It has not gone unnoticed (whatever does) by the medical blogger world the irony or hypocrisy of Stanford's Medical School prohibiting the receipt of drug companies' pens and mugs (which are recognized to contain tiny and incredibly powerful mind-control devices) but continuing to allow faculty to be involved in numerous financial arrangements with drug and other medically related business entities. Free lunches and drug samples are also prohibited in their new policy but apparently faculty members can sit on boards of directors of drug and other medical businesses.
Multiple examples of the multiple conflicts of interests at Stanford was highlighted by Health Care Renewal 's Sept 14,2008 posting. No mention is made in the Stanford game plan to do away with the lucrative arrangements between faculty members Big Pharma and other medically related commercial enterprises. Standford's Dean Pizzo's video explaining the new policy can be found on their web site.
2 comments:
In a very small but satisfying step, my rather large clinic barred all drug reps from talking with any of the docs. And way back in med school, my class was the first (so we believed) ever to return the freebie doctor bags that Eli Lilly gave to all med students. Woopdedoo, on the one hand: a start, on the other.
1.How do you find out about latest advances in pharmacotherapy even assuming that you have the time to do so after patient care and paperwork related to managed care?
2. Assuming that drug rep relay info favorable to their drugs, how would you make informed comparisons? Do you take the time to read up on the latest data, again assuming that you set aside time for this?
3. To stretch it a bit more, in the absence of a favorable environment ( a free enterprise society and a non-hostile medical community among others) how do you expect to have better drugs in the future? How did we get to have options for anti-hypertension pharmacotherapy for example, given that in many cases, monotherapy is not enough or options for patients who cannot tolerate certain a particular type of blood pressure medication? If the drug industry did not invest in any new drugs, we probably will still be using diuretics and first-generation beta-blockers way into 2050.
I think the key is to challenge the drug industry to raise their level of information dissemination (beyond pens, glossy literature) by demanding a higher caliber of sales professionals (insisting that only evidence-based, scientific information presented professionally will be accepted). In our office practice, we set aside time for drug reps (two-five minutes each for three representatives only from Tuesday to Thursday by appointment). No lunches, no snacks/candies. We insist that they come prepared with scientific data and we challenge the information. This has weeded out many representatives who just don't make the grade. With a maximum fifteen minutes a day we have created a valuable source of information that we ordinarily would not have obtained on our own. Plus the discussions ensuing from these exchanges have also kept us on our toes in terms of new knwolege.
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