Healthy Skepticism Library item: 5804
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
Who pays when a doctor accepts a free lunch?
The Age (Melbourne) 2006 Aug 7
http://www.theage.com.au/news/editorial/who-pays-when-a-doctor-accepts-a-free-lunch/2006/08/06/1154802754137.html
Notes:
Ralph Faggotter’s Comments:
“ Who pays when a doctor accepts a free lunch? “
Ultimately the consumer pays. Mostly with their money, some with their health, and a few with their lives.
“ WHO IS guilty of wrongdoing when a drug company offers a doctor
a gift and the doctor accepts the gift? “
The individual doctor, the medical profession as a whole, and the failure of government regulation are ultimately responsible. The drug companies themselves cannot be blamed as they have no conscience and are just trying to made a buck (or two).
Full text:
Who pays when a doctor accepts a free lunch?
http://www.theage.com.au/news/editorial/who-pays-when-a-doctor-accepts-a-free-lunch/2006/08/06/1154802754137.html
WHO IS guilty of wrongdoing when a drug company offers a doctor
a gift and the doctor accepts the gift? One answer is that no one
is to blame. Pharmaceutical advertising on mugs, pens and mouse
pads are a commonplace sight in doctors’ surgeries and not
necessarily a sign of corruption. What about a free lunch? Or
journals and books? Or travel (first class) to an overseas
conference? At what point do these gifts begin to influence a
doctor’s behaviour? And at what point should the drug companies
themselves be pulled into line for offering inappropriate
inducements?
Fifteen per cent of 823 specialists surveyed by the University
of NSW in a recent study published online in the Internal
Medicine Journal admitted they asked drug companies for gifts,
money and travel, while 52 per cent were offered travel to
conferences (two-thirds accepted). The study’s lead author,
associate professor of ethics and law in medicine, Paul McNeill,
has recommended the end of direct payments from drug companies for
travel and says industry funds for travel should be distributed
through an independent group. The suggestion is in line with
overseas practice: in the US direct payments for travel are
discouraged, while the British have ruled out business class travel
for doctors.
Similar restrictions ought to be placed on Australian doctors.
It is important that patients have faith in the integrity and
independence of their doctors’ judgements. Just because a doctor
accepts a junket now and then does not automatically mean his
medical determinations are influenced, but it does, unfortunately,
cast a shadow over them. In 2001, Peter Mansfield, an Australian GP
who founded the Medical Lobby for Appropriate Marketing, expressed
the problem in this way: “At the heart of the relationship between
drug companies and doctors lies a critical contradiction. Drug
companies know very well that their marketing is influential, but
they won’t admit that it’s harmful. Doctors know very well that
it’s harmful, but they won’t admit that it’s influential.”
Both parties obviously have a vested interest in not admitting
what they know very well, which is probably why the issue is often
discussed but rarely acted upon. There is a public policy dimension
to this question, as pharmaceutical companies are not only hoping
to influence individual doctors, they are hoping their drugs will
be added to hospital pharmacy lists. Doctors are supposed to
prescribe the best, most cost-effective medicines. They have a
responsibility to their patients, first and foremost, but also a
responsibility to the community whose tax dollars ultimately
pay for the drugs bought by hospitals and subsidised by the
Pharmaceutical Benefits Scheme. When a hospital adds a drug to a
pharmacy list, it is contributing to the profits of a
pharmaceutical company, but this should not be a consideration for
it when making its deliberations.
But to return to our original question: when a company offers a
doctor a gift that the doctor accepts, who is guilty of wrongdoing?
The tough answer is both parties, at least potentially. This means
restrictions not only need to be placed on what doctors should be
allowed to accept, but also on the drug companies themselves.
In 2002, the Bracks Government introduced tough penalties for
companies that enticed doctors to put commercial interests before
patient care. Under the act, companies would be fined up to $40,000
the first time they were found guilty of putting commercial
pressure on a doctor to act unprofessionally. In 2005, the maximum
amount companies could be fined increased to $130,000. (Doctors
suspected of putting commercial interests before patient care must
appear before the Medical Practitioners Board and may have their
registration revoked or restricted.) The law rightly recognises
corporations have a responsibility to act ethically and should be
punished if they do not do so. No one has been prosecuted under the
new law so far. The University of NSW suggests, however, that the
issue requires vigilance and greater scrutiny.
