This post at KevinMD has blown up and is generating significant interest.
Since writing it I was contacted by CNN, they talked about wanting to do a series on America’s addiction to medications and what sounded to me like the various excesses of drug companies to try to get people to take those medications. They wanted me to comment on the various excesses of Pharma from a physician’s perspective. They were interested in hearing about all the things the drug companies give us, specifically, free stuff, give-aways, trips, golf outings. . . you get the point. I explained that I had no experience with such things, nor did I know of anybody who had, and probably was not the right person to talk to.
I feel like in this discussion, we private practice physicians are guppies in a big ocean. The occasional office lunch amounts to essentially (excuse the pun) small potatoes compared to the influence that pharma has had on the opinion makers, and subsequently, in the drafting of practice guidelines (such as recent lipid guidelines or the use of activated protein C in sepsis). In this, the influence is insidious; it exists largely in rooms that are closed to the rest of us. The influence is not nearly as extroverted and obvious as CNN (and the rest of us) would like to see. However, I agree with many of you that having drug reps bringing lunch into the office at the very least gives the impression of influence, and may not be a practice that we as physicians can defend much longer. In retrospect, I wished I had agreed to the interview with CNN, only for the sweet irony of my interview being followed by a commercial featuring two elderly people sitting in bathtubs on top of a hill. . .