The message of a recent cartoon in “The New Yorker” was so self-evident that it didn't even require a caption. It showed a patient sitting on an examining table looking alarmed at his doctor, who was wearing a white coat covered with drug-maker decals. The doctor looked just like one of those race car drivers displaying all their sponsors. In this marketing-driven age of modern medicine, perhaps such attire for MDs is not such a bad idea.

After all, whenever I visit my doctor these days, I almost always see at least one, if not more, drug dealers (I mean pharmaceutical manufacturer sales reps), sitting and waiting to deliver their pitch.

Just like when you go “shopping” in the exhibit area at insurance conventions, these marketers come bearing gifts–pens, notepads, mouse pads, key chains, pretty posters…anything so the doctor (and the patients in the office) will remember their names.

I have also read about the junkets run by drug makers for doctors at plush resorts, where they attend “educational seminars” essentially touting the benefits of that particular product.

While there are no quid pro quos that I am aware of, any time someone pays your way on a glorified vacation, it's only natural if a physician might feel obliged to give the product a chance.

Indeed, doctors often dump handfuls of free samples into your lap, to move the process along. With the high price of prescriptions these days–even for those of us lucky enough to have health insurance–such freebies can be a godsend. I know one friend who depends upon such samples to keep his medicine cabinet stocked.

I am not saying that the drugs are worthless–or worse, harmful. In fact, I depend on a number of medications to keep my system in order. But you can't help but wonder whether the medicine is being prescribed because it is absolutely, positively the best drug for one's particular situation, or because the doctor feels an obligation to help their benefactors push their particular cures.

I understand that when prescribing a drug, a doctor is taking responsibility (although only to an extent, as harmful side effects are always a possibility, even with the most established medications), and I cannot imagine any doctor knowingly suggesting a medicine that isn't appropriate for a particular patient.

Still, shouldn't doctors have to disclose any incentives they receive from drug makers when they suggest a prescription? While having decals on a doctor's clothing might be going overboard, I think the idea is worth considering, especially with the marketing blitz across the media spectrum for dozens of new and established drugs targeted at consumers and their medical providers.

Of course, the best advice for any patient these days is caveat emptor–let the buyer beware. Before taking any medication, one should thoroughly research it on the Web, to at least make an informed decision.

In the old days, this was unheard of. A doctor told you to take something, and you took it, period. But times have changed, and with WebMd and the like out there, people can and should take more responsibility for their own health care decisions. (Although people can go too far when it comes to self-diagnosis and treatment. See tomorrow's blog entry for more about that.)

Given the way soaring drug costs are sending the cost of health insurance, workers' comp coverage and even auto policies through the roof, any speed bump placed in the path of runaway prescriptions is worthy of consideration. Besides, shouldn't patients know if their doctor is pushing a drug that just sent them on a golf junket in some sexy locale? What's the harm in providing such information?

What do you folks think?

Special Reports /

Doctors Should Provide Full Disclosure!

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