LETTERS From CAMP Rehoboth |
CAMP Fitness: The Money and the Drugs |
by Rick Moore |
When you go in to visit your doctor, I've always thought he or she should provide medical treatment that's in your best interest. After all, you're paying money for that service-even if the money is sent through your insurance company. But now I've learned that your best interest might not be at the top of the list. It seems that the drug companies have grown so powerful and brazen in this country that they are successfully overriding your doctor's judgment, often without you even knowing it. We've all seen those endless TV ads about prescription drugs. While they surely drive up the cost of health care and cause patients to ask for brand-name drugs they don't need, I don't think they're the main threat to the quality of your health care. After all, if you as a patient would rather believe a TV ad starring an aging athlete or movie star from the 70s-instead of your own physician-well, that's your problem. No, the real problem is the massive attack drug companies have unleashed on patients through their physicians. It goes way beyond promotional brochures and little office trinkets like pens and notepads. It goes way beyond office visits from a sales rep, free lunch for the staff, and glitzy free vacations and dinners held at big-city hotels. Would you believe-according to a New York Times story this week-some doctors are being paid by the drug companies to allow sales reps into exam rooms to meet with patients, review their medical records, and recommend prescription drugs directly to the patient and doctor? That just floored me. Let's imagine the scenario. You walk into the doctor's office, wait patiently for a while, and are ushered into an examining room by a friendly nurse. She takes your blood pressure and weight, and goes over a few questions with you. But then something goes wrong. In walks your doctor, followed by someone in a business suit whom you've never seen before. "Good morning, Mr. Moore," your doctor says with a smile. "Mr. Smith will be assisting me today in your examination." You nod. "He's from one of the drug companies, you know, the big one that was just bought out by the Dutch." Mr. Smith immediately pipes in. "Doctor, I believe Mr. Moore is an ideal candidate for our new hair re-growth drug." Something gets quietly scribbled down on paper as they exchange glances. "I see you are here for a sore throat, Mr. Moore." You nod again. "Mr. Smith, what would you recommend?" "Well, doctor, we've developed the latest broad spectrum antibiotic," says Mr. Smith, rattling an unusually shaped bottle of brightly colored capsules. "We're offering a free office computer if you write 10 prescriptions for it this month, and according to my records, you've only written eight." And on it goes. Within a few minutes, you're ushered to the check-out desk to pay your bill and receive your stack of prescriptions, all carefully stamped "Dispense As Written-No Generic Substitution." Here's one for toenail fungus... And we'll bet you didn't even know you HAD toenail fungus! Doesn't some ice skater advertise that one? No, she's got the arthritis drug locked up... How far will they take this? In the future, will I have to sign an agreement to use only one drug company's prescriptions in order to see the doctor I want? What happens when that drug company's competitor is the only one selling the prescription that really would be best for my current illness? What if I don't really need any drug at all? It could very well get to be like the world of professional sports. Athletes with an endorsement contract from Nike aren't allowed to wear Reeboks, even if the Reeboks fit better. At first, I wanted to heap a lot of blame on physicians for this whole mess. After all, they are the ones ultimately responsible for patient care. But when you realize the pressures physicians face as small business owners, the current situation becomes more understandable. Medicare and the insurance companies are not increasing their compensation paid to doctors at the same rate they used to, and in many cases, that compensation has actually dropped. Malpractice insurance is going up, as are staffing costs, office rents, even the cost of cotton swabs. The difference has to come from somewhere. And the drug companies are overjoyed to step into that void, because they're buying influence. I guess the problem is, medicine isn't like any other business. I don't care if a spark plug maker pays a car repair shop to use their brand of spark plugs exclusively. That's no big deal. But I do care if marketing money is the driving force behind my medical treatment, because it means that some big drug company's interests are coming ahead of my own health. When the physician stands to gain for prescribing one company's drug over another's, we have a serious problem. I realize that drug companies provide a lot of useful education to physicians. They help them understand all the new drugs on the market by providing professional seminars and reprints of journal articles. They hire expert doctors to explain how their drugs work. It's hard to argue with the fact that drug companies have a right to advertise and get their message across to their customers. They've produced a startling array of life-saving drugs, and of course, that should be encouraged. But the medical societies and licensing boards should get on the ball and issue clear guidelines to physicians about what's allowed, and what's not-and they should strongly enforce those rules. Ultimately, though, it's up to us as patients to realize what's going on and insist on what's best for us. Rick Moore is a personal trainer certified by the American Fitness Professionals & Associates. Visit his club, Rick's Fitness & Health, in Milton, Delaware or www.ricksfitness.net, or call 302-684-3669. |
LETTERS From CAMP Rehoboth, Vol. 12, No. 05, May 17, 2002 |