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If this guy thinks that regular med school education isn't built upon what big

pharma wants to be taught, he is blind. And it has been that way for about a

hundred years now. And a large part of it is reading symptoms and to prescribe

what type of drug although it may describe it generically and be taught by a

professor. Kinda like the information you get on the TV ads, but just a lot more

dressed up.

 

Frank

 

 

Tue, 24 Feb 2004 15:17:38 -0500

WC Douglass

Med " schooling "

 

Daily Dose

 

February 24, 2004

 

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The REAL " med " school

 

In just the last year or so, I've written many times about the

distressing degree to which the major drug companies' marketing

techniques are impacting the way medicine is practiced in this

country. From primetime TV ads that subtly convince people to

self-diagnose complex medical problems (and that their only hope

is some new wonder-drug) to the grassroots lobbying (see also:

bribing) of individual doctors to prescribe drugs for unapproved

uses, the marketing of these patent medicines is OUT OF

CONTROL.

 

This kind of thing ought to be illegal, in my opinion (yes, I'm

all for regulation in this instance - go ahead and mark this

date on your calendar). But then, if you've been a Daily Dose

reader for more than a few months or so, you already know that.

 

What you may NOT already know is this: Such drug marketing

interactions are practically part of the curriculum at some

psychiatric schools. What am I talking about? The indoctrination

of medical students to not just prescribe patented medicines as

a knee-jerk solution to all mental health diagnoses (whether

they're approved for the condition at hand or not) - but also to

recommend certain newer, more expensive drugs in the place of

older, now-generic medicines.

 

So who's doing this " educating, " you ask? It isn't PhDs. It's

the DRUG REPS from the major pharmaceutical makers!

 

According to a recent commentary published in The New York Times

(yep, every once in a while they get it right), many schools

where green MDs go to learn psychiatry as a specialty permit

drug sales reps nearly unfettered access to the residents. The

reps do everything they can to influence these residents to

prescribe their newest antidepressants and other drugs - and to

make sure they know (or at least believe) that these same drugs

are prescribeable for maladies OTHER than what they're approved

for. Drug companies sponsor clubs and discussions, pay for

seminar speakers, offer free dinners to residents and staff,

give out free samples of their drugs by the bag-load, and

more...

 

Written by an actual staffer at a major college of psychiatry,

the article even cites an instance where a female drug rep

loitered by the interns' mailboxes under the auspices of

delivering flyers about a medication - but while there, she

engaged and flirtatiously " detailed " three residents about new

(unapproved by the FDA, I'm sure) uses for her company's

antidepressants! This is exactly the kind of guerilla marketing

I've been railing about - the kind drug companies spend 4.8

billion dollars a year to perpetuate.

 

Finally, someone in the mainstream press is talking about this,

too. Halleluiah!

 

But the fact that this kind of thing happens all the time in

medical schools all across the nation isn't even the most

outrageous part of this story. Keep reading...

 

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Here's the real kicker about one-on-one drug marketing:

 

The targeted doctors feel as though they're immune to the charms

of both the drug company perks and the smooth-talking sales reps

themselves. That's right - according to the Times piece, studies

have shown that most physicians believe that their prescribing

habits remain uninfluenced by the siren-song of these

seductions.

 

Yet in one study of more than 400 psychiatrists, more than half

of them said they believed the newer antidepressants (SSRIs)

were both more effective and had fewer side effects than older

medications. But meta-analysis studies conducted at Oxford,

Duke, and other prestigious institutions found that these

expensive new drugs were no more than the equals of the older

antidepressants in effectiveness - and may even be slightly LESS

effective, with just as many side effects!

 

This discrepancy between scientific evidence and real-world

clinical practices all but proves a link between one-on-one

marketing and the success of new, expensive, and relatively

untested medications - even when they're no " better " (that's a

relative term, believe me) than the dirt-cheap, generic

varieties.

 

Proponents of the current system of unrestricted drug

rep/student doctor contact include many of the residents

themselves. Their reason? To become better prepared for the real

world of medicine - where they're assaulted on all sides by

shrewd marketers hawking the latest test-tube panaceas. Now, if

that's not a stark illustration of how out-of-control drug

marketing has become, I can't imagine what would be...

 

It's just another snapshot of how in-the-pocket of the drug

giants mainstream medicine (especially psychiatry, but this

happens in every discipline, I guarantee it) has become - and

they aren't even AWARE of it.

 

Again, I say: There ought to be a law!

 

 

Schooled back when " med " meant medical,

 

William Campbell Douglass II, MD

 

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