Medical journal lambastes culture of drug-firm perks

[Praxius]

http://www.thechronicleherald.ca/Canada/1045494.html

TORONTO — The Canadian Medical Association Journal is calling for an overhaul of the system by which working doctors keep abreast of medical developments, saying the reliance on funding from drug companies distorts medical practice and compromises the ethical underpinnings of the profession.

In a strongly worded editorial, the journal’s editor-in-chief Dr. Paul Hebert placed much of the blame on doctors themselves, saying they have developed a sense of entitlement to the lavish perks often passed off as continuing medical education or CME credits.

While there have been efforts in recent years to crack down on some of the largesse, stories abound of doctors being given family cruises if they agree to attend a few hours of lectures put on by the drug company that sponsored the cruise or CME sessions booked at exclusive golf clubs.

"Over the years, the powerful pharmaceutical enticements have resulted in physicians believing that strong industry involvement is not only normal but also that they are entitled to receive the benefits. This culture of entitlement is one of the most difficult obstacles to overcome," Hebert wrote.

"We seem to have conveniently forgotten that the pharmaceutical industry is in business to make money, not to educate health professionals."

The editorial, published in Tuesday’s issue of the journal, proposes that an arm’s-length "Institute of Continuing Health Education" be set up to design and run continuing education programs for physicians. To maintain their right to practise, doctors must complete a prescribed number of hours of CME each year.

Hebert’s editorial suggests funding for the institute could be derived from governments, the medical profession and a levy on profits from drug and medical device patents.

Critics of the broad influence the pharmaceutical industry exerts over medical education, journals and the prescribing practices of doctors were quick to endorse Hebert’s call.

"Hear, hear. . . . Three cheers for Dr. Hebert," said Arthur Schafer, director of the University of Manitoba’s Centre for Professional and Applied Ethics, adding that the current system of CME "has very little to do with education and a great deal to do with marketing."

"They’re on the gravy train," Schafer said, speaking of physicians.

"They don’t want to get off. They deny that they’re influenced — all of them do deny that they’re influenced. And I think that’s going to be the challenge."

Also enthusiastic about Hebert’s editorial was Dr. Gordon Guyatt, an outspoken critic of the pharmaceutical industry’s efforts to influence doctors. (Guyatt spearheaded a successful campaign to bar drug company representatives from meeting with — and buying pizzas for — medical students at McMaster University in Hamilton in the early 1990s.)

He praised the editorial for taking aim at the "enormous" and "pernicious" influence the pharmaceutical industry has over the continuing education of doctors. But Guyatt, who continues to teach at McMaster, said the fault for accepting the status quo lies with the profession.

 

[karrie]

great, so now can they stop the publishing of 'preliminary studies' on secondary uses of existing medications? Because doctors getting those ideas in their heads before final trials are complete, and nearly killing patients with side effects for meds that don't help in the first place, is more than a bit upsetting. And the drug companies make a killing with one simple little magazine article saying that 'preliminary studies show x may cure z'.

 

[tracy]

Of course when they wait for the final studies, they are just behind the times dinoraurs who don't care about patients suffering RIGHT NOW. It's a double edged sword unfortunately. No one has come up with an ideal method of educating docs about new developments.

 

[paullind10]

Doctors can be educated without any cruise tickets or green fees involved, thats what Dr Herbert is suggesting.

Larger, medical associations should review, recommend and inform it's member doctors of new medical advances, not a slick saleman in a golf clubhouse. It's not realistic to expect every doctor to review every new medical developement, it's impossible to handle that workload, you could do that as a full time job by itself, let alone practice medicine at the same time. P.Fezziwig, contributor for Healthcare Reviews , http://www.healthcarereviews.com , building a better healthcare system through patient feedback.

 

[MikeyDB]

The question has been asked here in CC "What came first the chicken or the egg, politicians or corruption?"

Look no further than a cadre of "professionals" who wearing white coats have for generations misused and mistreated patients. To be fair, they aren't alone in the money-grab and union executives and "professional associations" have been voluntary sychophants to whomever holds the purse strings as well.

You can't reasonably expect a culture raised on fantasy and boundless self-interest, professional organizations hanging on the teat of huge multi-nationals and governments standing in line with their "hands" out to coporate and industrial mega-giants to develop into anything other than a corrupt and fundamentally delusional society.

 

[tracy]

You are so cynical sometimes I find it sad. I work with a lot of those people you scorn. They aren't the evil, greedy or incompetent people you speak of. There are jerks among every field, but the big money perks some people are mentionning are hardly the norm. We sometimes get cookies, pens or notepads. I can't recall a single doc I work with taking a paid vacation from a drug company (you know, in between the time they spend abusing their patients).