Most US neurologists prescribing MS drugs have received pharma industry cash | Nearly 80% of US neurologists prescribing drugs for multiple sclerosis (MS) received at least one pharma industry payment, with higher volume prescribers more likely to be beneficiaries, 5 year study finds

[u/FunnyGamer97]

https://www.eurekalert.org/news-releases/1095648

[u/VrachVlad]

I'm a physician as well and I agree with everything you've said here. Especially if the Pharma rep buys lunch for the entire office that's going to be $300 per lunch and typically we'd have a rep in once a week. Seeing someone have >$10,000 per year from this is honestly not unusual. The last rep I had was trying to get me to prescribe Xarelto and I was asking a whole bunch of questions about it since Eliquis is substantially better in every single way except it's twice a day dosing and much more expensive. My drug prescribing habits don't change because of these reps in terms of what I will typically reach for. What I will say is that the rep reminding me of a drug being on the market is probably the more instrumental thing that these reps do. Especially the biologics because now there's becoming quite a lot of them.

[u/treehugger100 → u/VrachVlad]

I work in a professional field where accepting lunches/meals like that is considered highly unethical. I’ve never understood why it isn’t considered unethical in healthcare. Also, I’m not going to disagree with you about what you do but it seems highly unlikely, if not impossible, that those meals and reps don’t create bias in prescribing broadly. The companies wouldn’t do it if it didn’t.

[u/thinkbetterofu → u/treehugger100]

im glad it strikes you as weird that doctors are literally commenting "yeah we take bribes but its totally fine because im asking REPS FROM THE DRUG COMPANIES ABOUT THE DRUGS AS IF THOSE EMPLOYEES ARE NOT BIASED"

like HELLO?

[u/WillSupport4Food → u/thinkbetterofu]

Calling free lunch a bribe seems a bit intellectually dishonest. Doctors are still beholden to their licensing boards and ethical oversight so implying that they'd all compromise their standard of care for a $20 meal from Chipotle is a little insulting. Not saying it doesn't happen, but it's far cry from pharmaceutical companies sliding a doctor a big bag of money with a dollar sign on it like laypeople often portray it. If your employer pays for your lunch during a company meeting would you also consider these a bribe?

Continuing education is a vital part of medicine so that you don't end up with doctors who graduated 30 years ago and never updated their practices in that time. If a new treatment comes out, doctors in the field need to update their knowledge on that treatment. That generally requires taking time off work or traveling to where the lecture is held. All of that costs money and often times either your workplace or the host of the lecture will cover some or all of the associated fees. Otherwise you get into the situation where people don't want to/can't afford to take time off work to travel to these continuing education lectures.

[u/sneakypiiiig → u/WillSupport4Food]

Just because the continuing education of the field is wrapped up in the corruption doesn’t justify the situation. That’s insane. It seems like the perfect situation for a predatory pharma company to snake their way into to justify their bribes. And we’re not just talking about one lunch, obviously.

[u/WillSupport4Food → u/sneakypiiiig]

For continuing education credits to be considered valid they generally need to be approved by an independent third party associated with your licensing board so it's not like these are just random sales reps giving misleading/overly biased lectures.

The fact of the matter is experts in their field don't just take weeks off work to lecture everyone in their field every time there's a new treatment option. Literally no matter how you format the system, unless you force experts to provide their consultation for free, someone will be getting paid for CE.

The entire argument here boils down to people not trusting that doctors can make unbiased conclusions about new research just because someone paid for their lunch or their plane ticket to a lecture they took off work to see. Which at that point if you have so little faith in their scientific integrity or objectivity, no system will fix that because it's the doctors themselves you don't trust.

[u/treehugger100 → u/WillSupport4Food]

It’s like you are ignoring that doctors are people. People are influenced by the activities that you are describing. It’s like you guys were never taught human psychology.

[u/WillSupport4Food → u/treehugger100]

Doctors are people and people are fallible. But being trained to recognize bias and critically evaluate new information is something doctors are explicitly trained to do. As a veterinarian I had multiple courses exclusively about recognizing sources of bias in scientific literature, common flaws in methodology, and how to form your own professional opinion. That doesn't mean doctors are magically absolved of biases, but I'd argue that's a lot more training in recognizing and mitigating bias than non-medical professionals considering their continued licensing and likely sole source of income depends on it.

When the consequence for not doing your due diligence and recognizing conscious or unconscious biases is potentially killing someone and/or destroying your career, schools tend to place great emphasis on teaching you how to mitigate those biases and think critically about new information.

The system isn't perfect as I mentioned in a different comment. In a perfect world, an independent third party would review all new treatments and medications, all research would be funded independently, and experts in the field would present that info to practitioners free of charge and in convenient locations/times. But we don't live in that world and experts and researchers in their fields rarely work for free

[u/treehugger100 → u/WillSupport4Food]

Thank you for your response. Considering the volume of repeated problems with doctors not doing their due diligence when prescribing the training you describe isn’t leading to impact at the level that would happen in a decently well functioning system.

I don’t expect a perfect world but I want a healthcare system not driven by pharmaceutical company profits. Other countries don’t allow this and I think the US should ban it as well.

[u/WillSupport4Food → u/treehugger100]

I would love for healthcare and research overhauls as well. Sadly the US seems to be regressing at a rapid rate(and already wasn't great to begin with) which create the perfect system for a few bad actors to profit massively at the expense of the general population and concurrently erode trust in medical professionals.

[u/Rikula → u/sneakypiiiig]

As a social worker, our continuing education that we are allowed to receive in our hospital is usually tied to food as well. We can get education without food, but there is usually less attendance since the CEUs happen during lunch breaks. Local companies will sponsor/provide the lunch while someone separate provides the education.