Survey after survey of doctors says that they don’t think that gifts influence their behavior.
Study after study says they are totally wrong.
The big pharmaceutical companies spend millions upon billions on advertising and promoting to doctors and one of the biggest ways they do so is by using gifts of all types.
Sometimes it’s pens, sometimes it’s meals and nights out, sometimes it’s travel and accommodation, there are various rules and guidelines in place but historically it can be almost anything.
The evidence is overwhelming that this sort of practice is highly effective at altering doctor’s behavior.
The most obvious evidence is that so much money is spent on it. Drug companies do have ways of monitoring the effect of their marketing to doctors. They have been able to study the results for themselves inside their own companies, and they clearly just want to do more of it.
Some of the research is done outside drug companies and therefore is available for us to analyze, and this research too comes up showing that doctors become more willing to prescribe drugs rather than non-drug treatments, pay less attention to the scientific evidence, and bias to favor a particular company’s drug.
That would be much less of a problem if it wasn’t for the perception that is widely held by doctor’s themselves that they are somehow “immune” to this influence, and that they are “too clever” to be swayed.
This self-delusion is wrong, and dangerous.
It’s easy for me. I’m in the luxurious position of not prescribing much at all these days, so I can accept as many gifts as I like for a new medication and my prescriptions still are zero.
I don’t get as many invitations or gifts these days.
Back when I did prescribe a lot more and did get more gifts I looked into this.
In my time I’ve come across a few doctors who do in fact acknowledge the influence of gifts in their own practice, and one in particular got taken to task by my local newspaper.
One of the most senior surgeons at my city’s biggest hospital wrote a book on how to prepare for surgery.
A tiny piece in the book suggested that patients should give a gift, like an expensive bottle of brandy, to their surgeon before they had an operation.
Among all his recommendations, this “bribe” got the attention.
The outcry was huge.
“Doctor’s are already rich enough, and now they are asking you to give them bribes too!”
“You can buy off your doctor with booze!”
Well, the newspaper didn’t quite go that far, but that was the impression they were giving. I bet it sold a few newspapers and demonstrated a lot about what influences them. But that’s not my field so I won’t go into that.
I was working as a volunteer with a local radio station at the time and I took the chance to interview this surgeon.
He was bemused as to what all the fuss was about. He openly acknowledged that surgeons get influenced by gifts, and he put it something like this…
“When you yourself need surgery and you are being wheeled into the operating theater, do you want your surgeon to think of you as the Xth case of Y operation for that day?
Or do you want to be thought of as ‘the patient who gave me ……’?
Surgeons are human too and it DOES influence how they handle you and your surgery.”
Unfortunately I’ve never seen this particular technique studied, so this is one piece of self help that I simply recommend from my own experience with doctors and other human beings.
-Dr Martin Russell