It used to amaze me when I went to my old doctor. Every time I sat in the waiting room you would see all these sharp dressed sales reps come in from
January 20, 2008

It used to amaze me when I went to my old doctor. Every time I sat in the waiting room you would see all these sharp dressed sales reps come in from different drug companies. Once you got back to the exam room, the walls would be plastered with posters from drug companies, as well as pictures, little models of different parts of the anatomy and anything else you can think of. All the mugs would be from a drug company and even the office supplies would bear their names. All the sudden I would get a prescription and it would be for the same drug that is engraved on the side of the pen the doctor was writing the script with.

That was about four years ago and also the reason I switched doctors. I now go to a doctor who doesn't have all these little trinkets given to her. She doesn’t have sales reps coming in and out offering free meals or vacations - sales reps that leave me sitting in the waiting room feeling horrible why they tie up my doctor with their sales pitch. She is there to practice medicine, not auction off her remedies.

Well it now looks like one health provider has realized this conflict of interest and is taking action :

When a Duluth-based operator of hospitals and clinics purged the pens, notepads, coffee mugs and other promotional trinkets drug companies had given its doctors over the years, it took 20 shopping carts to haul the loot away.

The operator, SMDC Health System, intends to ship the 18,718 items to the west African nation of Cameroon.

The purge underscored SMDC's decision to join the growing movement to ban gifts to doctors from drug companies.

I can't tell you how happy I am to see a company actually taking action against these vultures. I have had to sit there and listen to the sales routines these reps give and you would think they are selling you timeshare or a used car. It always left me wondering; If their product is so good, shouldn't the fact that it saves lives or make people live better be a selling point enough? Why do they have to sit there and push their miracle pill like a man in a polyester suit with a bad comb-over trying to tell you how safe that 1980 Pinto station wagon is for the family vacation?

Of course this is only a start. Remember that thing we used to talk have - patient confidentiality? Well that is so much the case anymore. How do these sales reps know which doctor to target? Easy - they have a list of what doctor is prescribing what drug:

A battle over how much pharmaceutical companies and their sales reps know about specific doctors has begun in New England, and a local business is at the center of the fight.

Lower Makefield's Verispan is a data-gathering group that collects health care information — mostly from pharmacies — and sells it. Most of Verispan's buyers are pharmaceutical companies, which use the reports for marketing their products.

Every night, pharmacies transmit millions of prescription records to Verispan's data center. While patient identities are withheld, the records summarize prescriptions by listing drugs, dosages, quantities and the names of the doctors writing the scripts.

Once they get the information, pharmaceutical companies can determine what each physician is prescribing. That helps them tailor their marketing efforts to individual doctors. While Verispan's Jody Fisher acknowledged that makes some doctors unhappy, he said the data can help get the right medicines to patients.

Now that all sounds good, but there is a main part that leaves me scratching my head. How does this information help the doctors give the right drugs? If this information only contains the drug, dosage and quantity, then there is one key piece of data missing - the diagnosis. Is that person taking 10mg of Lipitor because his cholesterol is at 260 or is it because they are a diabetic and their cholesterol level is at 180 and it's being used as maintenance?

Perhaps this is another indicator of how badly this country needs health care reform. Making sure everyone has access to care is the highest priority, but making sure their care is coming from a well educated doctor, and not some pretty girl in a suit with some nice gifts, comes in a close second.

(cross posted at IntoxiNation)

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