Families in our practice know that we have never let drug companies into our office.
What does that mean?
Any employee of a drug company trying to sell us a product we have not ordered is asked to leave the office should they ignore our policy.
Any material from a drug company mailed or delivered to our office that we have not decided, independently, to purchase, is immediately thrown away.
Every offer of any gift from a drug company is refused, although in the last 15 years since we opened, no such offers have been made.
We have always felt good about these policies, and as families in the practice know, we have pursued this policy because we want to be as sure as possible that the information we base our advice on is based on facts, not marketing propaganda.
Another reason, we talk about less frequently, is that accepting these influences does lead to undue influence. Doctors have denied that taking a free lunch, a free sample, a drug rep’s conversation, actually changes their decisions. I remember over 25 years ago reading about a study of doctors who let the researchers observe them. The doctors did so, documenting in pre-study surveys, their total confidence that taking goods and time from drug companies would have no influence on their decisions. But that’s not what the researchers observed, they documented that for doctors who took goods and data from drug companies, about 44% of their decisions were altered in the direction the companies desired.
It was proven that the only group who were convinced that a bribe had no influence were those taking the bribe.
The Tragedy of Influence on the Opioid Epidemic
Now, many years later, comes this most upsetting evidence of the terrible impact of such influence peddling, as reported in the Times:
In this article, an investigation is discussed that looked at the rate of opioid deaths in counties and at the same time the frequency of doctors taking meals, trips, and yes even consulting fees. What they found was quite horrifying.
In counties where doctors took more goods from the companies selling opioids, the number of deaths from opioids in that county were higher.
The correlation was remarkable. “…for every three additional payments that companies made to doctors per 100,000 people in a county, overdose deaths involving prescription opioids there a year later were 18 percent higher.”
The article goes on to document that a lot of doctors took these goods from companies that sell opioids. Overall, 1 in 12 doctors across the country, and as many as 1 in 5 family doctors took these goods from these companies. In county after county, when the number of gifts to doctors from these companies went up, the number of opioid prescriptions went up and so did death from them.
These are extremely serious findings. As the article mentions, a big proportion of opioid deaths are related to the use of opioids prescribed by doctors, about 1/3 of these terrible deaths.
These gifts from opioid producing drug companies were most common in the Northeast of the country, and lowest in the Midwest, but one of the highest gift, and opioid death, counties in the US was Erie County (Sandusky), here in Ohio.
The article concludes on a note of hope. Public outrage at the epidemic has led the drug companies that make these drugs reduce their peddling, and so gifts to doctors from these companies are down, about 33% in comparing 2015 and 2016.
BOTTOM LINES
- Bribes work. They always have, they always will.
- In the instance of drug companies bribing doctors, the bribes take the form of meals, trips, and consulting/speaking fees. This article proves not only that they work, but in working, they spike the amount of opioids people take, and the number of people dying from use of these products.
Advanced Pediatrics continues to hope one day that all medical professionals join in refusing any goods from any drug company, but until then, we will continue to follow this policy, now knowing there are very upsetting new proofs of the urgency to do just that.
To your health,
Dr. Arthur Lavin
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