Thursday, December 19, 2013

Pharmaceutical Representative Lunch

I was feeling pretty good driving to work this morning, till I turned on CBC radio.  I sometimes feel like a crack addict must feel at the moment I press the FM 88.1 button and leave the safety and serenity of classical or inspirational music.
Anna Marie Tremonte in that screechingly judgemental supercilious, out of touch with reality, voice she can adopt was talking to a group of angry men making a living off of attacking doctors. 
This weeks condemnation of my profession took the twist that we were unduly influenced by pharmaceutical representatives. 
Some doctors, very few, extremely few indeed, apparently make as much as $500,000 working as speakers for pharmaceutical industry. I was once paid $100 to talk to a group of doctors about a drug  I was using with patietns and knew to be extremely beneficial so was happy to tell my colleagues. I was not going to do this if someone didn't pay me as I'd rather sit at home and read a good book but when offered a meal in a fine restaurant, time to be with colleagues, I took the $100 and ate the meal and told the family physicians why I, a specialist, recommended this drug.
Because Anna Marie Tremonte doesn't live on this planet but is a bubble girl , she doesn't know that there is somebody doing just this sort of thing in every industry in the world.  It's called 'education' and it's done by those who are most knowledgeable. 
I listened to a presentation on RV's by an RV owner on which RV's they recommend. I listened to a fellow talk about motorcycles. I know nurses get paid lunches to listen to different representatives discuss uniform clothing materials.
The greatest corruption in hospitals, if they are anything like the military, happens in supplies. CBC did mention that since buying doctors lunch was out the pharmaceutical industry had shifted to buying lunches for the beaurocrats who decide which drugs appear on the hospital pharmacy lists. Pharmacists, we learned last year, were getting 'kickbacks' from industry to the tune of millions of dollars.
So I normally don't have lunch. I'm too busy. As a doctor I am tasked to do 90 minutes of activities in every 15 minutes of time spent with a patient, and I'm only paid for by my time. Even if I do all this right, and am the most perfect doctor, I can lose my license because I'm 'unpopular'.  I don't even have kill or maim people, I just have to be politically incorrect.  So, like most doctors, who on average work 80 hours (the equivalent of two government jobs, and maybe 3 CBC jobs - senior management in CBC do make half million in perks and benefits at least, don't they? I'm not sure what rock star reporters make but I do know that every band is approached by someone in industry hawking their amps and guitars). 
So this person offers to buy me lunch and tell me about the latest product from their company whose products I already use, Eli Lilly, for instance, (think Mother Earth Magazine, Danier Leather, Ford Cars, IBM, Apple, Angelina Jolie).  That's what I think when I think Merk, Eli Lilly and such folk because their products have saved the lives of my patients.  I've been up in the middle of the night and some scientific wizard in some amazing lab has created a product that has stopped my patient dying in the wee dark hours of the morning and I look and see Hoffman Laroche has made this godsend that has just saved a life.  I am a front line worker. 
When I listen to Anna Marie Tremonte I think she's somewhere safe dressed in white silk and sitting on a soft sedan looking at her painted nails and berkenstocks sometimes soundly pleasantly sane other times sounding seriously daft.  Think of me as a crack addict with CBC, a love hate relationship. 
So yes, I'm influenced by someone offering to take me for lunch, or coffee even.  It's the lever to get me out of the office.  Now when this person makes their pitch, I'm influenced just like I was influenced when I heard this one guy, a motorcycle mechanic, talk about the pros of and cons of synthetic versus natural oils.  I ask questions and I reason and I eat lunch.  I have noticed that the people that the pharmaceutical industry sends around are bright attractive people.  They're in sales.
Only government funded agencies like CBC, sometimes called Communist Broadcasting Corporation, knock sales routinely. Salesmen and sales are not dirty.  I 'sell' life. I try to convince my patients daily to give up killing themselves. I'm not laying life out there like an 'option'. I'm not miles from reality in a radio studio talking about it in the abstract. I'm selling my soul out to keep an adolescent girl from killing herself because she's overwhelmed.  I love 'sales'. I love 'salesmen'.  Sales to me is like any communication system.  Hitler was a brilliant media person but used that media for ill. 
Anna Maria Tremonte and the CBC are too often hack journalists and propagandists rather than unbiased reporters.  Where's the 'balance'.
I'm now feeling guilty about having that lunch.  I spent a third of my life in free time studying to be the best doctor I could be and out of sheer curiosity, all post graduate, and no body was buying me lunch.  I don't have a pension. I think my hourly wage is now about minimum wage but then I started the workforce 12 years after my neighbours who bought a house while I was training and now are retired early and spending their winters in Cancun. 
Yes, there are bad doctors. Yes, there are bad media people, but why the broad brush and why the Watergate Scandal over somebody buying me lunch who wants to tell me about something in my field when this is 'normal' business.  It's 'normal' Anna Maria Tremonte. Somebody in your CBC got a lunch to discuss which microphone you used today. 
And as for free samples, you get them at the cosmetic store.  You can't tell me you never ate a 'free sample' of food at Christmas time walking through the shopping mall.
I take free samples of medications I'm going to prescribe. I take these because I can give this sample to my patient. I do this not to 'push' drugs like heroin industry. I don't even do this like the guys at the car mall who let me drive around the block my Miata Sports Car.  I love my Miata Sports Car. It's been 35 years of 7 day a week work and today I'm able to affor a car that has heated seats that help my back and I don't want to feel guilty because last I looked doctors individually and collectively weren't the really rich people in this country.  Oprah makes 2.6 million dollars. How much does Anna Marie Tremonte make and how many perks is she given.
What's wrong with making money, doing good.   To listen to CBC making money is evil, collectively. (except perhaps if you are an athlete and why did it take CBC so long to catch the government officials in Quebec stealing outright millions of dollars and seeing no wrong in in it. And why did that 'Scandal of the Year', get so little play when the Senate red herring that cost us all only $500, 000)
I ask for samples so I can give my patient a sample so if they get a side effect, most likely in the first week of use, they won't fill the prescription which would cost them $100 and they'd lose the money because you can't take back antibiotics or medications for psychosis, or any medications and we counsell everyone not to use their neighbours medications.  So rather than have a rash and lose $100 I am so thankful the Pharmaceutical Industry, these greats who have extended the lives of my HIV patients by 30 years and saved my Diabetes and allowed my schizophrenic patients to lead relatively normal lives, well I'm thankful they let me save my patients some money. 
My patients usually aren't rich supercilious news casters like Anna Maria Tremonte.  Because they're sick their income has been affected and they appreciate any help the doctor can provide. 
I liked test driving my luxury sports car.  I am by CBC standards a 'dirty capitalist pig' even though I can't remember not working and so much of my activity overlaps with my work and I don't own a house, don't have time to gamble on the stock market and don't have pensions and haven't really given money the thought I've given to 'curing' or 'comforting' the person who has come to me sick and suffering.
And frankly, I'm really thankful for the Pharmaceutical Industry because they've given me the tools that have helped me do my job and I get tired of academics and monday morning quarterbacks hawking their books.
Yes, I know, a department head at a university could be bought for $50,000 and there were those who were unduly influenced just as everyone is in 'big business' and there's a need for accountability.  But somehow Anna Marie Tremonte and the CBC do more 'carping' than reporting.
Influence pedalling happens in every nook and cranny of existence and every item in our day to day lives is a product of sales so please, wake up.  And I will be more impressed if you first tell me whose paying you off and how influence affected which soft seat you sat in and how you refused to let the car company get you to test drive their car and how you really are 'above' it all.  Because you do sound very high and mighty and judgemental in a most obsequious way and I guess I'm returning the same. 
So I'll pray and forgive and hope tomorrow I can resist turning on CBC.   

1 comment:

Anonymous said...

Well said Dr. Hay - I often struggle with my job, mostly because of the way my ilk is portrayed by the media.
Thank you for sharing your perspective.