![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Dr. Bob on January 27, 2004, at 21:16:50
In reply to Re: YESdoctors get kick backs from drug companies!, posted by flyingdreams on January 27, 2004, at 15:30:35
> Yes doctors get kick backs from the drug companies. There are drug pushers that show up at the drs offices all the time pushing these drugs!!!! They give out free samples so that you will get addicted to their drugs and then have to buy them!!!! Amazing and it's legal! $$$$$$$$$$$$$$$MONEY$$$$$$$$$$$$$$$$$$$$ is all the drug companies care about and most doctors become doctors because of the high salaries. I say drop their salaries and see more doctors that care!
Posted by Poet on January 28, 2004, at 10:22:26
In reply to Re: kick backs from drug companies! « flyingdreams, posted by Dr. Bob on January 27, 2004, at 21:16:50
I currently work for a nonprofit health care program that's part of a large health group. All of our salaries are paid for from grants, including doctors, believe me nobody here is in it for the money.
Yes, the drug reps stop by regularly, and for us the samples are welcome as our patients are teens who have no health insurance.
I agree that the cost of health care and meds is way too high, even for the insured. I just wanted to present another side of the issue when it comes to drug reps and free samples.
Poet
Posted by Penny on January 28, 2004, at 13:43:47
In reply to Re: kick backs from drug companies!, posted by Poet on January 28, 2004, at 10:22:26
I'll second Poet's message. My pdoc runs a number of clinical trials for drug companies and, by doing so, can afford to write off co-pays and/or large portions of his normal fees for patients who can't afford to pay him. He also is able to supply patients who can't afford meds with samples. It's not about the money for him.
P
Posted by ann33 on January 28, 2004, at 16:47:41
In reply to Re: kick backs from drug companies!, posted by Penny on January 28, 2004, at 13:43:47
That is okay that there is good professionals that get money from one side to help another but what is in general?
I have friends that are doctors and they said that once a month they have a wonderfull party with everything paid by pharmaceutical companies.
Nurses and other health professional are not invited . Only are invited doctor and medicine students.
Clearly direct advertisement.
Posted by Althea8869 on January 28, 2004, at 23:17:29
In reply to Re: kick backs from drug companies!, posted by ann33 on January 28, 2004, at 16:47:41
One psychopharmacologist I spent some time with at Harvard explained things to me this way: Young doctors, naive(though possibly very bright), with limited real experience and the desire to build a practice open themselves up to drug companies and can reap benefits from doing so. This is a great but unfortunately necessary indoctrination process for them. The advantage(also disadvantage) of young doctors is that (at least in my experience) they often are more willing to explore alternative treatment methods...combos..etc. For typical unipolar or other "textbook" situations these docs will do a fine job. However, as more 'atypicals' are coming forward for help, these folks are really out of their league. What this doc told me, candidly, is that he had to to the same thing right out of school, but now after being a psychopharmacologist for nearly thirty five years as well a professor at Harvard and MIT he no longer sees pharm reps and has a breadth of practical expereince to work from. These are the docs that the atypicals really need to search out. Interestingly, the doc that I am talking about here no longer prescribes ANY medication for depression. He has, over the last fifteen years, found that the correct combination of supplements in conjunction with proper eating and excersize has statistically a higher success rate for complete recovery than any single other method employed, and in point of fact he has twenty years of unbiased evidence to prove it. I wont get into the supplements in this forum, but my general point is that atypicals really need to look to someone that will be less under the influence of pharma's.
Posted by Penny on January 29, 2004, at 8:48:55
In reply to Effexor withdrawl nightmare and options, posted by Althea8869 on January 28, 2004, at 23:17:29
I think it's wonderful that this psychopharmacologist was able to help his patients through supplements and other alternative therapies, but my pdoc, who has 25+ years of experience, studied at Duke, also works in molecular genetics, and sees mostly 'atypical' and hard-to-treat patients, believes firmly in the proper use of medication. He also uses supplements to treat his patients and he doesn't prescribe medication unnecessarily. But many of us, myself included, need medication to treat our illnesses. I've seen quite a few docs, none of whom were young and just starting out, and none of them were as knowledgable, caring, and helpful as the doc I see now. I trust him implicitly. I also trust that by working with the pharmaceutical companies, his work is not only benefiting his patients, but benefiting others who take psychotropic medications as well.
I see your point about new docs and the impact pharm companies can have on them and I agree that it is a problem, and certainly not just in psychiatry. But I also refuse to believe that the pharmaceutical industry as a whole is entirely bad, and I think that experienced docs who don't prescribe medications because a rep tells them to but instead trusts their own knowledge and experience, and scientific evidence, that a certain med is right for a patient, can make the pharm industry work FOR their patients.
Posted by Althea8869 on January 30, 2004, at 15:36:32
In reply to Re: experienced docs and pharm companies » Althea8869, posted by Penny on January 29, 2004, at 8:48:55
Penny - your points are very well taken. In point of fact, I am a very strong supporter of the pharm/biot-tech industry as a whole (partly because my portfolio is bio-tech heavy) but more importantly because of the awesome responsibility they have. I believe far more federal spending(in the form of R&D) should be provided to many areas of research in the pharm/biotech industry - I would certainly like to see more money going into psych disorders and the search for a greater understanding of the role of neurochemicals in depression/anxiety/etc. Personally I think we are off base. But I digress.
I guess my main point ,Penny, is that a more established pdoc is in a far better position to know when to push back the pharms and when not to. Candidly, the doc that I mentioned before - I personally disagree with his methods. I believe that structural abnormalities in the brain - when they can be fixed or helped, in a timely manner, with specific medications, should be. Period. That notwithstanding, the body of evidence that he has to support his claims are quite incredible - unfortunately most supplemental based cures can and will take as many as 6 months or more before noticable improvement is seen. Having suffered now for the better part of fifteen years, I simply dont have that kind of time. The doc that im seeing now is actually quite young, but he is very open to letting the patient take an active part in the decision of medication(s). That, for me, has been one of my primary requisites for a doc.
Anyway, sorry to ramble Penny - and I think its great that you have a doc that you hold in such high regard - I truly belive that you stand a far better chance of success in treatment, when you are in a situation like that.
All the best...
Posted by noa on January 31, 2004, at 16:20:37
In reply to Re: experienced docs and pharm companies » Althea8869, posted by Penny on January 29, 2004, at 8:48:55
I read that this is a big issue in med schools and hospitals that train interns and residents---of course, no matter how much good the pharm industry does, they are a business and will try to find inroads for marketing to docs. So the question is, who is responsible for maintaining appropriate boundaries. I do not think the pharm industry is responsible, I think the medical profession and the government, ie, us, the people, are responsible for upholding proper boundaries between marketing and professional ethics. We the people, via laws to set boundaries around access and truth in marketing, etc. have an obligation to monitor those boundaries. And the medical profession most definitetly has the obligation to maintain boundaries that are consistent with the ethics of medicine. And the training institutions, I feel, do have a major obligation to maintain a distance between the pharm marketers and the trainees, because trainees really could be vulnerable to the influence of the marketing people. But I think that even experienced pdocs need to keep an eye on how much influence the marketers have in their prescribing decisions. And the medical boards and professional organizations need to be overseeing these relationships. Pharm reps should not be allowed to participate in patient office visits, for example. And there should be some way that patients should have access to honest disclosures from the pdocs about the relationships they have with marketers, and how the pdocs are maintaining professional imparitality in the face of these relationships.
Rant over. :)
This is the end of the thread.
Psycho-Babble Social | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.