Eat my bagels, and prescribe my drugs!
April 9, 2010 9:05 AM Subscribe
Please help me find a doctor who is not influenced by the pharmaceutical industry!
I am greatly unsatisfied with my current PCP because of a recent encounter where I feel he totally ignored what I was saying and prescribed me a medication that is inappropriate, not what I asked for, and way more expensive than other medications out there. There were no less than 4 pharma reps floating in and out of the office, and one even bought lunch for the office while my wife was waiting for me to come out. The office was littered with every manner of pharmaceutical company swag out there. I think I saw an oldster leave with a Zoloft-labelled walker.
Are there any databases of doctors who don't accept swag from pharmaceutical companies? I've seen No Free Lunch, but there are no doctors in my immediate area that are appropriate for me. Are there any other groups of doctors or resources for patients that are dedicated to eliminating this scourge?
If I can't find another way, I suppose I will just have to visit all the offices and see which one is littered the least with that pharma company crap.
My location's in my profile.
I am greatly unsatisfied with my current PCP because of a recent encounter where I feel he totally ignored what I was saying and prescribed me a medication that is inappropriate, not what I asked for, and way more expensive than other medications out there. There were no less than 4 pharma reps floating in and out of the office, and one even bought lunch for the office while my wife was waiting for me to come out. The office was littered with every manner of pharmaceutical company swag out there. I think I saw an oldster leave with a Zoloft-labelled walker.
Are there any databases of doctors who don't accept swag from pharmaceutical companies? I've seen No Free Lunch, but there are no doctors in my immediate area that are appropriate for me. Are there any other groups of doctors or resources for patients that are dedicated to eliminating this scourge?
If I can't find another way, I suppose I will just have to visit all the offices and see which one is littered the least with that pharma company crap.
My location's in my profile.
Response by poster: Don't know why my link got screwed up, but here it is again: No Free Lunch.
posted by Geckwoistmeinauto at 9:14 AM on April 9, 2010
posted by Geckwoistmeinauto at 9:14 AM on April 9, 2010
Check out Temple or UPenn's policies. I'm at a university-affiliated hospital and we aren't allowed pharm reps (oxygen reps are, as of right now, still exempt) that aren't at the very least vetted by the hospital for appropriate conduct. No meals, either. (The patients bring us plenty :)
posted by cobaltnine at 9:29 AM on April 9, 2010
posted by cobaltnine at 9:29 AM on April 9, 2010
You might want to check out some integrative medical docs who tend to lean less on pharma drugs to heal the body. These are medically trained doctors who are either (on their own) add in holistic approaches or have been trained to be more integrative in their approach. I'm not sure where to find them specific to your area, but check out American Holistic Medical Association, Arizona Center for Integrative Medicine, American Holistic Nurses Association and Preventive Medicine Research Institute. Good luck. It's nice to see someone being a responsible health consumer and thinking beyond taking drugs, good on you.
posted by healthyliving at 9:47 AM on April 9, 2010
posted by healthyliving at 9:47 AM on April 9, 2010
Thirding a call to hospital systems in your area to ask about their policy on this and then choosing a PCP from one that doesn't allow physicians to accept anything from pharma reps.
posted by Meg_Murry at 10:02 AM on April 9, 2010
posted by Meg_Murry at 10:02 AM on April 9, 2010
I am greatly unsatisfied with my current PCP because of a recent encounter where I feel he totally ignored what I was saying and prescribed me a medication that is inappropriate, not what I asked for, and way more expensive than other medications out there. There were no less than 4 pharma reps floating in and out of the office, and one even bought lunch for the office while my wife was waiting for me to come out. The office was littered with every manner of pharmaceutical company swag out there. I think I saw an oldster leave with a Zoloft-labelled walker.
FWIW I would go back to the original Doctor, and tell him this. Exactly as you put it.
Then consider leaving before he can bill you.
posted by thermonuclear.jive.turkey at 10:07 AM on April 9, 2010
FWIW I would go back to the original Doctor, and tell him this. Exactly as you put it.
Then consider leaving before he can bill you.
posted by thermonuclear.jive.turkey at 10:07 AM on April 9, 2010
You might also consider talking to the state medical board?
posted by arimathea at 10:14 AM on April 9, 2010
posted by arimathea at 10:14 AM on April 9, 2010
I completely understand where you are coming from on this one. You might want to consider a DO (Doctor of Osteopathic Medicine), as they take a more integrative approach to treatment rather than prescribing the newest brand name drug. They are most likely considered as PCP's in your state, if you have the type of insurance that requires PCP selection, but just double check to be sure.
What is a Doctor of Osteopathich Medicine?
posted by smalls at 11:47 AM on April 9, 2010
What is a Doctor of Osteopathich Medicine?
posted by smalls at 11:47 AM on April 9, 2010
Response by poster: The other physician in the office is a DO who was meeting with the pharma reps as well.
arimathea: the NJ medical board would not give any advice on how to select a doctor, nor their relationships with pharma companies.
posted by Geckwoistmeinauto at 12:06 PM on April 9, 2010
arimathea: the NJ medical board would not give any advice on how to select a doctor, nor their relationships with pharma companies.
posted by Geckwoistmeinauto at 12:06 PM on April 9, 2010
The new Phrma Code has put a stop to much of this, although adherence to the standards is not mandatory. It sounds like this doctor has poor communication skills. You want to find one with better skill in this regard.
posted by caddis at 12:32 PM on April 9, 2010
posted by caddis at 12:32 PM on April 9, 2010
I find it odd that people get so worked up about a doctor getting a few free plastic pens or an occasional lunch, yet our lawmakers can accept millions and millions of dollars from same Pharma companies, and that's just fine and dandy.
My opinion - maybe you just don't have a good doctor. I would focus less on finding someone who has a strong policy against accepting freebies (they're not all bad....free samples, anyone?) , and instead ask around and find out who is happy with their doctor.
posted by texas_blissful at 1:10 PM on April 9, 2010 [2 favorites]
My opinion - maybe you just don't have a good doctor. I would focus less on finding someone who has a strong policy against accepting freebies (they're not all bad....free samples, anyone?) , and instead ask around and find out who is happy with their doctor.
posted by texas_blissful at 1:10 PM on April 9, 2010 [2 favorites]
Response by poster: Blissful, here's a scenario that I think sucks:
Person goes to doc with an ailment which must be treated with drugs. They have very little money, and cannot pay for drugs. Doc gives free samples which begins to treat the problem. Time passes, samples continue. Eventually, the marketing budget dries up, and the doc cannot offer free samples anymore. What happens to the patient now? Samples are usually only available for the most profitable (and that usually means expensive, proprietary) drugs around, so the patient is pretty much hooked on an expensive drug. Get the first hit for free, and then once you're hooked, pay royally. I don't want to encourage such behavior.
posted by Geckwoistmeinauto at 1:37 PM on April 9, 2010
Person goes to doc with an ailment which must be treated with drugs. They have very little money, and cannot pay for drugs. Doc gives free samples which begins to treat the problem. Time passes, samples continue. Eventually, the marketing budget dries up, and the doc cannot offer free samples anymore. What happens to the patient now? Samples are usually only available for the most profitable (and that usually means expensive, proprietary) drugs around, so the patient is pretty much hooked on an expensive drug. Get the first hit for free, and then once you're hooked, pay royally. I don't want to encourage such behavior.
posted by Geckwoistmeinauto at 1:37 PM on April 9, 2010
Pharmaceutical company reps are a fact of life at most medical offices. Laws have been passed, I believe, limiting what kind of free things they can give doctors- and they find new marketing techniques (sponsored educational lectures at fancy restaurants, for instance). If pharmaceutical companies can't give away free pens, equipment suppliers and home health agencies and everyone else in an industry that relies on prescriptions fill the marketing void.
You can't judge a doctor based on what they have in their office, though. Any busy office will have reps around (usually trying to hassle the doctors while they try to work, from what I've seen) and get free lunches. That's not a reflection on the doctor, necessarily, but on the marketing side of the pharmaceutical industry. You seem to have found a one time correlation between your doctor being the target of marketing and providing poor care, but I don't see how you're justifying a causal claim. How has your relationship with this doctor been in the past? Did you ask them why they prescribed the medication they did? Even if they aren't a good doctor, they presumably have some idea of what they're doing. Perhaps this treatment has worked well for their other patients with your symptoms in the past. Maybe the medication you were "asking" for is inappropriate. Maybe the details you feel your doctor ignored are actually irrelevant.
Now, you may have a bad doctor- if they won't answer your questions, if the treatment they prescribed doesn't work, or if this is a part of a pattern of behavior, look for a new doctor for sure. But don't assume that a doctor being targeted by marketing means their behavior is influenced by it. We all live in a world filled with advertising, and yet not everyone falls for it. And if you have a serious problem with the care you're being provided, using the presence of marketing or lack of it as a metric for judging a new doctor is not the right way to go about it.
posted by MadamM at 3:16 PM on April 9, 2010 [1 favorite]
You can't judge a doctor based on what they have in their office, though. Any busy office will have reps around (usually trying to hassle the doctors while they try to work, from what I've seen) and get free lunches. That's not a reflection on the doctor, necessarily, but on the marketing side of the pharmaceutical industry. You seem to have found a one time correlation between your doctor being the target of marketing and providing poor care, but I don't see how you're justifying a causal claim. How has your relationship with this doctor been in the past? Did you ask them why they prescribed the medication they did? Even if they aren't a good doctor, they presumably have some idea of what they're doing. Perhaps this treatment has worked well for their other patients with your symptoms in the past. Maybe the medication you were "asking" for is inappropriate. Maybe the details you feel your doctor ignored are actually irrelevant.
Now, you may have a bad doctor- if they won't answer your questions, if the treatment they prescribed doesn't work, or if this is a part of a pattern of behavior, look for a new doctor for sure. But don't assume that a doctor being targeted by marketing means their behavior is influenced by it. We all live in a world filled with advertising, and yet not everyone falls for it. And if you have a serious problem with the care you're being provided, using the presence of marketing or lack of it as a metric for judging a new doctor is not the right way to go about it.
posted by MadamM at 3:16 PM on April 9, 2010 [1 favorite]
I'm just trying to brainstorm a little, because I think the 'bad doctor' line of reasoning is probably true but doesn't help you pick a new doctor, and because I definitely don't recommend homeopathic or 'holistic' alternative treatments as a replacement for regular medicine. I have also been stung awfully by doctors trying out 'new treatments', both economically (new drugs often hide their use of your benefits through subterfuges like discount cards) and in respects to my health (i.e. I've been switched from treatments that work to 'better' treatments that don't), so MadamM's point sounds more like rationalization of a bad system than anything else. It reflects poorly on a doctor to accept lunch from people selling pharmaceuticals. It does. If it didn't work to promote drugs that people wouldn't take otherwise, then the reps wouldn't spend the money.
I was surprised, when I moved out of NJ, how much I liked the low-rent, walk-in only Citizen's Medical Group, which was designed for patients with and without insurance. That span means that they deal with the vast majority of complex cases through referral, and focus specifically on getting you better in the way that's best for you and your insurance package. They were also not dripping with stuff -- I think because they're not moving a lot of the priciest drugs, and because they see their goal as patient care rather than advanced medicine. So perhaps looking at bigger clinics rather than small private practices would be helpful? Perhaps practices that aim at mixed income patients? Larger practices may also have a more centralized relationship with pharma reps, which means controls over individual physician access to direct lobbying.
posted by Valet at 6:16 PM on April 9, 2010
I was surprised, when I moved out of NJ, how much I liked the low-rent, walk-in only Citizen's Medical Group, which was designed for patients with and without insurance. That span means that they deal with the vast majority of complex cases through referral, and focus specifically on getting you better in the way that's best for you and your insurance package. They were also not dripping with stuff -- I think because they're not moving a lot of the priciest drugs, and because they see their goal as patient care rather than advanced medicine. So perhaps looking at bigger clinics rather than small private practices would be helpful? Perhaps practices that aim at mixed income patients? Larger practices may also have a more centralized relationship with pharma reps, which means controls over individual physician access to direct lobbying.
posted by Valet at 6:16 PM on April 9, 2010
I love my primary care physician. His name is Dave Zalut and he works out of South Jersey.
posted by melodykramer at 9:30 PM on April 9, 2010
posted by melodykramer at 9:30 PM on April 9, 2010
This thread is closed to new comments.
posted by Sophie1 at 9:07 AM on April 9, 2010