Dr. John Santa discusses the financial relationships between doctors and the pharmaceutical industry.

What’s wrong with promoting prescription drugs to doctors?

If you notice a lot of pens and scratch pads in your doctor’s office with logos on them, if you’re frequently offered free samples or often notice drug company "detailers" in the waiting room, you may be more likely to be treated with a new brand-name drug when an older standby would be just as good, cheaper, and maybe even safer. Free drug samples can end up costing more in the long run because eventually a prescription has to be written for that expensive drug. Those logos are very effective for brand-name recall. You might want to ask about your doctor’s policy on seeing drug representatives. I used to work in a big practice where about one-quarter of the doctors regularly saw drug representatives. They were more likely to prescribe the latest and most expensive drugs. But that’s just the start of the substantial and influential financial relationships between doctors and the pharmaceutical industry.

What more is there?

Physicians could virtually exist on the free meals delivered to their offices on a daily basis if they wanted to. One pharma detailer wrote an article about setting up a latte cart to get her foot in the door; doctors were more than happy to exchange a few minutes of their time for a free latte. Or you get invited to dinner at a nice restaurant for a "medical education" speech, and at the end of the night are handed an envelope with $100 inside. Or you participate in "research" that drug companies farm out to doctor’s offices. You don't have to do anything except follow their protocol, and they'll pay you $300 or $400 for every patient you put in the study. Doctors deny it, but the evidence is clear that these financial relationships lead to significant increases in prescribing and sales. If they didn't, the drug companies wouldn’t spend an estimated $20 billion a year on them.

Have you ever taken drug money?