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Healthy Skepticism Library item: 12181

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Fancy dinners and drug sales
The State Journal-Register (Springfield, Illinois) 2007 Dec 12
http://www.sj-r.com/Opinion/stories/21714.asp


Full text:

A drug representative allegedly attempting to smear the reputations of two local doctors and their wives made for a front-page story this week.

This curious spat became public largely because the two local doctors – Carl Lawyer and Paul Smelter – fought back, filing papers in Sangamon County Circuit Court saying the handwriting on anonymous, derogatory letters that were circulated appeared to be in the handwriting similar to Beth Kallal, a local drug representative for pharmaceutical company Merck & Co. Inc.
Kallal has stated in court filings that she had nothing to do with the letters – letters that apparently referred to a dinner the doctors, their wives, Kallal and other drug reps attended. The dinner was paid for by Merck.

Whoever was responsible for the letter certainly made it nasty. According to court filings the anonymous letter “makes an accusation of excessive consumption of alcohol (by the doctors and their wives) with the specific statement, ‘They (Dr. Lawyer and Dr. Smelter) and their spouses will order huge amounts of expensive alcohol, sometimes even ordering bottles (hoping to take them home).’”

Ouch.

Dr. Lawyer swore in an affidavit that he has not had an alcoholic drink for more than 30 years. He and Dr. Smelter apparently suspect the real reason for the letter was the fact they had raised questions about a new Merck anti-shingles vaccine called Zostavax.

Zostavax was supposed to be the reason for the dinner at Springfield’s Indigo restaurant where all this nastiness started. The dinner was set up to “educate” the doctors about the new drug.

Therein lies the real crux of this story. While there is no doubt this public battle is embarrassing for all parties involved, it also serves as an important reminder of the very ethically questionable relationship between medical providers and drug makers.

Drs. Lawyer and Smelter certainly are not in the minority when comes to partaking of a fancy dinner in order to be “educated” about a new drug. In fact, four out of five (83 percent to be exact) of doctors surveyed earlier this year reported receiving food and drink from reps of drug companies and medical device makers.

The survey published in the New England Journal of Medicine in April indicated that despite voluntary guidelines adopted in 2002 to discourage courting doctors with freebies, little has changed in the relationship between physicians and sales reps. The April survey showed 83 percent received food and drinks, 78 percent accepted free drug samples, 35 percent were reimbursed for costs associated with professional meetings, 28 percent collected consulting or lecture fees and 7 percent took free tickets to games and other events.

The local doctors say they are considering a defamation suit over the nasty letter. There is a more surefire way to keep ones name clear of such scurrilous allegations – don’t take freebies. This widespread practice is troubling. Do baskets of breakfast bagels, dinners out and sports tickets really translate to better-educated doctors, or do they translate to better sales of drugs that doctors then feel the need to prescribe? It’s a legitimate question to pose.

Consider this analogy: If you wanted to research a new car purchase, would you turn first to the car salesperson? The answer is obvious. And it is obvious that fancy dinners are not about educating doctors; they are about influencing them. Doctors should just say no to drug reps.

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963