|Opened My Eyes|
Generic Drugs -The list of generic medications keeps growing almost every day. There are now so many available that I seldom write prescriptions for name-brand drugs. The two times I might write the name-brand version of a pill is if the medicine was started by a specialist, or if the patient asks for name-brand. There was a time when generics were unreliable; those days are long, long gone. You can find more good info on generic medicines here.
I used to try to reason with such people but quickly realized that TV commercials and non-MD friends evidently seem to give more reliable medical advice that a silly doctor and so I just smile and write them the prescription (except for the re-sale folks). Usually we get a call from the pharmacy in a couple of hours from a flustered pharmacist (and the patient still yelling in the background) who has just made it known that insurance will not cover the televised pill, and that it will cost the patient $256 every month to take said pill. We quickly apologize for our error and change the medicine to the generic, and everyone is again happy.
The only place you will see pretty Drug Reps in my office today is at the front desk trying to con their way down my hall (and failing). I would much rather help another patient or two in a days time than listen to the canned sales pitch from a Drug Rep.
Science vs. Cuteness - The more I thought about the seeming inconsistency of the attractive people who knew so much about medicine despite lacking an MD degree, the more it bothered me. So I started doing a little research, read a book or three, and came to the obvious conclusion.
I thought back to my days of roaming the halls in the Biochemistry and Cell & Molecular Biology Labs and I remembered something; there were very few really cute people there, and none of them were well-dressed! These Drug-Reps are trained and polished to appeal to my weaknesses as a doctor, to study me, take notes about me for their partners to use, and to trick me into making a decision that I might not have made otherwise. In order for one to be a good doctor science has to win over cuteness every time.
|Another Good Book|
Even though I was talking to the Drug Reps with the best of intentions, my patients were basically getting the message that I would rather spend my time talking to attractive, well-dressed Reps than to my patients. That certainly is not true, and I don't want to give any such appearance to my patients.
What about the Free Samples - Times have changed. In the past those free samples could actually help patients. That was back in the days when Synthroid and Coumadin were brand new. Both these and hundreds of other important drugs are now generic which means no samples are left. Samples nowadays usually are for drugs that are very expensive and are of little more benefit than the generic equivalent. Oh, and they no longer leave any Viagra samples, sorry.
So much money is spent on Drug Ads that different dosages of the same pill often cost the same amount; this should tell you how much the drug itself really costs. For example, Viagra comes in 25, 50 and 100mg doses which all cost the same amount. How is it possible that the 4x's greater dose of 100mg cost the same as 25mg? It's because the chemical itself is relatively cheap; the multi-millions in Drug Ads, however, are anything but cheap.
Recently I found the video below, and I found it to be a little disturbing. It was made by a former Drug Rep who has "come clean" about the tactics, strategy and truth-stretching that are common when drug companies communicate with doctors. There is a whole science behind taking a college graduate and training them to walk and talk and act in such a way that doctors feel comfortable around them, and indeed, respect their advice. This lady seems to be pulling out all the stops and I think this information is very important for everyone who trusts their doctor's advicer.
|Another Disturbing Book|
Those nice people in the expensive suits have a job to do. It is not to make you healthier, it is not to make you feel better, it is not to make you less depressed; their job is to get your doctor to prescribe the pill their company makes in order to make their share-holders more money. It doesn't get more simple than that.
Click the arrow to watch this disturbing video...
Click the arrow to watch this disturbing video...
Make no mistake, some patients are quite sick and need to take medicine, some need to take a lot of medicine in order to function at a level meaningful to them. But we all need to remember that TV commercials are not there to educate us, they are there to sell a product. In the case of this product (pills), the company needs a middle man (your doctor) to close the sale. Taking a daily pill is a big commitment and should not be taken lightly.
|Buy for Your Doctor|
Feel free to bring a list of questions you have for me, print info off a website, or even bring your friend who recommended the pill; I promise I will listen and together we will decide the best course. It worries me when a doctor is offended by a patient who has been doing some of their own research; every patient should be very knowledgeable about their own condition and the medicine they might need. But, if I'm trying to tell you you don't need a pill, or that a generic pill will do just fine, remember that I make the same amount whether or not you take the name-brand pill; since I don't see Drug Reps, I tend to focus on what is truly best for you and your pocketbook. Trust your doctor, and if you don't trust your doctor, find a new one.