For those who don't know or can't recall that is what once was known in the English language as the comparative case. You know, slow, slower and slowest; fat, fatter and fattest; dumb, dumber and dumbest. In today's WSJ--and the Journal is noted for doing what it accuses others of frequently, running fairly smelly articles without digging deeper before publishing them--we get another one. In this case a front page one, "Study Says Gifts Affect Physicians' Drug Choices."
We're most likely the penultimate person on the planet to come to the aid of the medical profession or big daddy pharma. With that disclaimer out of the way, we can now get to the smell test. The crux of the article is clear, drug representatives, also known in even bigger circles as lobbyists, bring free lunches and other such goodies when they call on doctors and those free meals cause these doctors to prescribe more expensive drugs than non-generic alternative medicines.
Critics say drugmakers’ payments and gifts to doctors can improperly influence medical decisions and inflate drug costs by steering doctors to pricey brand-name drugs. In the face of such criticism, drugmakers have tried to rein in some of the more lavish perks, like free golf trips and tickets to hot sporting events. In 2002, PhRMA adopted a voluntary code governing dealings with doctors. It states, for instance, that companies shouldn’t provide tickets to the theater or sporting events, or vacation trips, to any health-care professional who isn’t a salaried employee of the company.
But the code allows for providing modest meals to doctors. Drug-sales representatives routinely bring free food and beverages to doctors’ offices in an effort to get face time to promote their medicines. They also invite doctors to free dinners at restaurants to hear other doctors speak about certain drugs. The industry says the practice helps to educate doctors about the appropriate use of new medicines.
The author, Peter Loftus, pens this smelly sentence: "Prior studies have shown that large payments can sway physicians’ prescribing habits." Wow! That's an earful, a real revelation. Since physicians are still, at least as far as we know, members of the human species, a group noted for succumbing from time to time to fear and greed, here's a question.
Can those large payments sway--and have they ever before--elected officials from the lowest to the highest offices when making decisions that affect many, many people? And at what cost and to whom? Our money says it's commonplace. Anyone want to cover that bet? Or do those officials ever receive free meals on or below the table? Some might call it a stretch of imagination--others pure lunacy--that every time one of our elected representatives in Washington goes out to lunch or dinner with a lobbyist, he or she picks up the tab for his or her own meal.
Now the Journal rolls out the prerequisite so-called expert, in this instances a pulmonologist with the requisite pedigree of degrees, MD, MBA from the requisite schools. Now after we're all finished rolling over on our backs with all four paws upright or jumping up and down three straight times hollering: Whoopee! Whoopee! Whoopee! there are some other questions that need to be answered in the name of that term all interventionists love, transparency.
The new study shows that even relatively small payments or gifts are associated with increased prescribing of the promoted brands, said the lead study author, R. Adams Dudley, a professor of medicine and health policy at the University of California, San Francisco. That revelation implies that people can be influenced on the cheap. Wonder if all those Washington-based lobbyists realize this. They could probably be saving lots of money.
Since the good doctor is trying to affect public policy which means many, many lives again, he can no longer hide behind the veil of being a private citizen. He could, a cynic might argue, be a lobbyist.
In the interest of public disclosure he needs to publish on the Internet certain information like whom did he vote for in the last presidential election and whom is he supporting, if anyone, in this one. He needs to reveal several years of his tax returns to see if he has ever been on the payroll---a kinder term in the profession is honorarium--of politically-driven or agenda-driven organizations.
Was he an advocate for the Affordable Care Act and, if so, is he still an advocate? Given his expertise and his position of influence these are all reasonable bits of information the public has a right to know. As do those accused physicians. No suggested crime here, just more of what he and his study claims he wants, full disclosure.
We will be waiting, Dr. Dudley.
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