It's Friday. Lunch is served. But I'm not professional or ethical - so says a New York Times article today. Well, I beg to differ.
The pharmaceutical industry deals in drugs, and doctors dispense drugs. The pharmaceutical industry wants doctors to use their drugs. So they market. This is America - we do this. Look at Starbucks, Panera offering WiFi, McDonalds giving away Disney Toys, Nike, Apple. They all have products, and they market these products to the average American who often can't afford higher prices for their products. Yet these companies spend zillions of dollars marketing their products. Their shareholders demand it, revenues rely on it. And guess what.... people buy their products. Can you believe? Yep, doctors might actually be influenced by a drug company buying them lunch! And companies might profit!
But in the case of marketing to doctors, well that's not okay, because they're rich! They are single-handedly increasing the cost of health care! Look at those drug lunches! Look at all that fat! See? I told you! And those free pills they get - those are driving up the cost of health care to American's, I tell you! See how unethical and unprofessional they are? I'm sure that's why the cost of healthcare is spinning out of control! It's the doctors having lunch! And free lunch at that!
But I would remind the casual reader that there are few professions that have sustained a negative reimbursement rate for services rendered like the medical profession. The July-August issue of Physicians Practice published a survey of internists, family practice doctors, and pediatricians salaries by Merritt, Hawkins and Associates. The average generalists' salary was $150,000 per year, over half of the doctors were "dissapointed" with their income relative to their work effort, and 28.6% of doctors stated that in retrospect, they would not choose to go into medicine again at all. All this with an aging and growing population that needs these guys more than ever.
Look, what the drug companies feel is useful or not is up to them. It's a great country and this is the American Way. The free market has permitted our health care system to be the best in the world. Certainly, I can elect not to attend drug lunches. My employer can elect to stop permitting drug lunches. But will this self-virtuous act change the cost or quality of healthcare?
I know there are colleagues who are emphatic about this issue: that we, the doctors, should live a puritanican lifestyle and not interface in any way with peddlers of products that might influence our decisions. Especially medical decisions. But we interface with these products every day. Nearly every major medical profession I can think of receives a significant portion of its operating budget from the pharmaceutical or medical device industries. Look at any "Scientific Session" or "professional society" in medicine. Even the AMA peddles our prescribing habits to the drug industry to receive funds.
Certainly physicians should take a lead in reducing the costs of healthcare for our patients. But we should not be disingenuous about our dealings with these companies either. I'd like to think I'm capable of independent thought on the subject of drug marketing. Believe me, as the article suggests, enticements were much more prevalent before 2002 and yet here we are, with a healthcare system that is emulated by many and yet with higher costs than ever before. Was this from doctor's lunches? Will we stop deluding ourselves to thinking that stopping this practice will influence the cost of medications? Newsflash: it won't. The days of the $10 pill are here. And drug lunches didn't start this.