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by obscur
1543 days ago
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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. |
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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.