Do Big Pharma Kickbacks Influence The Practice of Medicine? Do Hogs Grunt?

An article has appeared in PR Newswire about a Carnegie Mellon University research study dealing with drug company kickbacks to doctors. The heading speaks to the rationale behind the corruption of many dirty doctors, ‘Because I’m Worth It’ – CMU Research Sheds Light On How Doctors Rationalize Accepting Industry Gifts.

Despite heightened awareness about the undue influence that gifts from pharmaceutical companies can have on doctors’ prescribing practices, and despite expanding institutional conflict-of-interest policies and state laws targeted at preventing such practices, companies continue to reward doctors for prescribing their drugs with gifts ranging from pens and paper, to free dinners and trips. A new study by two researchers at Carnegie Mellon University, published in the Journal of the American Medical Association, helps to explain how doctors rationalize acceptance of such gifts, which author George Loewenstein, the Herbert A. Simon Professor of Economics and Psychology, describes as “barely described bribes.” The study found that physicians rationalize acceptance of these gifts as a form of reward for the sacrifices they made obtaining their education.

If you’re thinking about the relationship between Mexican cops, government bureaucrats and drug cartel racketeers, you’ve got a pretty clear picture of what’s going on here.

Somewhere along the line the idea of caring foremost about patient health has taken a nosedive where physician vanity, prestige and profits are concerned.

Reminding physicians first of their medical training burdens more than doubled their willingness to accept gifts — from 21.7 percent to 47.5 percent — and suggesting the potential rationalization further increased their willingness to accept the gifts — to 60.3 percent. The impact of the suggested rationalization was surprising because, when asked whether their hardships justified taking gifts, most respondents said it did not. Sunita Sah, the study’s lead author and a physician herself who is completing her Ph.D. at Carnegie Mellon’s Tepper School of Business, commented that “this finding suggests that even justifications that people don’t accept at a conscious level can nonetheless help them to rationalize behavior that they otherwise might find unacceptable.”

The authors of this study conclude that pharmaceutical company physician bribes should be outlawed.

Both authors agree that the implications of the study are straightforward. “Given how easy it is for doctors to rationalize accepting gifts, which, from other research, we know influences their prescribing behavior, the inescapable conclusion is that gifts should simply be prohibited,” said Loewenstein, who has done extensive research and writing on the role of human psychology in exacerbating conflicts of interest.

On a related note, South Carolina researchers have conducted a study that shows doctors who respond to such bribes are less likely to identify some of the harmful effects of the drugs they are using. As reported in Business Week, an article entitled Possible Conflict of Interest in Industry Funded Basic Research states the case very succinctly.

Researchers without pharmaceutical industry support are more likely than those with support to identify detrimental in vitro effects of erythropoietin-stimulating agents (ESAs), including potentially harmful effects on cancer patients, according to a study in the Sept. 13 issue of the Archives of Internal Medicine.

The ongoing, more or less, intimate relationship of the American Psychiatric Association to the pharmaceutical industry, and the continuing conflicts of interest involved, not to mention the damaging effects and the therapeutic ineffectiveness of some of the most commonly used prescription drugs they dispense, indicate why this area of research can be so very important outside of the narrow confines of the strictly physiological branches of medical science.

This sort of ‘conflict of interest’ research has a potential for being very beneficial. Just think, should any effective legislation come of it, given a pie chart or a graph, the results of that legislation could be tallied up in terms of saved lives.