The LA Times has been running a series of articles on the influence of drug companies on doctors. Whatever the merits of the articles may be, I found the opening of one of them to be particularly interesting. Here’s the spin:
- FOR many Americans, a doctor’s decision to prescribe medication is something of a sacred transaction. A physician considers the patient and symptoms and chooses the best drug for the job, drawing upon years of training and clinical experience. It is an exchange conducted in a hushed sanctuary, far from the heat and noise of the marketplace — a place where cool judgment reigns.
- That sanctuary has been breached. Today, drug manufacturers do everything in their considerable power to ensure that their brand-name prescription medications are on the lips of patients and in the minds of physicians every time the two meet across an exam table. A growing chorus of critics says their efforts have begun to rewrite the dialogue between patient and doctor, influence physicians’ judgments and open the act of prescribing to forces more profit-minded than sacred.
Now, perhaps my experience is different from most, but I simply don’t recall St. Peter being the receptionist at any of my recent doctor visits. I didn’t go through the pearly gates at the entrance, and the examining room certainly wasn’t a Garden of Eden.
So what we have here is an attempt to set up a straw man of some idealized past doctor-patient relationship, so that now drug companies can be portrayed as the serpents who invaded the garden.
Here’s my question: in truth, was a doctor’s decision to prescribe medicine really ever a “sacred transaction,” akin to some medical priest treating with us in the hushed confines of the exam room confessional? And if it was (and I have my doubts), what other factors besides drug company influence have changed the dynamic?
Before I start, I am admittedly biased. I’ve worked in the nutrition industry for years and have become a big fan of nutrition-based prevention, so take it for what it’s worth.
With that said, I think the LA Times writer is onto something. Was the relationship sacred before? Probably not, but it at least appeared that way. Now, it’s obvious that more patients are going to doctors requesting Lunesta, or Cialis, or FloNase, or whatever commercial they’ve most recently seen. And it puts doctors in an awkward situation. If they refuse, the patient often times just goes and finds a doctor who will prescribe what they want. So, in the name of good business, they give the customer what they want.
But most of us as patients really have no idea what drug will work best for us, and it’s scary to think that the best commercial or the drug rep who drops off the most donuts at the doctor’s office is determining what doctors prescribe.