The next time you write a check at your physician’s office, ask for a pen. It’s likely to bear the logo of a drug company.
After prescribing a new drug or salve, your physician may well dip into a drawer stuffed with samples to give you a few days’ worth, free, to tide you over.
The pens and samples constitute a subliminal presence, but these omnipresent freebies mark only the first stage of a campaign of influence.
More potent are the free company-sponsored education sessions, sometimes enveloped in week-long cruises, also free.
These educational sessions offer useful, current information, and clinicians rely on them to keep up-to-date. Yet the price of staying current is staying open to the payer’s influence.
Higher up in the arsenal-of-influence tools are the paid gigs: the part-time jobs for physicians as consultants to lecture, to write a paper, to discuss research. Even more potent are the research grants, tied to clinical trials of investigational drugs. More powerful yet are the subsidies to the professional panels that draft treatment guidelines.
As a result, patients are vulnerable. Has a physician recommended drug X because of a persuasive article in a medical journal?
The Institute of Medicine recently recommended that medical journals ask authors to disclose their ties to industry. Most crucially, it recommended that Congress institute a national reporting system in which companies that market pharmaceuticals, medical devices and biotechnology treatments disclose their funding.
Supreme Court Justice Louis D. Brandeis praised the disinfecting nature of “sunlight.” In this era of the Internet, the public disclosure of financial ties should be even more disinfecting. •
Joan Retsinas is the managing editor of Medicine & Health /Rhode Island, a monthly journal of the Rhode Island Medical Society.
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