There's still no such thing as a free lunch

An Association of American Medical Colleges (AAMC) task force says pharmaceutical reps should be banned from offering graft to doctors, staff, and students at medical schools, reports the New York Times.

The ban would aim to eliminate free food, gifts, and speaking or consulting arrangements and other offers that may "establish reciprocal relationships that can inject bias, distort decision-making and create the perception among colleagues, students, trainees and the public that practitioners are being 'bought' or 'bribed' by industry."

When I was a dirt-poor medical student--and not a student-loan-and-tax-poor physician--I appreciated the free pens and occasional doughnuts the drug reps brought.  That was the highlight of some of my med-school days.  Besides, would you really believe me if I said that I didn't enjoy the Christmas when drug reps gave me two Honey-Baked Hams, a $50 gift card to Barnes & Noble, and Xmas parties with an open bar?

Did those gifts affect my decisions?  There's no doubt it did when it came to home-health agencies.  One agency in particular would wine and dine us frequently in residency.  When it came time to discharge a patient from the hospital who needed home-health services, I would suggest to patients that they use that agency.  Eight years later, though I get nothing now but a cheap bottle of wine at Christmas, I still use the same agency.  However, I can honestly say that I use them now because I think they are superior to other agencies because patients love them, they do a superb job at getting me the info I need to properly care for the patients, and they make the paperwork as simple as possible.  (The same was true of this company during residency as well.)

I would also like to say that at least I've not been biased by drug reps when it comes to prescribing medications.  But I can't.  I prescribed the very expensive antibiotic Levaquin in residency countless times although a much cheaper drug would've caused the same outcome in almost all cases.  Why?  The influence of drug reps on my still-learning-medicine brain.

I am getting better, however.  I never accept free lunches anymore although I will accept the requisite cheap bottles of wine, candy and muffins come the holidays.  I still accept pens and notepads throughout the year though, and when the reps bring some dumb-ass snow globe or lava lamp, I'll marvel at the stupidity of it before promptly filing it in our corporate file (see our corporate file in the pic below) and wonder, "Why the hell don't they just make less crap and lower the cost of their medicine a couple bucks?"  And though my wife is sweet-baby-Jesus hot, sometimes it is just a wee more difficult to ignore the rep when it is Ms. Florida coming through my door, smiling and bearing gifts.

I still fool myself sometimes thinking I've sterilized my practice from Big Pharma.  But I haven't and I'm not sure I could completely.  I am always on guard, though, against them trying to cozy up to me.  In fact, one rep came close to actually becoming a friend until I realized what was going on and learned that a key lesson in the education of a rep is to befriend the doctor.

Now, my policy is to sign for medication samples but I do so in the absence of the rep.  It perturbs many of them, but 98% of them still leave the samples.  Rarely, I will poke my head out of the sliding glass window and say hello.

But only if it is Miss Florida.

[Source:  The New York Times (a free one-time registration is required)]

For the ultra anal-retentive:  Read the 43-page AAMC pdf here.