Some of you know I'm a practicing physician.

I have, until last week anyway, tolerated representatives of the pharmaceutical industry (drug reps) as a necessary evil in order to make available sample medications to patients, both to help defray their costs and as initial trials to be sure a particular medication both works and is well-tolerated before a patient has to incur cost.  Despite the widespread belief that doctors are in the pockets of the drug companies, the truth of the matter is considerably different.  I've been civil and courteous to drug reps and set aside time to meet with them; they're just doing their jobs, after all.  But we push them all the time about the high cost of their drugs and push them about why our patients should spend $$$ on derivative (me-too) drug XYZ when drug ABC costs $.  There are certainly many circumstances where I feel a more expensive medication is better for a given patient and advise them so, but they are free to accept a less expensive alternative after I explain my reasoning.  The widely-believed notion that we just push the newest & most expensive pills, because of all the money allegedly lavished on us by drug companies (and for no other reason), is just a myth.

The drug companies have taken a lot of heat from the left over the years for their allegedly cozy relationships with physicians and retail pharmacies.  Such heat was a big part of the impetus behind the creation of PhRMA.  Laws, accompanied by heavy penalties including jail time, have been put in place to regulate their behavior, based on the principle that all money de facto corrupts (though how much corruption you can buy with free ballpoint pens is up for debate).  These were in addition to voluntary limits on physician interaction already put in place by PhRMA.

Now PhRMA has leaped into the Major Leagues of influence-peddling with their decision to promote, sight unseen, no matter what ends up in the damn thing, healthcare 'reform.'  To the tune of up to $150 million in advertising urging its adoption, more than the entire advertising budget of the McCain presidential campaign.  The left has been disquietingly quiet about BO climbing into bed with them, though there have been some murmurs, and now even Wolf Blitzer is putting what passes for 'CNN heat' on the White House (see external link).  They've 'pledged' to reduce drug costs by $80 million dollars a year for 10 years.  Why waste $150 million?  Just reduce costs another $15 million a year and be done with it - that's serious money that could be put to good use helping real patients with real needs.

So, I'm no longer meeting with drug reps from companies which are PhRMA members and letting them know why.  I am a mere flea on the butt of the PhRMA elephant, to be sure, but I consider PhRMA's actions, negotiated behind closed doors (certainly NOT on C-SPAN), simply obscene.  They should be ashamed.

You probably won't be surprised to learn that most physicians, despite the AMA (to which only about a fifth of physicians belong) and the American College of Physicians (to which I belong), oppose the reforms that are on the table so far.  You might think it's because we expect to get the short end of the stick when all is said and done, and you would be right.  That'll be a topic for another thread, however.