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Traditionally doctors report using three sources of information to find out about new
drugs -- materials from sales representatives, CME conferences, and journal
advertisements. How these sources are used depends upon the specialty of the physician
and on the age of the doctor. Those in practice more than 15 years tend to rely more
heavily on drug sales representatives as a source of information about new drugs while
more recent grads tend to rely on CME courses. Several reports suggest that drug
promotional material is often used as a primary source of information for new drugs,
especially for conditions for which the doctor is uncertain. These are precisely the
conditions when we would want our doctor reading a reliable source or talking with an
expert (pharmacist).
Doesn’t it make sense for doctors to learn directly from the pharmaceutical industry?
There is no question that doctors are inadequately trained to use medications. Most
medical schools under-teach clinical pharmacology, and more importantly, few of us
teach medical students or residents how to appropriately use the expertise of pharmacists.
From a pharmaceutical manufacturer’s perspective education is about teaching the
“clinically naive” how to start using your outstandingly beneficial product. Such
activities are not educational in the slightest. They are pure promotion and in fact the
funds for this “education” come from the companies’ marketing budgets. This is
contrary to how medical schools teach our trainees.
The mantra in medical education is “evidence based curriculum” – in other words teach what the independent, non biased
studies actually show about a drugs effectiveness when compared to the most commonly
used alternative drugs. Medical educators are working to revise and update our teaching.
But educating the huge number of practicing physicians is far more difficult. Continuing
Medical Education (CME) is a requirement for doctors in nearly all states. This is
because medicine is not a fixed science but an evolving art. New knowledge quickly
supplants old and doctors, who would otherwise choose to see more patients, are often
hesitant to take time off to study and learn new material. CME has become an important
part of doctors’ professional lives and Pharma money has become the life-line of
CME. As every editor of a medical journal knows, and most providers of CME know, doctors
are hesitant – some might say unwilling – to pay a fee for quality learning material. This
is why journals are dependent upon advertising revenue and why professional societies
such as the AMA, the
American College of
Physicians, Society for Critical Care
Medicine and the Thyroid Society are all beholden to drug companies. The recent
prestigious American College of Physicians (ACP) annual meeting had nearly every
event and every possible minute underwritten by Pharma. In fact, in contrast to their
written ethical standards they chose to promote themselves to drug companies with the
following claim, “…an unparalleled opportunity to meet physicians with
power…prescribing power”.
The medical profession and Pharma have an unhealthy symbiotic relationship that is
pulling down the medical profession. The professional groups provide the doctors and
the drug companies provide the money. Medical journals, medical societies, and even
medical schools fight to woo drug company sponsorship of educational events. Without
their sponsorship CME activities would be more basic, less high-tech, and perhaps it
would cost a bit more to attend but they would be honest, accurate, and trustworthy.
Pharma maintains it is providing an “educational service” – even though Pharma provides
the food, the speakers, the slides, and the agenda. But it takes two to tango and the
medical profession – particularly academic medicine should be embarrassed. We’ve
allowed our faculty to become tainted – rather than insisting they be the arbiters of
goodness and truth. We’ve allowed our training mission to serve a dual mission – true
education and Pharma promotion.
Related articles: How
to doctors come to know about new drugs?
Interaction
of drug firms and physicians FDA
did not disclose FDA panel's conflicts of interest Vioxx
and Bextra decision by FDA panel in doubt due to
doctors' conflicts of interests Merck
manipulated FDA in Vioxx recall case
Ethics
of marketing new drugs to doctors Relationship
of pharmaceutical companies and doctors Impact
on prescription behavior due to marketing by pharma
companies
Overall
impact of drug promotion and advertising on pharma
industry |
