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Old 11-21-2015, 05:36 AM   #41
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Follow the money. Doctors are highly incentivized - about 7 times as motivated as patients...
https://www.washingtonpost.com/news/...ads-than-ever/
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I don't doubt it, but the docs should still just say 'no' if that's the right thing to do. Doctors are professionals, in a line of work that should be held to high standards.

I suppose I could say that cops are incentivized to take bribes, and car companies are incentivized to cheat on emissions testing, but they still should do the right thing.
It's illegal for cops to accept bribes, and illegal for car companies to cheat on emissions testing. Big pharma has found legal ways or gray areas to pay doctors billions for promoting or prescribing their prescription drugs, medical devices, etc. World of difference...

And so far doctors have not been required to disclose the payouts, though the Sunshine Act may change that.

http://www.drugwatch.com/2014/10/02/...tals-billions/
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Old 11-21-2015, 06:10 AM   #42
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That's very interesting, Midpack. I always felt like the drug companies always were bribing doctors. When something becomes commonplace it is accepted.

Ha...If we start taking those ED fixer uppers now we may turn our lives around. But remember...everything is in slow motion on those commercials...
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Old 11-21-2015, 08:41 AM   #43
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Old 11-21-2015, 08:45 AM   #44
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I don't know, some of the most attractive, "middle aged" women the world has ever known appear in those ED adverts. And are they ever friendly!

Also, these pills seem to improve the man's appearance and economic success too. Tall slim guys with wavy steel grey hair, piloting 40' sloops. A lot to gain just by risking an erection that lasts > 4 hours.

Ha

Reminds me a really bad joke about a guy who only had a few bucks left. Goes into the grocery with his few remaining bucks, and comes out with a box of feminine pads. When a friend asked why he spent his last few bucks on that, he replied that, according to the TV commercial, you can ski, play tennis, go dancing...
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Old 11-21-2015, 08:48 AM   #45
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It's illegal for cops to accept bribes, and illegal for car companies to cheat on emissions testing. Big pharma has found legal ways or gray areas to pay doctors billions for promoting or prescribing their prescription drugs, medical devices, etc. World of difference...

And so far doctors have not been required to disclose the payouts, though the Sunshine Act may change that.

Big Pharma Paid $3.5 Billion to Doctors, Hospitals in 2013

OK, it's different.

But my point still stands - even if a Doctor feels 'pressure' from a patient to prescribe x,y,z, because the patient saw it on an ad - the Doctor should do the right thing, ethically. Either the drug is appropriate (and then the Doctor should have offered it to the patient - he's the pro, he should be current on the subject), or it isn't appropriate, and the Doctor says "no", and explains why.

Shouldn't a Doctor be expected to meet that simple standard? My post was in ref to people talking about the 'pressure' these ads put on Docs. I say, tough - the Doctor just needs to do the right thing.

-ERD50
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Old 11-21-2015, 09:51 AM   #46
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Shouldn't a Doctor be expected to meet that simple standard? My post was in ref to people talking about the 'pressure' these ads put on Docs. I say, tough - the Doctor just needs to do the right thing.

-ERD50
You may be putting too much faith in the way things are supposed to be, and not granting enough to the way things actually are. We all have powerful motivational structures that may largely operate out of sight, but nevertheless get a strong say in what we do.

Ha
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Old 11-21-2015, 10:18 AM   #47
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And so far doctors have not been required to disclose the payouts, though the Sunshine Act may change that.
Propublica has been collecting and standardizing the sunshine data and you can browse it online here: https://projects.propublica.org/docdollars/ . I believe they get the data directly from the pharma company and not from the doctor.

Here's an example for some doc in NJ who received 190k over two years

https://projects.propublica.org/docd...ors/pid/324458


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You may be putting too much faith in the way things are supposed to be, and not granting enough to the way things actually are. We all have powerful motivational structures that may largely operate out of sight, but nevertheless get a strong say in what we do.
This is actually very well studied by medical researchers and there's a clearly unwanted influence and doctors are not able to remain completely objective:

Quote:
most studies found negative outcomes associated with the interaction. These included an impact on knowledge (inability to identify wrong claims about medication), attitude (positive attitude toward pharmaceutical representatives; awareness, pref- erence, and rapid prescription of a new drug), and behavior (making formulary requests for medications that rarely held important advantages over existing ones; nonrational prescribing be- havior; increasing prescription rate; prescribing fewer generic but more expensive, newer medications at no demonstrated advantage.)
from http://med.stanford.edu/coi/journal%...ust_A_Gift.pdf

Here's another interesting quote:
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One study found that 85% of medical students believe it is improper for politicians to accept a gift, whereas only 46% found it improper for themselves to accept a gift of similar value from a pharmaceutical company.
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Old 11-21-2015, 10:42 AM   #48
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OK, it's different.

Shouldn't a Doctor be expected to meet that simple standard? My post was in ref to people talking about the 'pressure' these ads put on Docs. I say, tough - the Doctor just needs to do the right thing.
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You may be putting too much faith in the way things are supposed to be, and not granting enough to the way things actually are. We all have powerful motivational structures that may largely operate out of sight, but nevertheless get a strong say in what we do.
+1. If you read the link, there's $24 billion from pharma to doctors that suggest you're faith is seriously misplaced. I wish your POV was more right, but it doesn't appear to be the case. Again, that's 7 times the $ pharma spends on direct to consumer advertising - and they're far too common IMO.

I know the Sunshine Act database is up and collecting, but it doesn't appear to have changed the pharma payoffs to doctors much - yet. Hope springs eternal, though I have to assume big pharma is already developing other "legal" angles...

And if you're not already incensed, ultimately the consumer pays every penny for all the ads and Doctor payoffs. What a racket!
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Old 11-21-2015, 12:32 PM   #49
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OK, it's different.

But my point still stands - even if a Doctor feels 'pressure' from a patient to prescribe x,y,z, because the patient saw it on an ad - the Doctor should do the right thing, ethically. Either the drug is appropriate (and then the Doctor should have offered it to the patient - he's the pro, he should be current on the subject), or it isn't appropriate, and the Doctor says "no", and explains why.

Shouldn't a Doctor be expected to meet that simple standard? My post was in ref to people talking about the 'pressure' these ads put on Docs. I say, tough - the Doctor just needs to do the right thing.

-ERD50
Quote:
Originally Posted by haha View Post
You may be putting too much faith in the way things are supposed to be, and not granting enough to the way things actually are. We all have powerful motivational structures that may largely operate out of sight, but nevertheless get a strong say in what we do.

Ha
I guess I was not clear - yes, I absolutely was talking about how things should be. I also think we should be able to expect that from such high level professionals.

Whether we are getting it or not is a different matter.

-ERD50
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Old 11-27-2015, 08:15 PM   #50
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Apropos of nothing, a friend sent me a link to a video where a young woman in a lab coat says, "If you have an erection lasting more than four hours, CALL ME."

These ads deserve satire.


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