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Physician Paternalists Bring Out Big Guns

Posted Oct 28 2008 9:57pm
The New England Journal of Medicine published a study today examining physician relationships with drug companies. According to the study authors, more needs to be done to address their concerns about physician-industry relationships.

I’m sorry. I’m so tired of the paternalists saying that doctors are manipulated by drug reps because they bring pens and salads. If these relationships are so detrimental, why don’t doctors stop seeing reps? More importantly, what evidence do the paternalists have that these inactions are bad? (Hint: This study does not provide any evidence to support those assertions.)

Just like the PLoS study by Adriane Fugh-Berman and Shahram Ahari which was underwritten by trial lawyers through their paid-for testimony in court cases, this study is also suspect. Study authors Eric Campbell and David Blumenthal of the Institute for Health Policy at the Massachusetts General Hospital and Harvard Medical School both have strong and compelling anti-industry ties. The Institute for Health Policy does not disclose its sources of funding on its website.

David Blumenthal epitomizes the physician paternalists. He argues doctors are so corrupt and deluded that they need every aspect of their professional lives to be regulated by the government. He states, “We have given physicians a lot of freedom to govern themselves and to voluntarily follow guidelines set by the profession. If they are unable to monitor and manage these practices, there will be increasing pressure on government to do it for them.” Brilliant.

And what compelling evidence has led Blumenthal to the radical position of a government-sanctioned crackdown on doctors? It is this: 94 percent of doctors report that they have had one interaction with the pharmaceutical industry (be it lunch or free samples to help their poor patients).

The only conclusion that can reasonably be drawn by this study is that nearly all doctors have had some interaction with the pharmaceutical industry. And that’s it and nothing more. There is nothing in this study to suggest that those interactions exert undue influence or harm patients. In fact, quite the opposite appears to be true from other studies—the physicians who do interact with reps receive samples that benefit poorer patients.
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