Monday, February 9, 2009

Notes from the Battleground

British Medical Journal focuses on industry/physician relations.

There are several editorials in the current issue of the British Medical Journal on the proper distance (or lack thereof) between doctors and the pharmaceutical industry. My favorite among them is Marcia Angell’s commentary, which can be found (for free) here. It begins with the following very clear message, and continues in a similarly powerful way:

"I believe there should be no relationship between the drug industry and either prescribers or patients. Drug companies are investor owned businesses with a responsibility to maximise profits for their shareholders. That is quite different from the mission of the medical profession, which is to provide the best care possible for patients. I start with this simple fact, because it is so often obscured by the industry’s public relations. Drug companies are not confused on this score. Their major output now consists of "me-too" drugs for mild or ill defined conditions in essentially healthy people. This is because that market is big and more easily expanded than the market for innovative drugs for serious diseases."

Doctor's group is allergic to the rules.

The American Academy of Allergy, Asthma and Immunology
has decided that it doesn’t like the official rules governing continuing medical education. According to the Boston Globe, the medical society has decided to cancel its scheduled 2015 meeting in Boston because of restrictions on drug marketing passed by the Massachusetts legislature.

Specifically, these physicians don’t want to have to adhere to ACCME’s national standards for commercial support:

“The state's rules say that continuing medical education courses, which doctors must take to keep their licenses, must comply with guidelines issued by the Accreditation Council for Continuing Medical Education. Kay Whalen, executive director of the allergy academy, and David Bodine, president of the gene therapy society, said this requirement is a major problem.”

I have some bad news for Ms. Whalen: ACCME guidelines apply in every single city, town and hamlet in the U.S. You can run, but you can’t hide.

"When the sun goes down in Las Vegas, steer clear of doctors."


So goes the catchy subtitle of this great article by Barry Meier in the New York Times. It concerns the ethically troubled orthopedic device industry, which specializes in paying prominent orthopedists millions of dollars per year to “consult” and “educate” regarding their devices.

The American Academy of Orthopedic Surgeons will hold its annual meeting
at the Venetian/Sands expo in Las Vegas later this month, and Smith and Nephew, the leading maker of artificial hips and knees, has instructed its reps not to talk to surgeons after 5 pm, presumably to lessen the possibility of shady consulting deals. But, according to the article, “It remains to be seen whether such seeming magnets as doctors and sales executives can resist each other.”

So true.

3 comments:

therapyfirst said...

Nice post. Caught your first part interview in Currents, a colleague forwarded it. Look forward to part 2, if it offers new perspectives?

Gina Pera said...

You quote Ms. Angell as saying: I believe there should be no relationship between the drug industry and either prescribers or patients. Drug companies are investor owned businesses with a responsibility to maximise profits for their shareholders. That is quite different from the mission of the medical profession, which is to provide the best care possible for patients.

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She sure has a rosy view of the medical profession and the expertise of most physicians. She should know that many of the scientists who develop medications while working for pharma left teaching positions at medical schools because they grew tired of the rote-memory intellects of the physicians they were teaching.

Leave science out of the process, and you're leaving out a lot. Most physicians do not understand science. They are proceduralists. Photographic learners. That's why they're so vulnerable to the pharma marketing pitches. Why else would they adopt everything they hear at these lunches and junkets without question?

Mark Houston Recovery said...

Great post...what are your own thoughts about the possible future government intervention with socializing health care?