Doctors as touts

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Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.

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21 Responses

  1. Avatar Maribou
    Ignored
    says:

    This is an excellent post, Russell. Which is pretty close to a content-free comment, but I imagine the rest of ’em are also just sitting there in appreciation without much content to add. So thank you.Report

  2. Avatar kenB
    Ignored
    says:

    It was a long time ago now, but I recall reading a book about the history of TV advertising that mentioned a study done not too long after TV sets had become a household staple. The researchers asked the respondents how much their purchasing decisions were affected by TV commercials, and the vast majority said they were hardly affected at all; but the company data the researchers had acquired that gave the before/after sales when a TV ad campaign was begun for a product generally showed a very large increase in sales.

    I might be mixing up the studies, but I think this one might also have found that they got a more credible answer when they asked people how much they thought their friends were affected by the advertising.Report

  3. Avatar Burt Likko
    Ignored
    says:

    It’s not just doctors: I am at least once a season offered awesome hockey tickets by a forensic accountant. Sometimes I accept them and enjoy the games. Do I steer forensic accounting work his way? You bet. I’ve used him for appropriate cases. I hope I’ve only selected his firm for cases in which it is appropriate to use that level of forensic accounting service. But I do certainly think of him a lot whenever there is heavy lifting to be done on the accounting side for pretty much any case. (Also, unlike the rep who came to visit Dr. Saunders, I wouldn’t describe him as “smoking hot” although I’m sure his spouse thinks he’s cute.) It’s fair to say that he’s captured a degree of my goodwill with the enticements, enticements which have nothing to do with his (considerable!) abilities as a professional.

    A difference between the lawyer being cultivated by a forensic accountant and a doctor being cultivated by a pharma company, though, is that the lawyer retaining the accountant is making a relatively infrequent sort of decision, and one into which substantial amounts of affirmative consideration and deliberation are typically made. The doctor, who usually only has five to ten minutes of face time with the patient, of necessity must move faster, make decisions faster, and move on to the next patient. Another difference is the sort of client whose litigation needs forensic accounting is likely to be more sophisticated with respect to these sorts of decisions and commitments than is a patient in a doctor’s office — the information imbalance is greater in the medical situation than the legal one.

    So perhaps doctors are actually more vulnerable to this sort of thing than other professionals. It’s a matter of degree, though, rather than of kind.Report

  4. Avatar Mike Schilling
    Ignored
    says:

    I have never been in a position to receive gifts from people trying to influence my workplace decisions, but I’ll tell anyone who’s listening: box seats near home plate, and you can have whatever you want.Report

  5. Avatar LeeEsq
    Ignored
    says:

    If doctors are touts, how much do I need to donate to PBS to get one?Report

  6. Avatar RichardS
    Ignored
    says:

    For years Big Pharma has been justifying the price of **sexy** new drugs by the cost of R&D, while spending substantially more on advertising than they do on said research and development. Meanwhile, they make huge profits selling antibiotics to factory farms which increases the growth rate of farm animals… but also contributes largely to the epidemic of antibiotic resistant organisms. To add to that, there hasn’t been a significantly new class of antimicrobials (that is, one which bacteria don’t already have a mechanism for resistance against) for something like 15 years.

    Pharmaceutical companies are more interested in high margin products that patients have to take for the rest of their lives. They’re more interested in peddling us the next Viagra than doing something concrete about a post antibiotic world where your child can die from a strep throat.Report

    • Avatar Russell Saunders in reply to RichardS
      Ignored
      says:

      Just for the record, even without antibiotics most children wouldn’t die from strep throat. Technically, we don’t need to treat it, but do so aggressively as a means of preventing rheumatic fever, a rare but serious side complication of strep.

      Report

      • Avatar Murali in reply to Russell Saunders
        Ignored
        says:

        Aggressive treatment with antibiotics is a classic prisoner’s dilemma. Each doctor can save the current patient by aggressively treating with antibiotics. But the global result of widespread aggressive treatment is antibiotic resistance.Report

  7. Avatar RichardS
    Ignored
    says:

    It’s true that Strep. pyogenes is fairly susceptible to most antibiotics, but other species form the genus have been gaining resistance (Group B Strep, a source of morbidity in newborns for example, is showing increasing resistance to penicillin… ).

    The point being is that our arsenal against microbes is becoming ineffective and the industry that produces it doesn’t appear to see it as an urgent problem.Report

    • Avatar Russell Saunders in reply to RichardS
      Ignored
      says:

      Oh, I was just in one of my pedantic moods.

      My understanding of the problem with no new antibiotic classes being discovered is that there are only so many ways of getting at a bacterium to kill or disable it, and that most of the efficient ways of doing so have already been exploited to their full potential. Now, I am no microbiologist nor pharmacologist, so my knowledge is pretty limited. But there may be more to lack of new antibiotic classes than simple industry indifference, and I imagine a well-tolerated new antibiotic would be a major seller.Report

  8. Avatar Patrick
    Ignored
    says:

    For what it’s worth, Russell, we’re all marks. Knowing that you are is the first step towards catching yourself before you step all the way in it.

    Marketing is about creating a bias. The methods of doing this are legion, and in addition to being teachable, some people out there are just naturally goddamn good at it, without knowing a thing about the underlying psychology of any of it.Report

  9. Avatar Damon
    Ignored
    says:

    Agreed. It’s done because it works. I’ve been in my doctor’s office several times when a rep has come in. Always female, always very well put together-nice suit, etc. Always very attractive…usually blonde.

    “just dropping off some samples…does dr. x have some time?”Report

    • Avatar Rod in reply to Damon
      Ignored
      says:

      I wonder if it’s any coincidence that our good doctor only mentions male reps? Do they know he’s gay and sending more appropriate eye candy? Cause I doubt the kind of leggy blonde you speak of would have much subliminal effect.Report

      • Avatar Damon in reply to Rod
        Ignored
        says:

        I’d like to think drug companies wouldn’t look into a doc’s sexual orientation but I wouldn’t put it past them…or frankly, anyone wanting to make a sale…Report

      • Avatar Russell Saunders in reply to Rod
        Ignored
        says:

        There were plenty of well-turned-out women who visited the office. I tried to be cordial, but aloof. The one who repped for a company I abjectly despise got the coolest reception.

        The rep I mentioned in the OP had been coming to that office before I joined them. They didn’t send him just because he was cute and there was a new gay doctor, I’m pretty sure. But I don’t think it’s a coincidence that his being cute had a subtle effect on my desire to have him think well of me, and I have no doubt that pharmaceutical reps are generally rather attractive for this reason.Report

    • Avatar Stillwater in reply to Damon
      Ignored
      says:

      “just dropping off some samples…does dr. x have some time?”

      I’ve seen that movie, too. She ends up making the sale, right?Report

  10. Avatar KatherineMW
    Ignored
    says:

    I used to room with someone who had worked on the same floor of a building as a pharmaceutical firm. He said the pharmaceutical company hired their marketing people for (among other things) their looks – everyone in that office was model-level good-looking. So there’s a good chance the company the eyedrops-guy worked for hired him in order to get that kind of effect.Report

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