If you have ever worried about whether doctors have too cozy of a relationship with pharmaceutical companies, a long commentary by a Massachusetts psychiatrist in the New York Times magazine won’t ease those fears. He recounts how even conscientious doctors can be lured (with plenty of cash) into becoming de facto sales representatives for the drug companies.
Posted by Phillip Brownlee
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25 Comments
I learned a long time ago that some doctors do not specialize in pharmacology.A lot of times doctors in training, they just go by a mentor recommendations and that recommendation can be based on hearsay assumptions conveyed to them without understanding the whole of the prognosis.As for an example, I went to a clinic and I‘ve met with a young doctor for treatment of a painful strain in my wrist.He prescribed a medicine (I can’t remember what it was) that was suppose to help get rid of inflammation.As it turns out after a day and a haft of taking the medicine, it had a side effect of causing painful problems with the kidneys, a side effect that the doctor was not aware of.After read up on about the medicine, I have decided to not take the medicine; I figure that I can live with pain in my wrist rather than the kidney pain.I have had my experience with voodoo medicine.
Same issue for specialty hospitals. The doctors own them and then send the least expensive patient to their hospital and the most expensive to the major hospitals.
Guess who pays? We do.
I thought that the docs were drug sales reps!
While drug reps have a place, to educate doctors on their products…and believe me- I’m glad someone is out there to educate them…the whole thing has gotten way out of hand. It aggravates me to no end when I see a drug rep walk into my doctor’s office right before my appt, because I know I’m going to have to sit and wait. They need to schedule times when no patients are expected. I also want to know what off label uses are there.
I think I discovered an off label use for neurontin- amazingly after I started taking the drug, my panic attacks went to zero. I had learned to just deal with them unmedicated, and any med I took for them didn’t really work, but it was really nice to not have them anymore.
I also used Zantac for warts on my daughter and it WORKED.
During my Dad’s long illness, I had the occasion to help him to visit his Dr. many times.
One time, we had to wait for over 20 minutes. The other 4 parties in the waiting room ahead of us?
Pharmaceutical reps. all of ‘em.
Too? My own personal health was virtually destroyed by another Dr. who shifted me from this drug to that to the next.
Next time you visit a doctor, take a look around. If the clock is from Phizer, and the exam table paper has ads on it? Might be time to find a Dr. who does medicine and is not a shill for big Pharmaceutical.
Nope, often those drug reps who leave lots of those samples. And they’ve saved me from time to time.
I don’t have insurance so I quit seeing docotors 5 years ago. It made me realize that I need to take care of myself. I actually feel that a lot of ailments can be taken care of without prescriptions, eat the right foods, avoid pop, drink 3 pounds of water everyday and exercise.
I also think anti-depressants are WRONG. I also don’t believe that crazy people or depressed people permanatly stay that way, but our health system with the drug companies keep people that way.
Anybody that wants to improve their health, cut down on meat, and eat BEANS everyday, yes I said beans. The human body is adapted to Beans, whole generations that lived in poverty over the past 2000 years have survived on beans. Meat used to be a delicacy, the human body isn’t adapted to survive on a meat diet, but today in America, meat consist of 40% of most peoples diets. We’re not cats, our Livers take a lot of work filtering out toxins from meat. Also, more than 2 servings a day of white starchy breads are bad for your thyroid. That color food system actually is better than the food pyramid. The system that says eat a few servings a differnt color of food everday. I’ve been on a dog food diet for the past two months, I call it a dog food diet because most of my food comes out of cans, I eat canned beans and corn everyday, plus fresh spinach and carrots everday, and I feel like a million bux, all my stomach problems from eating greasy fast food went away, I cut down on meat, and only eat turkey, 2-3 times a week, and I eat beef maybe once a week, plus I quit using salt. I’m not a health nut, I don’t watch my weight, but I’ve lost ten pounds in the last two months, and gained some muscle tone frome exercising. Maybe I am a health nut, but I can’t afford to see a doctor if I get sick, so I’m trying to prevent future problems.
Don’t have insurance because you can’t afford it WhiteElephant or don’t have insurance because it’s not something you want to spend your money on?
Interested, because part of the Census Bureau statistic was that people with incomes above $50,000 often chose not to get insurance, because they were young and healthy and didn’t want to waste the money.
It was in the millions of people that did this, you know – part of Michael Moore’s statistic. :)
I can get insurance through my job, but yes, I choose not to. Its very crappy insurance, and I’m fairly young and healthy (27), so I rarely see the doctor anyway. I wish I made above 50K a year, I make roughly 31k a year.
That’s what I figured WhiteElephant.
You do know that Michael Moore and people like him include you as part of the uninsured.
You might think about that insurance again or get an alternative plan, Medical Savings Account or something.
If there is an accident through no fault of your own, I’m sure having insurances to pay for it would come to much relief at the time of the tragedy. :)
“I also think anti-depressants are WRONG. I also don’t believe that crazy people or depressed people permanatly stay that way, but our health system with the drug companies keep people that way.”
Tom Cruise?
OkI am in the middle on this issue, too.
First, part of this is the patients fault: Go to the Doctor for some complaint, any complaint. If the Doctor tells you that you need to get more sleep, drink more water, and get a little bit more exercise, and perhaps go on a diet, — will you go back?Will you be more or less happy with that Doctor, if he gives you a perscription?
What would you think of a Doc that said: Take 2 of these a day, for your soar throut, and you will be better in 3 days — Or, toss the script in the trash, gargle with warm salt water several times a day, take lots of vitamin C and Zinc, or drink lots of orange juice, and you will be better in 3 days?
Americans feel cheated if not given the “key to the kindom” on every office visit. We think that the pharmacy holds the secret to our health, and we want that darn perscription, no matter what!—-Ok, now for the hard truth: There are some illnesses for which modern drugs have worked miracles.
Side affects are important. We should understand side affects, for our own health and so as to understand that it is unwise to share meds with family and friends.
A drug mentioned, upthread, for instance, has severe side effects, including “dizziness, sleepiness, confusion, depression, weakness, nervousnous, and nausea, poor concentration, speech or language difficulty, abdominal or other pain, tremor, sleeplessness, tiredness, diarrhea, vomiting, sore throat and rash.” People with liver or kidney problems should avoid the drug (Code here? If you are a heavy drinker, stay away from this drug, or tell your doctor. Any drug that harms the liver is even worse if you drink much) Also “Tiagabine may bine to parts of the eye. There is no evidence that this produces long term effects. Tell your doctor if you experience any changes in vision.)
(By the way, I used the Generic name)
In other words, your doctor should LISTEN to the sales rep., especially on issues of side affects.I once was precribed 2 different drugs, on different days, from the same doc.He forgot what he had done, the prvious week, which didnt work. He did not tell me to quit taking the other medication.The combination of meds turned the whites of my eyes blood red.I really freaked everyone out at the court house!
Anyway, the lesson here was well learned: Read the warning label on every drug, before you start taking it.Whenever given a new medication, make sure that your doctor is aware of what you are taking, already.Also, check and make sure on the warning label, what drug interaction problems might develop.
wish there was a drug for dsylexiaPrescription not Perscription.
By the way, you dont need to buy a PDR or “Physicians Desk Reference” to be an “expert” on your own drugs. The medical journals are expensive and contain too much jargon.Get a very inexpensive book, like “The Pill Book” from Bantam Books, for $6.99.
I can attest to what Kansas said. My employer bent over backwards to save us money on insurance, and did a great job, figuring the employees would jump at the chance. NOPE, and I see them spend more on beer and lunches than what it would cost them to be insured.
MANY CHOOSE TO BE UNINSURED! Their choices screw everybody else over, because they get emeregency care regardless, then don’t pay for it.
Their is a health care and insurance crisis, without a doubt. My mother could barely stay insured, because her health was poor, and she wasn’t part of a group. Her income is very limited, but even she managed to keep major medical only coverage.
Pure capitolism is the answer to solving this “crisis” not more government intervention. Government caused this, and it will not solve it. Think of medical care the same way you would any other widget being marketed. COMPETETION! Doctors, hospitols and drug companies fighting for your business. This would mean lower prices, and thus cheaper health care insurance.
The medicade/care fiasco created this problem, along with lack of competetion, and ridclious lawsuits!
Semper
One thing the Democrats supporting “Health Care Reform” arent saying:
We are looking at a NEW payroll tax, in all probability, in order to pay the “premium” on any “universal coverage”.
Hillary’s NEW plan looks like the way Kansas treats auto insurance: It is a crime to own a car without auto insurance on that car.
Under HillaryCare, it will be a crime to go without health insurance!
In other words, we are going to force people to “buy” a policy, if they dont have one already.
Those who are looking for a handout are probably going to bite the hand that feeds them!
Many of those going without insurance, by choice, will be upset if they have to pay anything at all.
Insurance is just the old Mafia protection racket cleaned up forced down upon the people instead of instead of some two bit thug you got the government and Insurance agents shaking you down.
The main problem with health insurance is that when do need it the insurance company will do everything it can not to pay
Semper, the problem with pure capitalism is they will construct their policies in a language that no one can understand and take advantage of the less educated.
Econ, damn good advice on reading labels and the Pill book but you can also rely on your pharmacist to answer your questions; they will give you copies of medicine documentations and revised updates on request.
WhiteElephant, your macho approach to health will bite you back especially if you do not know your DNA potentials.In other words by my own experiences, I did not know that I had arthritis until I reached my forties and arthritis has hidden side-effects that has to be treated carefully by a doctor, you cannot do it by yourself.Also I think that group policies insurance sucks on flexibilities because as a man and the only one on my insurance, I could save more money if I did not have pay for extra policies like well woman exams and pregnancies care.
Doctors need to be paid based on their sucess rate. If the patient lives or dies, the doctor still gets paid.
If the interest of getting the patient well were the most economically rewarding, there would be more research and knowledge in the medical community regarding holistic solutions that can be better than any drug.
Doctors in ancient China were paid when their patients didn’t get sick. It was the doctors job to keep people healthy, where its almost the opposite now in Western healthcare. Doctors make their money off the sick and injured. I really don’t like Western medicine in general, well the pharmacopia part of it. All the drugs the market pushes are just labratory synthesised chemicals, and even if those chemicals were designed by scientist to mimic a natural or holistic food or medicine, they are still just chemicals that have no proven saftey record, until decades after the population has been observed taken the drug. While holistic medicine prescribed by a professinol Herbal Doctor has a proven saftey record dating back with some foods or herbs 5000 years ago. I’d much rather eat some ginger or white willow bark for a headache than take aspirin or tylenol. Or Gotu-Kola or Ginko-Biloba rather than take alzheimers prescriptions. Be on the look out for drugs in the future that mimic turmeric. Oh and by 2010 herbal supplements might be illegal in the U.S. Thanks to our entangling alliances with the WHO organazation and the United Nations which could override U.S. laws pertaining to trade barriers and agreements. Now I like that the World Health Organaztion feeds starving African babies, but they need to leave U.S. law alone. I’ll be pissed off, if buying Gotu-Kola or Lavender becomes illegal.
I like saw palmetto, great for prostate enlargement.It is all I need.
You can’t rely on herbs to treat every illness, and they aren’t regulated by the FDA, so you just have to trust the manufacturer, which I wouldn’t. Granted, drug companies can be unethical in the way they push their drugs, some with side effects worse than the disease they’re supposed to treat. There is a balance…as a cancer survivor, I wouldn’t be alive today without modern medicine. Americans need to take more responsibility for our own health, but many of us want a quick, easy fix without any effort on our part.
I get frustrated by my patients who continue to smoke, eat wrong, and would die rather than exercise, but yet they bitch about how the health care system and their doctors don’t do enough for them.
Mary, your right about the unregulated part. The supplement industry needs to be regulated to an extent, but not done away with. Thats really the only problem, is that the manufacturers aren’t tested for consistency, such as pesticide contamination or mis-labeling of supplments. I think Western medicine is just great, except for the medicine itself. The best part is the actual procedures and operations that save peoples lives, we can’t do that with plants like you mentioned. But the family doctors and the drug companies pushing pills and advertising for hypocondriacs is what I have problem with.
Me too. There is an amazing number of people who take drugs they don’t really need just because they buy into the advertising and many doctors don’t set boundries, they often just give patients what they want, not necessarily what they need.
White Elephant it is very ignorant of you to think depression isn’t real. But it’s people like you who have to actually get sick with an illness to believe in it.
I have one client right now whose husband is so incredibly depressed, but he thinks like you do…that he doesn’t need pills. And he takes it out on everyone around him- especially his poor dying wife.