Or so opines one of the commenters on the WSJ Health Blog, where you will find many angry folks calling me a "hypocrite," a "pathetic liar," etc.... I'd be curious to hear opinions about: A. Whether I should return the dirty money; and B. Where it should go if I can bear to part with it?
Other comments that I've received about Dr. Drug Rep:
--"Don't blame Wyeth, blame yourself. Nobody was holding a gun to your head--you chose to take the money." Can't argue with this. The article was, in fact, a long confessional about a series of unethical choices I made every step of the way. I don't blame Wyeth, nor do I blame the pharmaceutical industry in general. I blame the doctors who allow themselves to be complicit and corrupted by the allure of money. And yes, I was there with the worst of them!
--At his excellent blog, Hooked, Howard Brody raises the interesting possibility that Wyeth paid me the 30K as a bribe to get me to prescribe more Effexor in my practice. I'm sure that was one of the motivations, and I received letters from some drug reps indicating that this is standard operating procedure in the industry.
--I've received many letters from people who either are taking Effexor now or had difficulties coming off the drug in the past. While my article may have seemed an indictment of Effexor, it was not meant that way. Effexor is a very effective antidepressant, and I continue to prescribe it in my practice, usually as a second-tier agent. But the hypertension and drug withdrawal risks are real. For a very interesting article profiling one man's struggle with Effexor withdrawal, see Bruce Stutz's article, "Self Nonmedication," also published in the New York Times Magazine.
--Many physicians wrote their own mini-confessionals about giving drug talks. One doctor, also a reformed Effexor speaker, described a teleconference in which Norm Sussman minimized withdrawal problems with Effexor. In response, the doctor had an "ethical lapse" and couldn't help mentioning to the audience that Lexapro might be an easier drug for primary care doctors to prescribe, much to Sussman's annoyance. The writer eventually quit speaking for Wyeth.
--I've also received some shocking marketing stories from drug reps and former drug reps, some of which I'll be sharing in the future as I get permission to do so from the parties involved.
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