From the Facebook profile of Dr. Stefan Mitev
Medical convention season is upon us. It has its “dark secrets” that you might not suspect if you work outside of the healthcare field.
First, pharmaceutical companies compete to fund congress participation. They mostly target famous and influential doctors, but almost anyone can easily find a “sponsor”.
For the most desirable medics, there is sometimes a struggle over who will pay their expenses. I have seen it with my own eyes. Why do they do it? It’s very simple. Pharmaceutical companies know that their investment will return, sometimes many times over.
Sponsored doctors are more likely to prescribe relevant products, as evidenced by numerous scientific publications. It is not by chance that companies set aside special budgets for the care of doctors. It is certainly not accidental that this practice must be announced at various appearances because it is universally perceived as a “conflict of interest”.
Second, advertising lectures and presentations, which were put on hold during the summer, are becoming more frequent. With the return of the medics from a well-deserved vacation, more participants can now be targeted, usually in the morning after a report or at dinners in luxury restaurants and hotels. It is also scientifically proven that even minimal “gifts” change the behavior of doctors. They don’t have to cover your travel and hotel for a convention abroad. Even a modest treat of food will do the trick. It is no coincidence that every advertising lecture is followed by “catering” at the expense of the pharmaceutical company.
Let’s look at an absurd example. Imagine attending a medical report early in the morning, maybe even slightly sleepy. At the end of it, a representative of a pharmaceutical company enters, passionately and convincingly convincing you of the benefits of a certain product. The presentation lasts about 10 minutes and is immediately followed by the distribution of promotional materials. Sometimes a mandatory “list” of attendees is even released. A report is needed though. So far everything is standard.
But now the example becomes absurd. Imagine that at the end of the lecture, the presenter goes around the attendees and sticks a twenty leva banknote on the forehead of each of them. Like a nasty chalga concert from the mid-nineties. If such a thing were to happen (which I doubt), any doctor would be outraged. He would not accept such a bribe for his attention and attendance at the lecture.
But really, food, pens and notebooks are just that. Well, they are not banknotes on the forehead, but sometimes they are worth even less than 20 BGN. And doctors accept them willingly. Who would refuse a delicious breakfast at the start of a hard day?
The problem is that corporate sponsorship, in any form, even of minimal value, changes physician behavior. I see it every day when I read epicrisis. Completely unnecessary products are often prescribed – probiotics, immunostimulators, nutritional supplements and what not. Let there be.
The explanation may be that the doctors have not read enough and do not know which medication is effective, but it is also quite possible that they are simply “returning a favor” to the companies. I emphasize that it happens subconsciously, not necessarily purposefully, because of a deeply innate instinct for reciprocity. You got something, you have to give it back. All of this hurts the patients, who will have excess costs and, in rare cases, even receive potentially dangerous prescriptions.
Yes, I know that the subject is not talked about and is unpleasant for many colleagues. I am raising it myself because I have not been sponsored for many years. Early in my career I was and I realize it’s very tempting. Not only do you get paid for your expenses, but you also feel appreciated that someone has noticed you, especially as a young doctor. In reality, however, companies know that any expenditure in this direction will be returned to them with profit. It’s good for you to know that too.
It’s worth repeating again. It is now extremely difficult to find a scientifically based doctor. And it is virtually impossible to find a science-based doctor who does not have corporate return services and is completely independent in his decisions.