A doctor-patient relationship is one of the most vital relationships many people will have in their lifetime. Patients trust their physicians to recommend the safest and most effective forms of treatment for illnesses ranging from the common cold to life-threatening cancer. Patients expect their physicians to give them unbiased advice based on years of experience and each person's individual case history.
Are these expectations being met?
Over the past few years, pharmaceutical companies have been experiencing an economic boon that has not been seen in any other industry. Companies are earning and spending billions of dollars each year on prescription drug advertising designed to convince physicians that their drug is the best drug. Advertisements in medical journals, drug companysponsored galas, and even personal sales visits that can earn physicians thousands of dollars a year are all regular occurrences.
For example, a small-town doctor spent a weekend in New York City at a seminar sponsored by Pfizer, the makers of sildenafil (Viagra). He walked away with more than $10,000 dollars worth of "freebies," including an all-expenses-paid trip to a resort in Florida, dinner cruises, hockey tickets, a ski trip for his family, and free computer equipment. Other physicians accepted free massages, food, and portraits. A company that manufactures an antacid drug was giving away fire extinguishers.
"It's very tempting, and they just keep anteing it up," said one physician, "I feel in some ways it is kind of like bribery."
Will the next patient who is examined by this physician be given a fair and unbiased diagnosis? If there is a chance that a safe alternative therapy would be a better option, will the doctor instead prescribe an unproven, and possibly dangerous, drug that is produced by a company that is bankrolling his vacation?
Individual physicians, however, are not the only ones feeling tempted to receive money offered by the drug companies. The New England Journal of Medicine recently relaxed its strict conflict-of-interest policy because, of a shortage of publishable authors who had no ties to the pharmaceutical industry. Since 1990, the Journal's rule was that no one could publish an article who had any financial interest in a company that made a product discussed in the article or in one of the product's competitors.
Now the Journal restricts authors who have a "significant" stake in a product's interest. Payments over $10,000 are considered significant. In 2000, the Journal admitted that it had violated its own policy 19 times in the previous three years.
Some pharmaceutical companies have gone as far as to write articles themselves, and then search for a reputable doctor to attach his or her own name as the author.
"Some of us believe that the present system [of ghostwriting] is approaching a high-class form of prostitution," said Fuller Torrey, executive director of the Stanley Foundation Research Programs in Bethesda, Maryland.
What of the drugs themselves? A perfect drug that is free of adverse effects does not exist. On the contrary, evidence suggests that many potentially life-threatening drugs are being prescribed in great numbers each day. A study published in the New England Journal of Medicine shows that complications from taking older anti-inflammatory drugs-- such as rofecoxib (Vioxx(R)) and valdecoxib (Bextra(R))-results in hospitalization of more than 107,000 patients each year in America, whereas ulcer complications kill approximately 16,500 patients each year. …