Wednesday, April 9, 2014

Dear Drug Company: Thanks, but I'll Pass on the Free Food

During pharmacy school, my classmates and I were promised a future with seemingly endless streams of cash - $$$$$$$$$$$$$$$$$$$$$$$$$$$$.

In fact, I remember on several occasions when one of my pharmacy professors would bring this up in a joking, yet lighthearted manner each time we'd face a grueling assignment or exhaustive exam in his class. "Just remember, you make lots o' money one day as pharmacist," he'd say in his fun-loving, Southeast Asian accent, as he rubbed his index finger and thumb together towards us. He meant well and was a very nice man, one of our class favorites actually. He always seemed to make things more bearable while going through academic torture during those tough years in pharmacy school.

Those were certainly grueling times and the financial payoff turned out to be true. I tell this story in a previous article of mine - Lessons From A Pharmacist - I Get a Big, Fat Paycheck While You Stay Sick.

What strikes me as odd though—especially as I get older—is why we have 'systems' in place that seem to cater to the well-to-do in society? Why do doctors, pharmacists, and other healthcare practitioners—who make a very nice living—get all the perks? After all, we are all human beings and put our pants on one leg at a time just like everyone else in life. So why the freebies—from corporations who make billions, to individuals that make millions (over their lifetime), so corporations can make more billions? I don't understand the purpose.

What I'm referring to is money, gifts, and meals given to doctors, pharmacists, and other healthcare practitioners by multi-billion dollar pharmaceutical and medical device companies in order to gain 'favor' with these same practitioners to use their newest blockbuster drug or fancy device. (Check out the Dollars for Docs database to get a better idea of the specifics.)


Free Food for the Wealthy

Since my days of working as a pharmacy [student] intern in a retail pharmacy, to today working in an inpatient hospital setting, I've seen lots of changes in the drug-promoting business.

When I was a student, it was not uncommon to get a visit from an attractive, young sales rep at least weekly or biweekly in our pharmacy. He/she would bring in bags of goodies—free pens, notepads, clipboards, and interesting trinkets—to pass out to the pharmacy staff. They'd also bring in a briefcase full of brochures and information on the latest and greatest drug they were promoting. This information would be handed to the pharmacist for review while a friendly conversation ensued between the two. They'd usually depart soon after as the pharmacist was called back to duty. Most of the time the drug information they gave would end up in the garbage can the minute they walked out the door, while everyone else clambered feverishly for the five cent pens left behind.

What the sales reps would also bring (more so in the hospital setting) is an invitation for the pharmacist to attend an elegant, all-expenses-paid fine dining experience at a local upscale restaurant. It's not uncommon to score a free $30-$40 dinner of filet mignon or succulent Chilean Sea Bass while attending these "educational events," where a paid speaker (usually professional peer—doctor or pharmacist) gives a thirty to sixty minute speech on a particular medication that the drug company is selling. Doctors and pharmacists tend to listen to other doctors and pharmacists more, so this is a great promotional angle to engage upon for the drug companies.

What is also standard of practice is for drug reps to cater all-expense-paid lunches directly into the pharmacy (again, usually the hospital setting). The pharmaceutical rep is then required, at minimum, to give a short five to ten minute spiel on the drug they're trying to promote for "educational purposes" for the free meal to be considered ethical and legal.

So what does all this accomplish? Free food for everyone! At doctor's offices and pharmacies all over the place. All to convince doctors and pharmacists to use one particular drug over another particular drug to increase market share and profitability for a particular pharmaceutical company. (To give you an idea of how much is spent on free food, Pfizer actually shelled out $18 million in free meals to doctors and other healthcare professionals in 2010 alone.)

These freebies happen all the time, but not as much as before. Actually, they're going away altogether in some settings. I witnessed one big box retailer actually outlaw (via their own company policy) visitations from pharmaceutical reps to any of their establishments without getting corporate approval first. That pretty much put the kibosh on that. I have a hunch it had more to do with keeping the pharmacists busy filling prescriptions (and making the company profits) than anything else. Regardless of the reason, it's a good thing in my opinion.

Back to the big picture: wealth begets wealth, "favors" are handed out, doctors and pharmacists get the perks, and patients stay sick and medicated for the rest of their lives. So, where does this leave me as a practicing pharmacist? How do I make a difference in my profession given all the freebies that come my way?


"Thanks, but I'll Pass on the Free Food."

To start with, I realize some patients still need medications. Some individuals have medical conditions in which safer, more natural methods of treatment—lifestyle medicine and plant-based nutrition—simply do not work. Vegetable Shepherd's Pie will never bring a halt to a terrifying epileptic seizure, nor would I suggest anyone attempt using this approach.

Along the same lines, some patients have no interest in entertaining the option of making lifestyle changes in the face of a diagnosis of coronary artery disease, type 2 diabetes, or a debilitating stroke. In such instances, the best I have to offer is an injectable medication or pill to subdue their pain, lessen their symptoms, or delay the progression of their disease.

With all this being said, there is one small thing I can do to make a difference. I can lead by example. I can say no to drug-company-sponsored meals. I can skip the catered lunches and forego the fine dining experiences.

I've done just that during the last several years of my pharmacy career.

Personally and professionally, I don't see how indulging in a free $10-$40 meal helps my patients regain their health. It only increases marketing costs of medications and drives up overall healthcare costs. When I see my own grandmother struggle (in years past) to come up with the funds to pay for her prescription co-pays, I know freebies don't help this cause. I know there are other grandmothers, grandfathers, mothers, fathers, sisters, brothers, and loved ones out there trying to scrape together the funds to pay for their prescription co-pays too. So the least I can do is not contribute to the problem.

I also understand that pharmaceutical reps are human beings too, trying to make a living to support their family. I don't have anything against them. Many of these individuals are very kind, hard-working people. They're simply doing what they do best—sales. They just happen to be in an industry where the product they sell affects other people's lives, for better or for worse.

So when asked by one of these kind pharmaceutical reps if I want to dig in to their all-expense-paid lunch (regardless of how healthy it is), I politely respond by saying "Thanks, but I'm good. I appreciate the offer though." I do my best not to judge others who do dig into the free grub. If asked by them (my colleagues) why I don't grab something to eat, I'll tell them the truth, doing my best to be as considerate as possible in my explanation. Mostly, however, I try and let my actions speak for themselves.


I Love Being a Healthcare Professional

My job is to help patients get healthy, practicing within the scope and limitations of my credentialed profession, all to the very best of my ability. I can't single-handedly change the profit-driven healthcare system we've all become accustomed to, but I can lead by example. I can let my actions both inside and outside my profession speak for themselves. As a healthcare professional, I'm always on the clock.

My hope in living my life the way I do is to serve as an inspiration to others, to make it easier for them to make positive changes in their own life because I give them someone to look up to. I have people I look up to. They've made me who I am today. In my mind I owe it to them to pay it forward. Two of these individuals are my parents. Without them I wouldn't be standing here before you 'talking the talk' and 'walking the walk.'

Honesty, integrity, and hard work were instilled into me because of how my mother and father carried themselves in life. They led by example. They're not perfect human beings, nor am I. But I learned the value of letting actions speak louder than words by watching their behaviors growing up as a child.

My father would always tell us three boys (and he still does today) that he has one expectation and one expectation only for us as we make our way through life - "You be a good person. I don't care if you're rich or poor, or end up a doctor or a ditch digger. You be a good person in life." That's exactly what I will attempt to do as I make my way through life. Regardless of how our societal or healthcare 'systems' are set up, I must never forget about being a good person in life. People come first. They should always come first. Money and profits mean very little when all is said and done.

May health and happiness be at your disposal when you need it the most in life. Thank you joining me today. Be happy, be well, and enjoy the following video from physician Dr. Zubin Damania, MD.










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by Dustin Rudolph, PharmD
Clinical Pharmacist

Check out Dustin Rudolph's book The Empty Medicine Cabinet to start your journey towards better health. This step-by-step guide leads you through many of today's common chronic diseases (heart disease, obesity, diabetes, cancer, and more), giving you the facts on foods versus medications in treating these medical conditions. The book also contains an easy-to-follow guide on how to adopt a whole foods, plant-based diet as a part of an overall lifestyle change, producing the best possible health outcomes for you and your family. Hurry and get your copy today!

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Photo credits: Freedigitalphotos.net

3 comments:

  1. I love your dad's advice to you and your brothers, and bet you couldn't possibly make him prouder. As I read this post, I thought of the recent BBC news story about Glaxo being charged with bribing Polish doctors. I've worked in two hospitals in two states (not as a healthcare provider) and when I read the Glaxo story I immediately thought, "So what else is new?"

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  2. Hello, my name is Dustin Rudolph as well. It is nice to meet you

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