Pharmaceutical Gifts Corrupt Doctors: A Physician Confesses

I write now in a moment of introspection wondering if I am a corrupt doctor. Why would I even consider that my integrity is in question? I am not on the payroll of any pharmaceutical company. I am not paid to speak to physicians or the public about the latest medical breakthrough for flatulence. I submit squeaky clean billings to Medicare and insurance companies. I do not order medical procedures on patients for personal gain.

My failing, if it truly exists, is an example of the power of the pen. In our office, many of the pens floating around are labeled with the name of a new drug. I assume that these evil instruments are left by pharmaceutical representatives, but I never actually see them make the drop. They are the ‘Adam and Eve’ of medical practices; they are fruitful and they multiply. These pens over time have mutated, like bacteria and viruses, and can now exist in a variety of harsh environments. For example, when I am in a restaurant about to sign my credit card bill, the sly server hands me a Nexium pen. Is he a doctor, I wonder? Is he part of the nefarious Nexium network? What’s next? Will we see President Obama signing important health care legislation with Viagra pens, which he will then present to the legislators who spearheaded the bill? How can this plague be ‘penned’ in?

No, I am not overworked or overreacting. Last year, a new set of pharmaceutical industry guidelines, agreed to by 40 companies, was enacted. These companies, aiming to elevate their ethical behavior, have sworn an oath to never distribute any pen labeled with one of their products. As if this draconian ban were not sufficient, labeled coffee mugs and staplers will also be strictly prohibited. These measures are supposed to make physicians more ethical since we will be now free from the hypnotizing effects of all of the labeled kitsch in our offices. This must mean that up to now that I have been an unwitting tool of pens, pads and post-it notes that have induced me to prescribe their medicines to my patients.

Soon, I expect the pen police to start patrolling doctors’ offices. When they arrive for their unannounced inspections, I’ll demand to examine their clipboards to verify that they are unlabeled and conform to the highest ethical standards. When they ask me to sign an attestation that my office is clean, I’ll pretend to search my pockets and then will ask the inspector to borrow a pen. You can bet I’ll be examining it quite closely.

When Should Doctors Retire?

I am asked with some regularity whether I am aiming to retire in the near term. Years ago, I never received such inquiries. Why now? Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area? Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring. “Interesting,” I remarked. Since I was unaware of this retirement news, I asked her when would be my last day at work. I have no idea where this erroneous rumor originated from. I requested that my nurse-friend contact her flawed intel source and set him or her straight. Retirement might seem tempting to me as I have so many other interests. Indeed, reading and studying, two longstanding personal pleasures, could be ext

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier. There must be a reason why so many professions require a uniform. Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele. It certainly doesn’t enhance professional performance. For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings? If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits? The medical profession for most of its existence has had its own uniform. Male doctors donned a shirt and tie and all doctors wore the iconic white coat. The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families. Indeed, even today

The VIP Syndrome Threatens Doctors' Health

Over the years, I have treated various medical professionals from physicians to nurses to veterinarians to optometrists and to occasional medical residents in training. Are these folks different from other patients? Are there specific challenges treating folks who have a deep knowledge of the medical profession? Are their unique risks to be wary of when the patient is a medical professional? First, it’s still a running joke in the profession that if a medical student develops an ordinary symptom, then he worries that he has a horrible disease. This is because the student’s experience in the hospital and the required reading are predominantly devoted to serious illnesses. So, if the student develops some constipation, for example, he may fear that he has a bowel blockage, similar to one of his patients on the ward.. More experienced medical professionals may also bring above average anxiety to the office visit. Physicians, after all, are members of the human species. A pulmon

Elaine Schattner, MDMay 20, 2012 at 8:41 AM
Hi Michael,
I liked this post until I noticed the crude jab at President Obama. I wish you'd take it out, because otherwise you make a great point: People who mind doctors (like journalists, besides politicians and administrators) are often themselves imperfect.
JSSMay 20, 2012 at 8:56 AM
MK: I don't see the same objection as Dr. Schattner. I believe the point of the good article was the influence of the pens and other now banned gifts. My guess is that at any point in time you would have used the current President's name.
Healthier StuffMay 20, 2012 at 8:57 AM
In more years in health care than I can remember, I cannot think of one prescription or a medical device used which was instigated by a Pharma pen or for that matter a ‘post it pad’ (probably the most useful branding item I have ever been the beneficiary of! It’s true that most Pharma regulatory bodies have declared branding items a ‘no go’ area. I suspect this is more to do with image than corruption?
MichaelMay 20, 2012 at 12:44 PM
You missed the point, ES. It wasn't a jab at Obama the man, but a statement about the influence of this "corruption" to make it to the highest levels of power, the presidency.
Toni Brayer, MDMay 20, 2012 at 5:53 PM
I will really miss the post-it notes.

The irony of banning these little promotional gifts to physicians and still allowing direct to consumer ads is noted. Let us not interfere with true $billion dollar commerce when we can obscure things by focusing on pens and coffee cups and pretend it matters.
Michael Kirsch, M.D.May 22, 2012 at 11:23 AM
Great comments all! The Obama reference was not directed at the president, but at Pharma's omipresence. I have to assume that the silly items with drug names and logos on them are useful to the pharmaceutical industry. They wouldn't spend millions of dollars on the effort if it didn't serve their interest. While there is no one-to-one response when a physican picks up a Protonix pen and then pens a Protonix script. I suspect that the companies are trying to increase brand awareness and imprint on physicians' subconsciousnesses.

MD Whistleblower

Search This Blog