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October 04 2007
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Virtually All U.S. Doctors Accept Money, Freebies from Drug Companies

Based on four different papers, published in The New England Journal of Medicine, the PLoS Medicine, and the Journal of General Internal Medicine, the efforts to curb drug companies’ courting of your doctors is still ineffective.

In fact, the industry is working harder than ever to influence which medicines you are prescribed, by sending out sales representatives with greater frequency, bringing gifts, meals and offering consulting fees to high prescribers.

According to the study published in The New England Journal of Medicine,

  • 94 percent of doctors have some type of relationship with the drug industry
  • 80 percent of doctors commonly accept free food and drug samples
  • One-third of doctors were reimbursed by the drug industry for going to professional meetings or continuing education classes
  • 28 percent of doctors have been paid for consulting, giving lectures, or signing their patients up for clinical trials 

Contacts between doctors and sales reps have jumped from an average of 4.4 visits per month in 2000, to an average of: 

  • 16 times per month with cardiologists
  • 9-10 times per month with internists
  • 8 times per month with pediatricians
  • 4 times per month with surgeons 

The only group appearing to be meeting drug company representatives less often than before is anesthesiologists, who now see reps twice a month. 

These sales tactics are working. In the second PLoS Medicine study, visits by drug detailers (sales reps) prompted nearly half of 97 doctors to increase their prescriptions for Gabapentin, an anti-seizure drug. In many cases the reps were advocating the use of Gabapentin for non-approved, so-called “off-label” uses. 

The Journal of General Internal Medicine study found that physicians do understand the potential conflicts of interest, but that they still view their meetings with drug reps as both valuable and appropriate. According to the authors of that study, this proves that the voluntary guidelines currently in place are inadequate.

The New England Journal of Medicine April 26, 2007; 356:1742-1750 (Free Full Text Report)

PLoS Medicine April, 2007; 4(4):e150 (Free Full Text Report)

PLoS Medicine April, 2007; 4(4):e134 (Free Full Text Report)

Journal of General Internal Medicine February, 2007; 22(2): 184–190 (Free Full Text Report)

Washington Post April 28, 2007



Dr. MercolaDr. Mercola's Comments:

If you do not believe your doctor is influenced to change their prescription patterns for personal attention, dinners, gifts, and cold hard cash, think again.

It’s not entirely their fault though, because drug company sales reps are highly trained in using very refined and specific psychological warfare techniques on your doctor. In many cases, they may not even realize they are being bamboozled.  

Doctors usually believe they are immune to persuasion tactics, and drug reps know just how important it is to maintain that illusion – which is why it works so well. 

According to the in-depth report published in The New England Journal of Medicine, co-written by a former Eli Lilly drug rep, Shahram Ahari, and Adriane Fugh-Berman, an associate professor of physiology and biophysics, pharmaceutical sales reps are trained in tactics that are on par with some of the most potent brainwashing techniques used throughout the world.  

It’s a fascinating read. I have supplied a link to the full text report above, so you can find out for yourself just how meticulously trained these drug reps are to spot the “in’s" and weaknesses of every client.

Remember, pharmaceutical companies spend more than $20 billion each year promoting prescription drugs in the United States.

These campaigns are designed to effectively alter prescribing behavior, in order to sell more of the high-profit drugs, as opposed to the most effective, and least dangerous.

In the end, you are the one paying the price twice, by emptying out your wallet, and endangering your health with drugs you probably don’t—and never did—need in the first place. 

But it doesn’t end there. In recent years, the additional practice of script tracking has gained momentum as well. Health information organizations, like IMS Health, Dendrite, Verispan, and Wolters Kluwer, buy pharmacy prescription records and resell them. This is how drug companies keep tabs on the return on their bribes, as it tells them the prescription rate of each individual doctor.  

This information also reveals how many of a doctor's patients receive specific drugs, how many competing drugs are prescribed compared with the target drug, and how the physicians prescribing habits change over time. It tells them if a drug is “in favor” or not, and gives them the tools to cook up a winning strategy for future manipulations. 

Between 1990 and 2004, spending for prescription drugs increased five times, to a whopping $188.5 Billion, and drug reps increased from 38,000 to 100,000 strong. That’s a ratio of one drug rep for every 2.5 physicians targeted for “detailing.” Talk about having a personal “Big Brother.” 

The idea that reps provide some kind of valuable, informative service to physicians is total fiction, created and perpetuated by the drug industry, to keep this deadly, but profitable, scheme going.

 

 


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Community Comments ( 28 )
Comment on this Article
  
  
BeyondOrganic
[ Joined on 06/06 ] [ Posted on September 17, 2007 ]
16 Points        
   
 
Savvy User
Oh yeah this I know is true.  I used to work in the pharmacies and loved it when they brought us catered meals and pens and paper and all kinds of goodies!  We looked forward to that crap.  It is such a joke!  And I have mentioned before, you can't ever go to your Dr. without seeing at least 1 drug rep. pass through with his free drug samples and pamphlets.  This is exactly how the game is played!!! 

And you are right on about the MD's having no nutrition training.  I always had heard it was four hours, but recently I quoted that to a surgeon that I met at one of my children' gym classes (who by the way is married to an Ob-gyn and they do NOT vaccinated their kids either!) he corrected by saying he was only given 1 HOUR  of training (if you can call it that) on nutrition in all of his medical schooling and training.  NOT surprising I must say.
 [ Reply ]
Mercola
  
BeyondOrganic
[ Joined on 06/06 ]  [ Posted on September 17, 2007]
12 Points        
   
Savvy User
  Mercola
Oh that last comment was in response to Russ's comment.  Dr's in my opinion are mainly legal drug pushers. 
Mercola
  
Patty D
[ Joined on 06/07 ]  [ Posted on September 18, 2007]
4 Points        
   
Savvy User
  Mercola
Doctors aren't going to make money for big Pharma counseling nutrition, and big Pharma subsidizes medical schools...Think there's a correlation there?   As an RN, I got a whole semester of nutrition...of course I no longer believe in the "nutrition" I was taught.
Mercola
  
schnauzermom
[ Joined on 08/07 ]  [ Posted on October 4, 2007]
1 Points        
   
Novice User
  Mercola

I used to work for a big pharm, so I KNOW that is so very true.

Most alopathic MD's pull their script pad out, pen in hand read and willing to write out the "cure" to all that ails you. From my own experience over thisi summer when my cholestrol was high (212), my sugar read 112, I was (still am) experiencing hair loss, I did have anxiety, weight gain with inability to lose regardless of what I was doing, edema, heavy menses. Two alopathic MD's shrugged it off, immediately wanted to put me on statins, benzodiazapems, diet pills, you name it. It was not until I went to the OWC that the professionals there dug for the root of my issues and are treating me as a whole person and not utilizing a band-aid approach. Meds do have their place for serious illnesses, but many of these alopathic doctors are extremely "pen quick", getting "points" for scripts which entitle them to trips to Hawaii, Bahamas, Florida, Arizona, California, etc.  Let's be serious! These are all "rewards" that are labeled as "conferences", that is the loophole they use and our government turns a blind eye as usual!  Why? The drug companies, the doctors, the investors (most hold seats in our government), the overpaid board members have an interest in it all!

  
  
samurai
[ Joined on 04/07 ] [ Posted on September 14, 2007 ]
11 Points        
   
 
Savvy User
I concur with you, Russ.
I believe that I have posted this before, but when I was a cocktail waitress going through college, all the waitresses would vie for the Pfizer parties because they would spend lavish $$$$$ on the doctors's dinners  (we made 20% of the bill).  Of course these dinners were all in the name of educating the physicians. 
 [ Reply ]
  
  
Russ Bianchi
[ Joined on 09/06 ] [ Posted on September 14, 2007 ]
11 Points        
   
 
Savvy User
MD's are not trained in nutrition, or preventative, protocols, they are trained to write prescription for reactive drugs or evasive surgical procedures.
 [ Reply ]
Mercola
  
Patty D
[ Joined on 06/07 ]  [ Posted on September 14, 2007]
16 Points        
   
Savvy User
  Mercola
Even certified nutritionists are not taught nutrition.  Before I found the chiropractor, I started attending a group at the VA for weight loss.  Figured this was one way to get under a doc's care for a year so I could get gastric bypass.  Even after I started my current path, I kept going, more for the company and weigh-ins.  A few months ago,she asked me what I was doing, and I started to tell her about no sugar etc...she told me to hush and don't tell anyone else in the class.  Well in August, she started calling people who pursue natural health FOOLs, IDIOTs and things like that.  She gave out so much misinformation it made me sick.  After that class, I called and told them I was NOT returning and exactly why.
Mercola
  
Russ Bianchi
[ Joined on 09/06 ]  [ Posted on September 14, 2007]
11 Points        
   
Savvy User
  Mercola
You are quiet correct in your assertion Patty D, some of the least correctly educated folks I have ever met or spoken to are Registered Dieticians and some Nutritionists. 

It's quite scary actually these folks are being paid to give sound nutrition advice; I remember being at a national Registered Dieticians Convention, about 12 years ago, and they were thinking aspartame, maltitol, HFCS, and other harmful chemical ingredient cocktails were "Just fine, because the FDA says so".
Mercola
  
Phantom O' Banjo
[ Joined on 09/06 ]  [ Posted on September 15, 2007]
23 Points        
   
Savvy User
  Mercola
Gamma you forgot to add blah blah raw milk will cause instant death in small nervous animals which means not fit for humans.  Be sure to get your daily does of fluoride that will fix your health right up.
Mercola
  
Lloyd Fielder, D.C.
[ Joined on 06/06 ]  [ Posted on September 17, 2007]
21 Points        
   
Savvy User
  Mercola
Me personally I do not think any physician should be "trained" which is the problem.  They need to be educated and open to other philosophies.  Their philosophy is how to treat sick people, others are centered around what it takes to keep a person healthy and well.    The exception would be for the technical aspects, heaven forbid I lost a finget and wanted that dude back on I would greatly appreciate a well trained surgeon  :)
Mercola
  
CSR
[ Joined on 08/07 ]  [ Posted on September 17, 2007]
19 Points        
   
Apprentice User
  Mercola
Interestingly, I was speaking with a friend of mine yesterday who was complaining that "all someone needs to do is sneeze in the room and she gets sick".  I began telling her about some of the things I've learned and that help me stay healthy and she was completely clueless to all of this, despite the fact that her mother is a nutritionist !  Enough said.
Mercola
  
emm76
[ Joined on 07/06 ]  [ Posted on September 17, 2007]
7 Points        
   
Savvy User
  Mercola
My husband has an aunt that is an LVN who is teaching diabetics at a low income, government run clinic how to eat and exercise.  She is just an LVN and has NO formal training in the subject.  She herself is overweight, (pre-)diabetic, on anti depressants, and eats out all the time. Talk about the blind leading the blind.  I'm sure this is the case everywhere.  How many "medical professionals" have you seen that are overweight, smoke, etc. 
  
  
tby000
[ Joined on 06/06 ] [ Posted on October 4, 2007 ]
9 Points        
   
 
Novice User

I concur...I was a Pfizer rep for decades.  Retired early due to all the really disgusting practices I was forced to participate in.  Everything stated by others is true, but there is so much more.

Dinner for doctor & his whole family if he'll just listen to a "medical specialist" while his dinner is being prepared.  Of course this "medical expert" has no bias....(if he didn't, he wouldn't be there)

Doctors had so many invites to expensive restaurants that they could take their wife out every nite if they wanted to to hear a "medical expert" talk. These guys were being paid anywhere from $500-1,500 for a 30-60 minute talk, and they were nothing more than a dog and pony show.  We called them "prostitutes", to say it nicely.

Some physician groups advertised in classifieds when looking for help: Free breakfast & dinner every day. (paid for of course by pharmaceutical companies)

So much more....but out of space.

 [ Reply ]
  
  
Zipper
[ Joined on 10/07 ] [ Posted on October 4, 2007 ]
5 Points        
   
 
Novice User

  I have seen both sides of this ugly coin. I used to work as a medical sales rep selling everything from insulin to surgical trays to anesthesiogists (in the 1990's) The companies put an extreme amount of pressure on sales reps to get face time with the doctors. Sometimes there was 2-3 sales reps selling the same product to the same doctor, talk about burnout!.. and the lunches and free trips! I finally got fed up, very depressed and quit!

  Now I am the patient. I see a psychiatrist for depression. Here is what she has prescribed for me... Effexor, Seroquel( off label), Temazepam and Gabapantin(off label). I can only imagine what she is making in spiffs. Of course I don't take all these meds.. I would be a dead horse if I did! But I do have a tough time with depression and sleeping and am doing the best I can with exercise.

People just have to use common sense when it comes to their own health.. doctors don't care.. it is up to us.

 [ Reply ]
Mercola
  
sobber
[ Joined on 10/07 ]  [ Posted on October 4, 2007]
-1 Points        
   
This user is BELOW novice level and all their comments need to be reviewed with great caution.
  Mercola

use dmsa accoording to cutler protocol http://www.noamalgam.com/

to get rid of mercury and u will never have depr again also do all what mercola recomends

  
  
Katee Roux
[ Joined on 07/07 ] [ Posted on September 18, 2007 ]
5 Points        
   
 
Savvy User
I worked for a MD while in college ('91-'92).  Before the marketing direct to consumers/patients.  It never occurred to me that providing MDs with sample meds & pens & paper pads was something "crossing the line."  Even tho we know that pharmaceutical companies spend money on much more than this, i think it is these small things that have a huge impact.  Of course, the doc i worked for didn't use the samples as the company intended.  Those companies planned for the docs to give 2-3 days of samples & then write a script for the rest.  She would give folks handfuls of drugs.  If it was for something like antibiotics, short-term, she'd give them the whole script & they didn't have to purchase any.

My former MD had a sign in his office for the drug reps telling them 5 minutes a month, don't come into my office more than once a month.
 [ Reply ]