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Drug Companies Target Next Generation of Physicians, Put Patients at Risk

A couple of non-physician executives from Challenger used to occasionally go, at the behest of residency directors, to deliver short live lectures to residents about marketing, sales, and influence. They’d address a room full of doctors with pharma bags, pharma pens, device company hats, and notebooks that looked like prescription pads featuring a particular drug. Every time, when asked if that advertising had any impact on their practice, the residents would emphatically say that it did not!

The next question would be, “Well, why are marketers spending all this money to give you stuff? Are they just stupid?” The residents’ answer? “Yup!”

Effectively, the billions of dollars’ worth of "geniuses" in corporate America aren’t as smart as a resident.

In defense of pharma and device companies, this article conflates various types of money that move from these industries into physician and university grants with direct purchase of influence. It also somewhat conflates spending on direct-to-consumer and influencer advertising with physician-directed funds. More regulations or codes of conduct, like PhRMA, are unlikely to have a significant impact. The 2009 revamp of PhRMA and the ACA’s Sunshine Act did little.

Movement towards reducing direct-to-consumer influence and limiting insurer drug overrides would likely have a much greater impact on reducing advertising influence in health care provision.

Drug Companies Target Next Generation of Physicians, Put Patients at Risk

Physicians are the Nation’s Top Earners – a Slideshow

One of the popular features in Medical Economics is salary reporting.  This year, pediatric surgical specialists are in the top rank.

While fun, articles like this miss the wide pay gaps in clinical practice types, which types are family and day-time friendly, which suffer from horrendous burnout and personal cost.  But here’s your 20 highest paid occupations - 16 of which are physicians. 😀

Physicians are the Nation’s Top Earners – a Slideshow - Medical Economics

Tuition-Free Medical School Is Not Working Out

We have a couple of money articles today: someone finally pointing out that money isn’t the primary deterrent to educating new doctors, and then the ever-popular Medical Economics physician payment slideshow.

This excellent article points out a fundamental flaw in thinking about doctors and practice—namely, the assumption that money is a primary motivator in becoming a physician. Money can be a constraint in getting a medical education, but one of the fundamentals that we try to drive into the heads of every new employee at Challenger is that doctors are not motivated primarily by money—or they wouldn’t have gone into medicine in the first place. 

Money is certainly important, as a way to keep score, a way to perceive the value of help delivered, and lives changed and saved—but to assign a primary role to money in choosing medicine as a career is incorrect. It is equally incorrect to say that the thing that keeps them in practice is just money. Money influences the specialization choices of physicians; it doesn’t solely drive them. Still, the disparity in pay in different practice environments (looking at you, primary care) influences decisions that students make.

In fact, what’s driving doctors out of medicine is mostly intangible: the desire to be able to provide care, to be appreciated, and to feel that the system has their back. Money problems related to declining payment to physicians contribute to that sense that the healthcare system certainly doesn’t have their back. 

There’s a benefit to educational philanthropy; it’s just not going to fix the problems it was meant to address: primary care and rural practice. 

Tuition-Free Medical School Is Not Working Out - The Daily Economy

QUIZ QUESTION

42-year-old presenting with acute heatemesis