by Stewart B. Segal, MD


I confess!  I did it!  I ate lunch with a representative from a pharmaceutical company (drug rep).  Yes, I confess, most days of the week I eat lunch with drug reps.  I take 15 minutes between patients to sit and eat and listen.  Drug reps provide the lunch.  They teach me about their newest products, both the risks and benefits of their medications.

In an effort to disparage my profession, the government has passed the Sunshine Act.  They are going to publish, on the internet, the names of doctors who dine with drug reps.  The inference is that the pharmaceutical companies are buying my business.  The inference is that doctors are cheap whores and will sell out their patients for a pad of paper, a pen with a product name on it (both now banned by law) or a lunch (still legal).

In the business world, it is called a business lunch.  It is a long accepted business practice.  A businessman extols the benefits of his product and hopes to sell his wares.   In the world of government, the drug reps' equivalent is the lobbyist.  The lobbyist has unlimited funds to spend on congressional leaders.  They provide trips to exotic places, extravagant dinners, and contributions to campaign funds.  Luckily, congressional leaders are too ethical to sell out their constituents for tens of thousands of dollars in trips and campaign funds. 

In the medical world, the drug rep follows a carefully scripted, FDA approved, sales pitch/educational experience.  Yes, the FDA regulates what the drug rep can say and can’t say.  Those regulations are based on scientific research and proven results.  If the drug rep varies from the highly censored script the FDA approves, it is a crime punishable by tens of thousands of dollars.

The time I spend eating lunch with the drug rep is time well spent.  As your doctor, I need to stay current on the latest treatment options.  I only have so much time during a day to study so I use the web, conferences, journals and even drug reps.  I am trained to analyze research and capable of differentiating between what is sales pitch and what is fact.  My patients benefit from the knowledge imparted by the rep as well as sample medication and discount cards left by the drug rep.

While I’m confessing, I also confess that I am a teacher and am paid to teach about various medical topics.  The same pharmaceutical companies that send reps to my office hire me to go to lunches and dinner with other doctors and teach them about the latest research and uses of their medication.  There is another website that posts how much money pharmaceutical companies pay me for my time and expertise.  I am embarrassed to admit that it is a remarkably small sum, but I love teaching so I will continue to do so.

So now you know the truth.  Your doctor teaches, for which he is paid.  That’s nothing new.  I hope that each of you has found that your office visits are most often like going to class.  Your doctor spends most of his work lunches studying how to be a better doctor.  As your doctor, I am proud to have the opportunity to learn and to teach.  Most of all, I am proud to care for you.



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