A Question of Influence – Are Doctors Morally Bankrupt?

I’ve been struggling with this question recently. There’s a paternalistic movement in the U.S. today to shield America’s doctors. For some reason, doctors need to be protected—from drug companies, from insurance companies, from patients and even from even each other. And it is this notion that doctors are morally bankrupt that the paternalists are selling.

This argument has boiled over in the last six months with respect to pharmaceutical companies (and insurance companies, I might add) providing free lunches and pens to physicians and their office staffs. The argument that has been chronicled in dozens of media stories (including two New York Times pieces; the first, and the second) and quasi-journal articles is that lunches, pens, notepads, etc. unduly influence physicians.

There is even a “grassroots” movement called No Free Lunch organized by the Corporation for Non-Promotion-Based Medicine (which, according to its website, accepts donations, although does not disclose its sources of funding or its IRS 990; the group is not registered with the GuideStar non-profit clearing house). This organization urges physicians to avoid any interaction with pharmaceutical companies, including pens, lunches, etc. However, their disdain of drug companies doesn’t seem to apply to anyone else (including insurance companies) trying to influence their physician’s prescribing patterns, the diagnostic tests they order and the medical procedures they perform.

This whole paternalistic attitude stinks to me. Evidently, physicians are different than the rest of us. Evidently, the same physicians who spend years in school learning professional medical judgment throw out their knowledge the minute they graduate and latch onto the first pretty female drug rep from AstraZeneca or Pfizer. Evidently, physicians are willing to sell their souls for a $7.00 Quizno’s sandwich and a Snapple.

Does this sound ridiculous? Well, this is exactly what some physicians and the paternalists are claiming. The paternalists would have us believe that doctors are morally bankrupt and their judgment is not to be trusted.

For the record, I’m in favor of pharmaceutical companies trimming their marketing budgets, including the chochkeys and free lunches. The money could be better spent on R&D. But doctors don’t need to be coddled and I don't believe physicians can be bought for a salad.