Big Pharma

It’s ironic that The American Medical Student Association is “the only mainstream medical organization with a principled position against taking industry gifts.” As Carl Elliot suggests, the pharmaceutical companies’ more aggressive market-based tactics are a relatively recent trend. However, it’s surprising that doctors who have been practicing longer and lived through this propaganda shift seem, in this sense, more receptive to pharmaceuticals’ bribing tactics. In contrast to the association of currently powerless (in comparison to physicians) medical students, it’s horrifying to see the American Academy of Family Practice’s response to No Free Lunch. After the initial shock and wave of cynicism, however, I began to take on a more optimistic view of this paradox.

Again, it’s during the late 90’s that this new wave of aggressive tactics by the pharmaceutical companies began. On one hand, the current medical students’ wary stance against pharmaceutical-physician relations indicates a very high level of ethical vigilance instilled in yet young physicians-to-be.

No Free Lunch’s advice to “Just say no to drug reps” all together, made me wonder if this ethically and pragmatically puzzling issue of relationships with pharmaceutical companies should be passed onto the hospital administration-level. This is highly theoretical, since this would require strict forbiddance by hospitals of any medical or hospital staff’s relationship with any pharmaceutical sales rep. The hospital administration would allocate a special force or board in negotiating talks with pharmaceutical representatives, and this board would collaborate with committees dealing with hospital ethics or finances. Would such a system liberate or confine the integrity and pragmatic resources of physicians in the United States?

Carl Elliot also questions the identity of physicians in the current age. As suggested by Lantos’ apt example of shoes without cobblers, healthcare and physicians, while not (yet) mutually exclusive, no longer are synonymous. Since by definition, pharmaceutical companies are profit-driven businesses, I would argue that healthcare needs to be salvaged from a market-minded framework. Physicians are clearly fallible, but they are a human sector whose fundamental drive is, historically and even today, good will. Physicians in the United States are, as Elliot points out, bound by the Hippocratic Oath. Should healthcare move away from the paternalistic shadow that physicians can sometimes represent? Sure, but not when the next Big Brother is Big Pharma.