There was a piece in the New York Times Magazine in November entitled "Dr. Drug Rep" by Doctor Daniel Carlat who discussed the interplay of drug companies and physicians, and his own evolution concerning the appropriateness of aspects of that relationship. I thought it was a fascinating article.
Then, this past week, the Magazine published a letter to the editor from Dr. Amy N. Ship, a superb internist in our hospital's primary care practice. Here it is, in case you missed it. Strongly held beliefs, clearly presented.
Even without Dr. Carlat's delayed recognition of the positive spin Wyeth clearly expected him to put on its product, why did it take a year for him to realize that he was being paid and pampered to sell a product? How could he seemingly miss the obvious: that his M.D. and credentials provided for Wyeth a patina of legitimacy that its drug reps couldn't muster independently? Why did it take him so long (while he amassed $30,000) to see that his position was morally corrupt?
The "lessons" that he reputedly learned are not new or unique. I'm proud to work in a medical practice where pharmaceutical representatives are not permitted.
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5 comments:
I'm glad Dr. Ship wrote that letter. In Dr. Carlat's self-congratulatory journey, he ignores the residual ripples of all of this marketing on the PATIENTS. Because psychopharmacology is still an infant field - and because it's patients are often in such pain - positive data feels like a lifeline to doctor and patient alike. He sold false hope and put people through the difficult task of trying a new drug on themselves.
Paul,
Here is Dr. Carlat's blog with the continuation of this story.
http://carlatpsychiatry.blogspot.com/
I think that the current evolution will have a much bigger impact on the whole problem than it would have had if he just gave up the job up front.
For the public, this story was new (more like: it is actually even worse than I imagined) even if the medical community already knew all this.
I think it's fascinating that such a fascinating article generated so little response. Methinks that this is an issue that docs don't want to confront -- even pizza, rather than cavier, is better than no free lunch at all...
What are the pharm rep policies at your system?
See Dr. Ship's letter...
In response on why it took Dr. Carlat a year, that's the power of money and fame.
It took me close to ten years as a pharmaceutical executive before I acquired awareness of the nature of my vocation.
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