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/thinkbetterofu]

so, you, as a doctor, would be totally comfortable telling any patient you are prescribing a drug for, a full disclosure that you had previously entertained these outings, dinners, or paid speaking events, or trips, from the pharma companies of the drug you are prescribing?

[u/Relax_Dude_ → u/thinkbetterofu]

I wouldn't mind a but i would need the time to explain all yhe above which would add another 10 min of back and fourth discussion which there isn't time for.  And fyi, all of these "payments' including food or whatever are all publically available information.  You can look up any individual, institution, or company and see who is paying who for what purpose down to the exact date. 

I also want to say there is often a preconceived bias favorable to the drug before a doctor attends the event.  For example I went to a Tezpire dinner because I wanted to prescribe it.  I'm sure neurologists are going to dinners of these new MS drugs because they are already interested in it.  I think this part gets completely missed is these discussions.   

[u/pswissler → u/Relax_Dude_]

I understand what you're saying here but in my job (professor at a public university) we're not even technically allowed to take free swag from suppliers at conferences due to the perceived conflict of interest it would result in. Honeraria for talks given is common but it's the sort of things we need to report to our ethics office.

When I worked in industry these sort of supplier lunches were more common, but the fundamental difference is that any induced bias started and ended internally, rather than propagating outward to the public at large. 

"Everyone does it so it's not a big deal" is a poor argument and can only serve to erode trust in your profession. The fact that you acknowledge that it would require a detailed discussion with patients shows that you recognize this. I understand that entrenched field standards are difficult to change (especially since the status quo results in some nice perks for those in the field), but it's something that your field needs to start recognizing as a problem.

[u/Relax_Dude_ → u/pswissler]

I totally understand but I also don't want to give into popular opinion if I strongly believe it's just wrong. All I really care about is my relationship and trust with my patients which I feel like I have. I know for a fact that I only make decisions with my patient's best interest in mind, and they know I go above and beyond for them. And if we're on the subject of erosion of trust in doctors, I would say a much larger percentage of that has to do with social media misinformation for clicks and it has to do with doctors not explaining their decision making or having the time to do so. Maybe 30 years ago if a doc told you to take this medication for your blood pressure, you'd take it no questions asked. Nowadays you have to explain what hypertension is, the consequences of untreated hypertension, what the drug does, less common side effects, etc. Theres nothing wrong with that but its often a time issue. Example: I had a friend's mom tell me the other day that her pulmonologist put her on an antibiotic to take long term. She feels like she doesn't have an infection and her sisters daughter is a nurse and told her she should never take long term antibiotics because it builds resistance and that that doctor didn't know what he was doing. She felt better when she was taking it but then stopped because of her nurse friend. So now they dont trust their doc and dont know what to do. I saw her med list and it was azithromycin 3x per week, it was for bronchiectasis. I explained to her that this is a perfectly good treatment, I explained why and how it works, and told her I would've done the same. I told her she should also be on certain other breathing treatments. She told me she was already on them. What I advised was exactly the same as what that pulmonologist advised. In one interaction theres mistrust, in the other interaction theres trust and comfort. I think those things factor more into mistrust than this idea that doctors are getting kickbacks, which btw are illegal and can get your medical license taken away.