[qnsi]

Medical industry is corruption prone.

Another example: Industry sponsored conferences. Doctors are invited to a 3 day 4 star hotel stay to attend a conference. Technically, talks that are paid shilling are specially marked as sponsored talks.

But are the other doctors, who are getting paid to speak there 100% independent?

Will you be a 100% independent doctor after getting free presents?

Maybe you will. But industry probably found its profitable if they spent millions on these kinds of conferences.

Also lie repeated multiple times makes you believe in, there are psychological studies. So when you spend hour listening how drug X is gold, you might start believing its gold

[sarchertech]

My wife’s a doctor and the “free presents” she’s gotten from conferences are laughable. A 128mb flash drive and a canvas bag are about the best things I’ve seen.

She’s also never gotten a free hotel stay at a conference unless her group was paying for it.

She tells me there are strict (very small) limits on gifts from drug companies.

[rscho]

True... but she's not a famous tenured professor, is she?

[sarchertech]

What does being a famous tenured professor have to do with the OP’s claim that doctors attending conferences were getting free gifts.

I’m not talking about the separate claim that speakers get paid to speak.

[rscho]

Well, that's precisely the crux of the matter. When I go to conferences, I also only get a measly ballpen with a notebook if I'm lucky. Corporate financing is mostly targeting established researchers who, crucially, hold influence over their peers. It's just like YouTube influencers. So the question is not what we get at the conference, but what arrangements are made for the funding of future projects for those researchers. And conferences are great locations for interfacing well-known researchers with industry representatives. That also happens elsewhere, of course.

[sarchertech]

Again this is a different thing than “doctors go to conferences and get free hotels and gifts”. If you think researchers (the majority of whom aren’t doctors) might make shady deals with industry reps at conferences, I don’t have any evidence they don’t I guess. I don’t have evidence that industry reps don’t just call them on the phone and offer bribes either.

[Enginerrrd]

>Will you be a 100% independent doctor after getting free presents?

>Maybe you will. But industry probably found its profitable if they spent millions on these kinds of conferences.

So... theoretically the industry putting on the conference is also pushing the state of the art pharmaceutically and believe that they have an improvement on the existing standard of care. I don't think it's got anything to do with the presents as much as the message.

[pessimizer]

Nah. Speakers fees are a way to launder direct contributions. There was at least one famous case where the "conference" was done in one of the speakers' living rooms. Imagine getting a speaking fee for speaking extemporaneously in a Florida hotel room with two pharma reps and one other doctor five minutes before you all leave for golf.

[nobody9999]

>Nah. Speakers fees are a way to launder direct contributions

The comparison to money laundering is specious, IMHO.

In the US, at least, there is a database[0] of any value (including monetary and in-kind) exchange between doctors and medical companies.

As such, there is no "laundering" at all. All moneys and in-kind (hotel rooms, meals, swag, etc.) payments are documented and detailed.

Is there an incentive for doctors to favor a particular pharma or medical device company based on those payments? Perhaps. But since (again, at least in the US) such payments are documented and publicly available, it isn't some sort of secret set of payments designed to surreptitiously co-opt doctors.

Sure, some payments (my brother, a physician, received ~US$20,000 in 2020, mostly (~$13,000) from a single consulting fee.

Is my brother favoring the company who paid him $13,000 in 2020? Maybe. But if and only if their products/devices have clear beneficial effects over other products/devices.

What's more, that $20,000 (aside from the consulting fee, it was food/beverage and other in-kind stuff) is a small fraction of his annual income and doesn't make a significant difference in his quality of life.

As such, while there may certainly be doctors who are co-opted/corrupted by medical companies, assuming that the majority of doctors are swayed by such things is iffy at best.

[0] https://openpaymentsdata.cms.gov/

[obscur]

Seems very unlikely to me that it would not be a combination. We have both rational and irrational parts, conscious and unconscious parts.

I'd venture one does not have to look far in the anthropology literature to find good evidence that gifts just like other favors serves a function in building reciprocal relationships. Since it is likely so fundamental, I have a hard time believing it would not have any effect on the independence of the doctor.

[Enginerrrd]

I don't disagree, but I think it's likely only so much as to make them more receptive to the message of superiority.

I've actually been wined and dined quite a few times at pharma-rep presentations as a guest of an M.D. so it was interesting to see the process. In general.... it's definitely a sales thing, but the message wasn't ever "Here's how much money we'll give you" and always was "Here's why you should be prescribing this new drug to patients". Typically it would involve a presentation that first offered a bit of review of underlying mechanisms and disease processes, then high-lighted the need (how, why, and how severely condition X leads to bad outcomes and why it should be addressed aggressively in patient population Y, and lightly considered in population Z, and isn't needed in A), then discussed the current standard of care (Options B, C, D, etc.), then discussed this new drug (How it works, Why it's better than existing options and to what degree, Side effects, contraindications) and then a nuanced discussion of weighing issues related to the drug (e.g. it's excreted through kidneys... is untreated condition X worse in renal patients than treated X with sideeffects? ) etc. and a long Q & A session. Rarely if ever were costs discussed except perhaps whether it would be covered by insurance carriers.

Everything was pretty factual (as far as I could tell) and to the point and aimed at treating patients better.

Now.... the wining and dining I think definitely could make humans more receptive to the message, but the vibe wasn't at all that of an exchange. They just needed to do something to get the ears of the M.D.s, and so treating them to a nice fancy dinner with some guests allowed was a way to do that. A nice gesture, but not nearly of an order of magnitude where someone with Doctor earnings would even remember it too much.

[sarchertech]

Many states have banned those kinds of pharma lunch and learns and learns now. My wife says they basically don’t happen anymore (at least in her circles).

[stretchwithme]

"Even $20 meals can sway doctors, study finds"

https://www.sfgate.com/health/article/Fancy-meals-can-sway-d...

[drewcoo]

> Medical industry is corruption prone.

Corruption is incentivized in any for-profit industry.

[ipaddr]

And non-for-profit industries

[notriddle]

And groups of people who are driven by ideology, rather than profit.

[forum_ghost]

profit IS an ideology.

[notriddle]

Fine. I'll rephrase it:

> And groups of people who are driven by ideologies other than profit.

[waterhouse]

This essay about an American Psychiatric Association conference, with the pictures of all the ads plastered everywhere, was kind of fascinating: https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-phot...