[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...