So here I am walking out of the bathroom, my hands still damp, when who should greet me but X, my ever-cheerful drug rep. Drug reps are hired to make friends with doctors. After they make friends, drug reps provide information. The information helps doctors prescribe more drugs.
Families, insurance companies, and the government pay for the drugs; the money goes to the drug companies. Some of the money - a lot of it, actually - pays the salaries of the drug reps. It also pays for meals for the doctors. Meals are an important part of the drug rep's toolkit because they allow drug reps to give doctors more information (that is, sell more drugs.) I understand that the dinners are pretty nice.
Drug companies often claim that they have to charge a lot for their drugs, because they cost so much to develop. What the companies usually don't say is that the cost of marketing a new drug is often even more than the cost of discovering it.
Still, X is a very nice person, and she can be truly helpful. For example, she gives out coupons for free samples of her company's drugs. I use these coupons for children who have lost their Medicaid, and whose parents can't afford to pay for the drugs themselves. Of course, if the drugs were less expensive, Medicaid might be in better shape, and more parents might be able to buy the drugs themselves. But, as Dick Cheney might say, you go to the drugstore with the system you have, not the system you might want.
Which brings me to the topic of lobbying. It occurs to me that what my friendly drug rep does is just like what goes on in Washington all the time. In Washington, lobbyists buy lawmakers drinks and dinner and other things, in order to have the opportunity to talk with them and develop relationships. Those relationships make it easier for lobbyists to deliver their messages to the lawmakers. In the same way, and for the same reasons, drug reps work hard to build relationships with us doctors.
In both cases, the person left out of the relationship is you, the tax payer, the patient, the parent. I'm not sure how to fix the Washington lobbyist problem, but a law introduced in the Senate last year by Senators Feingold, Lieberman, Obama, and Tester looks like a step in the right direction. Among other things, it would stop lobbyists from buying lawmakers lunch. Maybe if the elections go well, we'll have a federal law that covers drug lobbyists, too.
In the meantime, what can you do? As a citizen, you can let your elected officials know how you feel, and you can elect officials who feel as you do. As a patient and parent, you can look for a doctor who keeps the drug company lobbyists at arm's length.
If you feel uncomfortable asking about your doctor's relationships with the drug companies, consider this: For the last several years, it has been common practice for doctors who publish research or talk at conferences to declare whether or not they accept funding from a drug company. The idea is to expose any possible conflict of interest. Why not hold the doctors who are responsible for your child's health to the same standards?
I suspect that some of you will wonder why you've wasted your time reading this far. After all, your child's doctor would never let a little thing like lunch or dinner sway his or her medical judgment. I suppose all those friendly drug reps are just wasting their time.
