Ethics questions arise as doctors pitch to colleagues - medical representative

1. Ethics questions arise as
doctors pitch to colleagues
Shireen Rawajbeh
Areej Abu Hanieh

2. What do you think about medical
representative ?

3. Dr. Daniel Carlat sank into a choice seat at Lincoln Center,
surrounded by other psychiatrists, all staying at the same four-star
hotel in Manhattan and attending the same show for free

4. The practice of using doctors to pitch products to other doctors is legal,
though several states — including New York — are trying to curb it. They are
opposed by the pharmaceutical industry, which argues the practice is a kind of
professional consultation.

5. Carlat was on the "speakers' bureau" for the pharmaceutical companies, speaking to large
groups of doctors, or holding intimate, expenses-paid meals with a pharmaceutical
representative and one or two doctors. In one year, he earned $30,000 — about one-fifth of his
salary. Ultimately, his conscience started nagging him and he quit.

6. "The information about medicines provided by technically trained company
representatives, some of whom are health care professionals themselves, is
important education for physicians who must understand side effects and the
proper use of potent prescription pharmaceuticals,"

7. At the end of January, PhRMA, the drug industry's lobbying arm, said it is
considering scaling back on smaller gifts to doctors, including pens, coffee
mugs and other items. Johnson said the idea is not a response to pressure about
its marketing practices.

8. •In a survey published last year by the New
England Journal of Medicine:
• 95% of doctors said they had contact with drug or device companies.
• 35% were reimbursed for costs associated with professional meetings.
• 28% accepted consulting or lecture fees.
• 7% took free tickets to games and other events.

9. When drug companies pay Weart to speak at a medical school or conference, he said, "they
can't influence the topic, the speaker, the venue, any of these things." He said the drug
companies provide unrestricted grants for his speaking engagements and he must disclose to
the audience the connection he has to the company.

10. • Weart, who said the side work pays "a fair amount," won't participate if he is
expected to promote one drug over the other, or if he feels the research is
unsatisfactory.

11. If you are paid to talk
about something better
than the other ?Are you
agree or not?

12. • Dr. Paul Root Wolpe:
• Nothing wrong with doctors speaking about pharmaceuticals
• but a conflict of interest can arise when they are paid.

13. •Should keep ethical
integrity /safety in
your JOB?

14. The pressures of money and relationships

15. • The best way to teach people about new drugs and their impact is to get the
experts in the field to talk about it.
• What I didn't hear anywhere in that process is that that has to be sponsored
by the drug companies???.

16. • Should doctors take the Gifts from representative?

17. • Some hospitals and medical schools prevent doctors from accepting gifts from drug
reps.
• Create a database disclosing the names and addresses of doctors who receive gifts or
payments. It would also include pharmaceutical company names and the value of the
gift or payment.
• Drug companies???(Agree or oppose)

18. PhRMA(Acronym ???):
• Gifts to $100 or less
• All forms of free entertainment, including sporting events and golf outings, are
inappropriate.
• These rules cut the risk of problematic relationships between drug reps and doctors.

19. • Another bill :
• Prohibit pharmaceutical companies from buying data on the prescribing
habits of doctors — information used for direct marketing and to recruit a
sales force.

20. • At least eight states and the District of Columbia have laws or resolutions
related to pharmaceutical marketing, including California, Florida.

21. • Initially, Carlat didn't have a problem with the work he was doing, but he
gradually became concerned.

22. • "I stopped because I decided that it was unethical to alter and to tweak
information that would ultimately affect patients' welfare and patient safety,"
he said.

23. Pro-Drugs