December 05, 2004

• Unbelievable -- what a load of crap. Thanks for alerting us that this jackass organization exists, Gyan.
• Free access to dedicated issue of British Medical Journal, regarding Drug Promotion, here.
• My mum's a drug rep. For a Merck subsidiary. She's been trying to get out for several years now. It was a pretty reputable profession when she joined it several decades ago. Like, you had to know your stuff, you had some sense of social responsibility. Now they're hiring temp sales staff, with no medical knowledge of any sort, to do the job. The idea that you might be trying to get the right products to the right people... out the window. So yes. She was going for early retirement. Then Vioxx happened in the States, and all those nest-egg share options we were relying on- pffft. Hey ho. But that stuff about drug company lunches has always been true. And when I was a kid, I didn't have a pen or a calculator without a drug brand name on it until I was about 14. Heh. She did have a model arse, though.
• I have a Merck leather folder in the other room, though I did loose my vioxx travel mug a while back. SO's mother is an epidemiologist in arthritis research.
• The only "drug reps" I ever met talked really slow, yet they moved really fast.
• It's a conspiracy I tell ya. A c..o..n..spiracy. Your mum's not alone, flashboy. I know several reps who feel like they're nothing but drug pushers stealing money from old people. When you've got people on Medicare with no drug coverage paying $120 a month for Plavix (an overpriced aspirin for all intents and purposes), the analogy isn't too far off. (Don't be fooled by the new Medicare drug benefit for 2006...it sucks. Green donkeys, it does.) OTOH, I will be forever grateful to the patient assistance programs who made it fair and simple to get free meds for my patients who qualified, especially Astra-Zeneca and Bristol-Myers-Squibb. Glaxo-Smith-Kline, who routinely denies people hiv meds because of "missing" or "incomplete" paperwork or any other number of inane reasons deserves the biggest cockpunch on the planet. *ka-POW*
• My mom works for a doctor, and I have lots of drug-rep pens, post-it notes, etc. They just passed a law in TX that said that drug reps can only hand out office supplies and lunch to doctors. Before this, docs were getting high end electronics equipment, trips abroad and all sorts of wonderful bribes. My doctor always turned down the big ticket items. (Post law, they're sending gold-plated pens and desk sets... how many of those do you need?) I *think* it's also a law in TX that you have to have your pharmacy license to be a drug rep, though I could be wrong.
• *raises hand* *has many a big pill spitting postits and like writing on giant uterus diagram paper pads* it's like the trickle down theory i don't personally know any docs who have gotten high end anything but reps do come prepacked with lunches and such. the best thing i ever saw was this suspended marble rack that held notes. usually only the "big time" docs and endorsement leaders get these major kickbacks one hears of like trips to islands. Mostly they did just show up with claritin cookies and free drug packets. remember, you can always ask for the free samples as most doctors one deals with know you can't afford a ten dollar pill or whatever depending on your financial/insurance status
• to clarify, i mean your usual doc baker isn't getting plasma screens as far as i knew, but depending on your "new medical team" and their affiliates-- --even if they were, they've gone all chicken now. those malpractice/malfeasance things make a doc all pesky and tense
• ...and let's just say no to political lobbyists, too. (RDA of windmill tilting done for the day)
• Just say "Yo!" to posting the exact same thing to both MeFi and MoFi.
• Eh. Different audiences with a small overlap.
• I really appreciate that you posted on both sites, because I want to comment, but don't have a MeFi account. My best friend is a nurse practitioner. She gets me thousands of dollars worth of free samples from "her" drug reps of the 2 expensive drugs I take, so I'm personally grateful for that, and shouldn't throw any stones, I guess, but I gotta say, the drug reps have her totally taken in. I can't have a meaningful conversation with her about medications, even though we're both nurses, because she believes anything the drug reps tell her. She thinks Vioxx should still be on the market, and thinks SSRIs for kids are the cat's meeow, even though all but Prozac tested no better than placebo with 4 times the suicide risk. It's sad, and really makes me see there's much greater power in those pens and sticky pads than any reasonable person would imagine.
• Just out of curiosity, do a plurality of monkeys seem to consider MoFi as a tangental supplemental posting place to MeFi? Because I never go to MeFi, and feel left out when people talk as if I should know what's going on over there.
• Oh we discussed that over on MeFi ages ago TenaciousP, and we all agreed that you totally suck and deserve to feel like Lou the Left-Out Loser.
• Just jokes! I love you! ;)
• Good job ignoring the troll everyone. *prescribes a cockpunch for the troll* Is this a big problem outside of the people with imagined mental health issues? (not to be confused with the people who actually do have mental health issues.) I understand how a doctor could be encouraged to prescribe a SSRI to someone who's just sad. But if I just get a sore throat or something and need some antibiotics, do I have to worry about the doctor giving me some crazy shit because some drug rep took him out for steak? Needless to say, it's important to talk to your doctor when he or she is prescribing something you're not familiar with. Also, talk to your pharmacist. I don't mean grill them about getting kickbacks from reps, I just mean ask about things like what the drug does (a simple explanation, like it's an antibiotic, it's an SSRI, etc), what are the possible side effects, is a generic available. I know it seems obvious to some people. Most doctors deserve your trust, but you should still know what's going on.
• That was a pretty piece of alliteration. Not to encourage the derail, but crossposting's fine by me. We're not MeFi2 anymore. On topic, it's absolutely obscene to me that they spend so much money advertising a product that only a licensed doctor should recommend, driving up the prices.
• Different audiences with a small overlap. Ironic, then, because the only reasons I mentioned it were, first, the links were presented exactly the same way, link for link, more appropriate for identical rather than different audiences. Second, it if it were to become standard practice for "dual citizens" of MoFi and MeFi to make identical postings, the identities of the two sites would be made indistinct rather than the reverse. And I for one would definitely not like that. There are some, many actually, MeFi posts that I'd rather not see here if at all, alhtough this one was really pretty good. Therefore, my earlier comment. If everyone thinks it's a fine thing to do, then fine with me and I may do the same in the future too.
• smallisn bear wrote:But if I just get a sore throat or something and need some antibiotics, do I have to worry about the doctor giving me some crazy shit because some drug rep took him out for steak? Yes, smallish bear, you do. Vioxx was mostly prescribed for arthritis, but also for other moderate level pain that "normal" people get, like chronic back pain, bursitis, etc., until it turned out to cause heart attacks. Estrogen replacement therapy was prescribed for menopause, until it turned out to cause strokes and cancer. Many drugs that are frequently prescribed for everyday ailments have cheaper, equally good alternatives, but doctors don't prescribe the alternatives much because the drug reps convince them that the expensive ones are better. For example, gastric reflux will respond well in most people to Pepcid (over the counter, cheapish, though not generic), but doctors usually prescribe a PPI right away now, even though most people probably don't need one. The problem is systemic, its just that the SSRIs are a particularly egregious example.
• When I first got back to NZ, I was on Serevent for my asthma, having been prescribed/given free samples in the US. I found out when I went to my new doctor here that Serevent use is monitored closely by the government because of its high steroid levels, and use is restricted to people who have had no success at all with any other preventatives. Now I'm on a milder preventative with no problems, and I'm not worrying about growing facial hair.
• doctors or otherwise, unless someone is especially familiar in certain areas and of certain drugs, why they work for anything is still a mystery for the most part. Aspirin is still a mystery and it's old, medicine is a soft science-- Depending on your unique chemical make up, it's all a crap shoot, especially with off label dispensing. a General Practitioner handing out specialized medicines is different than a specialist is different from a pharmacist, nurse, client, rep, etc all initialed dotted qualifiers-- people only access as much info as they need or want. a lot of people leave specifics to anyone else they think did the research and use that brain space for gossip, golf trivia, phone numbers-- the bloom of psych and geriatric drugs left a whole open market to people getting use to drugs as a part of life, for drugs to be used, hence tested widely. at some point i think a lot stopped asking if you wanted to try [whatever] and just say try [whatever] as thet don't assume you would know any better. sometimes just asking what class of drug something is is a ridiculous chore as they answer is a long string of blah blah blah instead of "no, it's not an antihistamine" a big part of mismedication is the failure to get an adequate patient history, so certain drugs get recalled at the hint of a law suit. it doesn't necessarily mean they don't work well, just not for everyone. Overuse of an antibiotic, wrong dosages of something, mismanagement at any level can cause a drug to be stygmatized and cease research into it in favor of something less worrisome. non prescriptive elements get pulled at the hint of effectiveness, but it's not like people in the US regularly look at the serviceable dosage of food, so if they'll eat six pints of ice cream, why not take three pills of whatever? people think they can blow dry oil paint ferphilssake with doctors becoming more worried at people even asking question, esp. if they aren't use to it or being any good at explaining, getting answers is about finding them or at least reading that little tissue paper wad it comes with and how many people do that that haven't had to?
• the push comes from the possibility of money like with bad music or mediocre services-- what range of drugs available to countries that don't produce them is another question, and if there is a propensity of some condition in certain areas that make them seem common. steroids are very effective, immediate relief is a reason a lot of people overuse certain types of medicines and it's pretty commonplace for people to think a lot of something is equal to its effectiveness wehether it works that way or not-- --then you get addiction, tolerance, overdose, decreased effect, etc--
• el_hombre: Ironic, then, because the only reasons I mentioned it were, first, the links were presented exactly the same way, link for link, more appropriate for identical rather than different audiences. Different audiences == different eyeballs, not necessarily different mentalities. The reason this is cross-posted is for providing a discussion space, not just following the links. It used to be a common refrain from Mofites, before Mefi opened up, that they couldn't comment on stuff posted at Mefi. With Mefi still being a paid gated community, the service is still warranted.
• Yes, I will admit that I also get hundreds of dollars worth of free allergy meds from my doc every year. He's very good about giving out samples when he has them, especially if he knows you're uninsured.
• Good job ignoring the troll everyone. *prescribes a cockpunch for the troll* Thanks. Bye.
• Thanks. Bye. Not you. Unbelievable -- what a load of crap. Thanks for alerting us that this jackass organization exists, Gyan. Him. I didn't want to give him the attention he so sorely craves by calling him out specifically. getting answers is about finding them or at least reading that little tissue paper wad it comes with and how many people do that that haven't had to? I read the inserts... They're helpful if something happens after you start to use the medication- you can reference it to see if it may be a side effect.
• Jesus fuck, smallish bear. Can you get any more fucking holier-than-thou? Can you please lay off calling anybody who disagrees with you a troll? For an advocacy organization, the N.F.L. site shows an excellent nuance and sense of humor. ("Take the CAGE") I wish more could do such. David, I certainly understand your distrust. Skim the BMJ issue that Gyan cites. /grew up in a household with pharma freebies