. It's an ADULT movie, don't watch with kids. Where there is money to be made, there are "adult activities" offered.

      WTF!?!?!?! When did I move to the Republic of Gilead?!

      by IARXPHD on Mon Dec 10, 2012 at 02:08:05 PM PST

      [ Parent ]

      •  This isn't being paid to prescribe. (3+ / 0-)
        Recommended by:
        susanala, dogdad, cynndara

        It is being paid to conduct a clinical trial. It is a different issue. This has been a very big problem- drug and device companies have flat-out bought some prominent researchers to shill their products.

        Most academic medical centers have cracked down hard on this over the last few years. IRBs require conflict of interest statements on both the protocol and on consent forms. Free meals, trips, and other give-aways have mostly disappeared.

        The other problem that you don't mention is the drug companies providing meals and swag to medical students. An MD making upwards of $200,000/year is not going to be impressed by free pizza. Medical students and residents who are piling up enormous debts are easier to influence. If they develop a habit of looking at a particular catalog early on it could pay enormous benefits to the drug company over their career. Therefore many medical schools have banned free meals.

        •  I don't want to get into a big arguement.... (0+ / 0-)

          But I know from my PhD research these are NOT true clinical trials, they are done in order to promote brand loyalty.

          They may go through IRB as ethical, but for the individual clinic or physicians office there may not be an IRB.

          Many of these trials are merely prescribing a medication for a patient, and having the patient report adverse effects at their next visit. There is no hypothesis being evaluated, these are drugs that are FDA approved, so there is not a pressing need for information to bring a medication to the market.

          They are, for all practical purposes, a sham. They give physicians an incentive to use and become used to using, newer and more expensive medications, often with no clinical benefit beyond the 10 other medications already available in a therapeutic class.

          WTF!?!?!?! When did I move to the Republic of Gilead?!

          by IARXPHD on Mon Dec 10, 2012 at 03:07:51 PM PST

          [ Parent ]

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