The REAL "med" school

The REAL "med" school

In just the last year or so, I've written many times about the
distressing degree to which the major drug companies' marketing
techniques are impacting the way medicine is practiced in this
country. From primetime TV ads that subtly convince people to
self-diagnose complex medical problems (and that their only hope
is some new wonder-drug) to the grassroots lobbying (see also:
bribing) of individual doctors to prescribe drugs for unapproved
uses, the marketing of these patent medicines is OUT OF
CONTROL.

This kind of thing ought to be illegal, in my opinion (yes, I'm
all for regulation in this instance - go ahead and mark this
date on your calendar). But then, if you've been a Daily Dose
reader for more than a few months or so, you already know that.

What you may NOT already know is this: Such drug marketing
interactions are practically part of the curriculum at some
psychiatric schools. What am I talking about? The indoctrination
of medical students to not just prescribe patented medicines as
a knee-jerk solution to all mental health diagnoses (whether
they're approved for the condition at hand or not) - but also to
recommend certain newer, more expensive drugs in the place of
older, now-generic medicines.

So who's doing this "educating," you ask? It isn't PhDs. It's
the DRUG REPS from the major pharmaceutical makers!

According to a recent commentary published in The New York Times
(yep, every once in a while they get it right), many schools
where green MDs go to learn psychiatry as a specialty permit
drug sales reps nearly unfettered access to the residents. The
reps do everything they can to influence these residents to
prescribe their newest antidepressants and other drugs - and to
make sure they know (or at least believe) that these same drugs
are prescribeable for maladies OTHER than what they're approved
for. Drug companies sponsor clubs and discussions, pay for
seminar speakers, offer free dinners to residents and staff,
give out free samples of their drugs by the bag-load, and
more...

Written by an actual staffer at a major college of psychiatry,
the article even cites an instance where a female drug rep
loitered by the interns' mailboxes under the auspices of
delivering flyers about a medication - but while there, she
engaged and flirtatiously "detailed" three residents about new
(unapproved by the FDA, I'm sure) uses for her company's
antidepressants! This is exactly the kind of guerilla marketing
I've been railing about - the kind drug companies spend 4.8
billion dollars a year to perpetuate.

Finally, someone in the mainstream press is talking about this,
too. Halleluiah!

Here's the real kicker about one-on-one drug marketing:

The targeted doctors feel as though they're immune to the charms
of both the drug company perks and the smooth-talking sales reps
themselves. That's right - according to the Times piece, studies
have shown that most physicians believe that their prescribing
habits remain uninfluenced by the siren-song of these
seductions.

Yet in one study of more than 400 psychiatrists, more than half
of them said they believed the newer antidepressants (SSRIs)
were both more effective and had fewer side effects than older
medications. But meta-analysis studies conducted at Oxford,
Duke, and other prestigious institutions found that these
expensive new drugs were no more than the equals of the older
antidepressants in effectiveness - and may even be slightly LESS
effective, with just as many side effects!

This discrepancy between scientific evidence and real-world
clinical practices all but proves a link between one-on-one
marketing and the success of new, expensive, and relatively
untested medications - even when they're no "better" (that's a
relative term, believe me) than the dirt-cheap, generic
varieties.

Proponents of the current system of unrestricted drug
rep/student doctor contact include many of the residents
themselves. Their reason? To become better prepared for the real
world of medicine - where they're assaulted on all sides by
shrewd marketers hawking the latest test-tube panaceas. Now, if
that's not a stark illustration of how out-of-control drug
marketing has become, I can't imagine what would be...

It's just another snapshot of how in-the-pocket of the drug
giants mainstream medicine (especially psychiatry, but this
happens in every discipline, I guarantee it) has become - and
they aren't even AWARE of it.

Again, I say: There ought to be a law!


Schooled back when "med" meant medical,

William Campbell Douglass II, MD


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