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Ending the doctor gravy train

By Jay MacDonald ·
Tuesday, January 24, 2012
Posted: 10 am ET

Before you swallow that new drug prescribed by your doctor, wouldn't you like to know whether the drug's manufacturer recently treated your physician to an all-expenses-paid golf junket to Pebble Beach or Hilton Head to extol its miracle properties?

The pills-for-perks dance is commonplace in modern medicine, where based on appearances alone, one might easily conclude that the tail is wagging the dog.

According to an analysis by The New York Times, about 1 in 4 doctors take cash directly from drug companies or medical device makers and 2 out of 3 take free food for themselves and their staff. And it works: according to the Times, those who ride the gravy train are more willing to prescribe drugs in unapproved or potentially risky ways.

Is your doctor prescribing the drug because he or she truly believes it's the best course of treatment for you? Or is it because Maui's Royal Kaanapali is the course they've always dreamed of playing?

Soon, you won't have to wonder. Healthcare reform architects are about to shine a spotlight into this ethical back alley by requiring all drug companies and makers of medical devices covered by Medicare or Medicaid to disclose all gifts or payments they make to doctors.

According to the Tampa Bay Times, every financial expenditure, from golf junkets to coffee and donuts for the doctor's office, will be posted by the federal government on a public website.

The bipartisan reform, sponsored by Sens. Charles Grassley, R-Iowa and Herb Kohl, D-Wis., was one of numerous consumer protections included in the Affordable Care Act.

Will public disclosure of the longstanding pills-for-perks practice end it? Hardly. The pharmaceutical industry isn't about to abandon one of its most cost-effective income-generating strategies, even if some doctors may beg off lest it cost them prestige and/or patients.

But at least it will finally give health insurance customers the opportunity to shop for a doctor who is not a frequent passenger on the pharmaceutical gravy train.

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March 22, 2012 at 1:35 pm

As a PA who has worked in numerous fields before going to medical school, I can without a doubt state that this article is nothing more than muck-raking at its best. It targets and slanders a field that gets very little reward for the sacrifices of those who choose it work as healthcare providers. Why doesn't the mainstream media look at the US Congressional "fact-finding" trips to Gstadt, Aspen or Austrailia? All expenses paid for family and staff! Working in the ER, I haven’t seen a pen, pad of paper or even a sandwich in five years, much less a trip to Maui. Get a grip and practice some good journalism, if I practiced medicine like this guy writes, I would be sued into oblivion.

Dr. Rich
March 20, 2012 at 8:31 pm

I am a doctor and I don't even get pens from the drug reps anymore !!! They aren't allowed to give them out !! Golfing in Hawaii ?
Ha !! It never happens. I got a sandwich last month. Wow....

Stop trying to make us the bad guy and do some research before you write your next article.

It took 15 years to pay off my student loans at $1000 a month. If I had to do it again, I would have done something else. Especially with Obamacare on the horizon.

March 19, 2012 at 9:01 pm

I am curious as to why the doctors here are dumping on Jay MacDonald about inaccurate information when the informatiom comes from THE NEW YORK TIMES! Shouldn't you take it up with them instead of shooting the messenger!

Doctor’s Dad
March 19, 2012 at 12:59 pm

Jay MacDonald's comments are not only offensive but ignorant. My son who is an anesthesiologist is very careful to use only approved drugs or approved treatmnet of a patient. Any interaction with drug reps or medical equipment reps are for learning purposes only, and he cannot be bought for the price of a meal, nor does he accept expensive gifts and trips.

Jay MacDonald, why don't you write an article about doctors who have to provide medical services free of charge to those who have no insurance and repeatedly seek and receive free medical care.

My son has staggering financial loans that he incurred while attending medical school and residency, but he is repaying these loans through hard work and not from freebees from drug or medical equipment reps.

March 19, 2012 at 9:56 am

As a healthcare administrator, not some op-ed writer with zero experience, I can say that there are some benefits to those lunches. They provide the physicians with an opportunity to learn about new drugs. Ask any physician who is restricted from meeting with reps, how they learn about the lastest drugs or even what is on the horizon. There are very few channels for this education. Also, ask my physicians if some sandwich from Potbelly's, that is now cold, is going to be an inducement to prescribe a particular drug - (insert laughter) um, no. It is about what is best for the patient. And believe it or not, there are a handful of patients who "have tried everything" and benefit from the new drugs/options. Politicians take brides and money, which fit the definition of "conflict of interest" far better than a physician eating soggy sandwiches or a take and bake pizza from Costco. Give me a break.

March 19, 2012 at 12:47 am

I don't see any problem with providing reasonable oversight. Whenever there is money involved, there can be corruption. I do believe that the majority of docs are ethical, but as a consumer I have a right to know if they are not.

I have had some experiences with "iffy" practices from doctors. For instance I recieved from a doctor an inhaler (ProAir) and a prescription for Advair for my exercise-induced asthma. He wanted me to go on these BEFORE I had a breathing test. The inhaler seems reasonable to me but I refuse to go on the Advair until I know that I need it. My understanding is that that medication should not be used unless the condition is serious and uncontrollable by other means. I only have some shortness of breath but I don't turn blue or pass out. Plus my sister who is on it says that it is almost impossible to get off of it without a rebound effect of the symptoms returning. She has decided to stay on it for that reason. I am sure the drug company is happy about that!

I have had another doctor put me on FIVE antidepressants at once without any concern about the possibility of my becoming manic (I am Bipolar). He probably just has bad judgment but who knows?

Unethical behavior is common among doctors. How many doctors actually spend enough time with a patient to make a proper diagnosis and prescribe the right treatment? Not many. I once went to a doctor complaining of severe fatigue and after having blood tests I was told that there was nothing wrong with me. It was a friend who suggested that I should be tested for sleep apnea! Why didn't the doctor think of that?

I once saw a doctor who was late for an engagement and simply walked through the waiting room, and without even asking how I was doing, handed me scripts for my refills and walked out! I should have reported him for insurance fraud!

I am not saying most doctors are like these examples but there are enough of them that the bad apples need to be weeded out by any means necessary. If it means more government supervision then so be it!

I also don't have any sympathy for those doctors who whine about making less than $100,000 a year. Ask me how much I make? Oh yeah, I am disabled and have to watch every penny! And how about all the Americans who are homeless and destitute? Be grateful for what you have and just do your jobs!