Doctors — reject the ‘free lunch’ and renew our trust

The Pfizer poster pinned to the wall at my local medical clinic made me wince. Most of us are suspicious of a sugar-daddy-type affair happening…

The Pfizer poster pinned to the wall at my local medical clinic made me wince.

Most of us are suspicious of a sugar-daddy-type affair happening between physicians and the drug industry, and we certainly aren’t fooled by a drug advertisement thinly disguised as pure education.

But what the Pfizer poster shouted at me is that things are worse than I thought — could doctors be so cozy in their relationships with the drug companies that even the optics of this propaganda hanging above their examining tables fails to stir them?

Now, finally, this troublesome relationship is the talk of the town, thanks to a recent editorial in the Canadian Medical Association Journal.

“We seem to have conveniently forgotten that the pharmaceutical industry is in business to make money, not to educate health professionals,” said the editor of the Canadian Medical Journal, Dr. Paul Hebert, in his the strongly worded editorial.

Hebert goes on to write that the pharmaceutical industry’s lavish treatment of doctors, which can include free tickets to the ballet and professional sporting events, cruises and access to exclusive golf courses has created a culture of entitlement among physicians.

No doubt this drugging of the ego can impair a physician’s judgment when it comes to pharmaceuticals, especially when these lavish pharma conferences are promoted as “educational,” and when little else in the way of professional upgrading is being offered.

Herbert wants Canada’s physicians to break if off with the drug companies and “place our continuing medical education system firmly in the hands of unbiased and qualified people, not corporations whose main concern is the bottom line.”

He’s right, of course; what Canadian would disagree?

It’s not really our problem where the money will come from, if not from a private corporation. But I’d say our tax dollars will do fine for this worthy cause of keeping our doctors humble and educated, and out of the pockets of drug pushers.

A Whitehorse man we’ll call George is convinced he doesn’t have a doctor because he won’t take drugs.

George, who has made an official complaint with the Yukon Medical Association, asked that his name be changed while his case is under consideration.

George was taking blood pressure medications for five years until a heart specialist told him there was nothing wrong.

But, for lack of an alternative diagnosis to George’s intermittent symptoms, his doctors continued prescribing the heart meds.

George broke it off with his last general practitioner two years ago and has been without a GP ever since, a pretty scary situation for a 66-year-old-man with chronic respiratory problems.

To find a new GP in February, he went to a meet and greet he saw advertised in the newspaper in which a local clinic made up of several physicians was interviewing prospective new patients.

George failed the interview. “They probably rejected me as a patient because I didn’t fit their easy business model,” he says.

George is more than cynical — he is angry. He knows all too well how the “free lunch” system works, especially here in the Yukon where doctors are running their own businesses in a fee-for-service system.

Every time George — or any of us — goes into the doctor’s office for a prescription, the doctor can bill the government. It doesn’t matter if the appointment lasts 15 minutes or three seconds.

And if you sign up for high-blood-pressure meds, you’re a cash cow. George says he felt like someone’s “lifelong cash register.”

George’s issue isn’t money. Like many of us, he gets most of his prescription costs reimbursed by his medical insurance policy.

He just feels used and uncared for by doctors. And that’s just too cruel.

If this is how patients are feeling in Canada, then the physician industry must do something. And changing its relationship with drug companies — and here, in Whitehorse, its fee-for-service relationship with the government — would go a long way to reassure us that our doctors are neither compromised, cold-hearted or stupid.

Herbert says there is evidence that suggests medical education heavily subsidized by big pharma “embellishes the positive elements of studies and downplays the adverse effects.”

And drug-company-sponsored medical education is so skewed in favour of prescribing drugs that education about treating patients, in general, is neglected.

“If you’re talking about depression management, it’ll all focus on drugs and not on cognitive behavioural therapy, screening techniques — you name it,” he says.

“We give drugs to people every single day; it’s part of being a doctor … Patients need to feel that we’re doing it with their best interests in mind all the time.”

The “pharma-driven ‘free lunch’ approach” needs to end, says Herbert.

George agrees.

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