Arabian nights—1001 tales of how pharmaceutical companies cater to the material needs of doctors: case report
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7276.1563 (Published 23 December 2000) Cite this as: BMJ 2000;321:1563
All rapid responses
Resisting temptation is only a matter of putting it off till no one
is looking ! was said by a cynic. The scenario depicted in the article
clearly brings out the hardworking doctor being taken for a ride by the
company.it is clearly a two way arrangement as there is no such thing as a
free lunch. the doctor who does not prescribe the latest may be more
ethical but may not be as popular as the one who knows about the latest
treatment. one has to chose between ethics and money. i think most of the
doctors would chose the former.
dr r kapur
Competing interests: No competing interests
It is really all no secret that all is not well between the
bedsheets. Only that in the developed countries, the drugs at least can
work the way they are supposed to, the adverse effects are not hidden
under the garb of "equal to that of the placebo group", and the raw
materials do have undergone the painful rigors of testing to the last
degradation product.
What of the poor bretheren in developing countries?
We are concerned about the sad state of our pharmaceuticals, where every
drug is pirated, where all the "in house" results have been cooked to a
cinder, where clandestine deals are conducted under the garb of
promotional strategies, where the market teems with every type of raw
material for making drugs, where we prescribe the next drug with
uncertainty whether it will work or not, and where all ethics has vanished
with the going away of Hippocrates.
At least, the only thing that bites people on that side is the conscience
alone.
We can only say that" please deliver us from all evil, Amen".
Competing interests: No competing interests
Sadly I can only agree with the cynicism of the article. Why is it
that when I genuinely believe my products have merit I so often find:
a/ Some of the better GP's will not see reps
b/ Those doctors who will see me expect lavish entertainment but frown on
me if I seek to discuss the technical merit of my products.
I'm a professional. I'm a graduate. I have trained hard. Why is it
reps are treated with so little respect. Is it because the reps are
leading doctors astray or because doctors have encouraged the industry in
this direction?
Perhaps if the energy and money given to "entertainment" were given
to training, education and awareness then some of the more professional
and ethical doctors would see reps. Perhaps if the doctors rewarded an
ethical approach to selling then the industry would change. Our destiny
is, I would argue, far more in the doctor’s hands than in the big
pharmaceutical companies. You are the customer. We can only succeed if we
do what you tell us to do.
Is the article fair? Well I'm not sure I can answer that, but it
seems to take a very moral high ground for the doctors. I would suggest
the drug companies simply give what most doctors ask for.
Editorial note
Name and email address supplied
Competing interests: No competing interests
There is nothing like a Free Lunch!
Free lunches; this is some thing we all want but never admit we do
so. This is some thing akin to going to a super market daily to look for
things on sale and believing that we are smart enough or the sales man is
stupid enough to do so! There are atleast 2 central points which this
article spontaneously evokes. One is plain nostalgia and the other is a
critical look into the system that has probably failed to deliver.
If there is one generic element with 1000 pharmaceutical names how
does it really matter who prescribes what. As long as the patient receives
the right chemical he/she would not mind if the doctor had a gala time for
writing that. Above all who does not do it? If health is a purchasable
commodity what is wrong in enjoying the fruits of that merchandise?
The second point is bit troublesome. I clearly remember one of my
good friends (God bless him!)during our final MBBS medicine viva voce
looking blank when asked about few antihypertensives but had no problems
in narrating one dozen names of the same medicine of the reputed
companies. I don't think he failed the final examination just because he
did not know the pharmacological names of the drugs but for remembering
too many trade names! The drug reps could not score here as much as they
had been instrumental in selling him the names. But as time passed by his
practice soared sky high and he was blessed with many a patients and
following that as many drug representatives. We had given him the alias as
the "6 - drug doctor" as his prescriptions invariably contained atleast
that many items.
Young graduates often get bamboozoled by the sudden deluge of
information wonderfully crafted for free by the pharmaceutical
representatives. They were hardly taught during their half decade training
as to how to tackle/evaluate this load especially in a competitive world
of 'practice to survive'. It becomes quite difficult not to learn the
quick tit-bits from the medical reps than trying so from the rather
impersonal text books or medical journals. The problem however gets
chronic when one starts defending their practice.
It is high time to have a transparent stand on this common place issue. Do
doctors have a right to see the medical representatives and if so how they
may be saved from their commercial claws?
Competing interests: No competing interests