Hi everyone - hope you all had a nice holiday. I really enjoyed the comments on the last post - people had a range of reactions to the hospital CEO's blog. I think it can definitely be viewed on multiple levels ranging from a personal vanity project to a teaching tool for emerging health care leaders.
Below is a link that Amy asked me to post - this article appeared in the NYT yesterday and it is a very interesting look into the pharma-MD world and covers some ethical ground that may be relevant to the guest lecturer this week. http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html?pagewanted=1&ei=5087&em&en=14f86674a4b9bfd7&ex=1196226000
Kim
3 comments:
The most frequent refrain repeated throughout this article is that there is a constant pressure to emphasize the positive and downplay the negative. While Dr. Carlat is careful to mention how he never lied per se in his pitches, he admits that that pressure strongly influence the 'degree' of truth represented and damaged the integrity of the information being presented. For that reason I am really uncomfortable pharmaceutical promotion in general, given that the net result of direct-to-consumer advertising alone has resulted in 60% of patients knowing only benefits and not risks of any particular drug. Utilizing a doctor to promote drugs is an even more ethically unsound practice in my opinion, and I would like to see it banned. Having a doctor be a pharmaceutical spokesperson seems to be an exploitation and subversion of the common perception that a doctor's only purpose is to provide good care to patients without influence from materialistic concerns, and certainly should not harm patients for their own gain. Using a doctor to promote a drug gives a veneer of more professional validity and reliability while undermining the foundations of the traditional patient-doctor relationship.
I came across this article last week and found it really illuminating. I've often thought about this issue and the conflicts of interest that arise. It's interesting to read about a doctor's own experience as a drug rep, and consider the ways that he was swayed, despite his strong scientific training and commitment to accuracy. Following his thought process helped me see how so many doctors fall into marketing schemes, despite their very best intentions. Of course it's dangerous when medical decisions are being made on the basis of profit instead of science - it seems like one the biggest medical/ethical issues of this era.
Dr. Carlat also spoke about his discomfort throughout - and it raises the question of whether all doctors who promote drugs in this manner feel uncomfortable, but do it anyway for the money, or whether some really don't question it.
At the end of his article, Dr. Carlat said that he was invited to a big pharmaceutical company event, and the featured speaker was a well-respected colleague. He did not attend, and it seemed like his respect for that colleague went down a notch. To me, that's worrisome. I think that quality medical care depends upon the respect and trust that medical professionals have for each other and their field.
so, I came across this article in the NYT and had to read it, because the NYT and the rest of the media have been coming down really hard lately on psychiatrist for their relationships with drug manufacturors. I'm not sure if the problem is indeed more rambet in this subset or if they are just getting the attention. Anyway, my gut feeling is that being a drug "promotor" which is essentially what I think Dr. Carlat was here is not a good idea for a physician. I think that it is somewhat unavoidable that doctors will get some of their drug information from pharmacuetical reps, but I don't think the person prescribing and promoting a drug should be the same one.
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