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Life savers ??

April 19, 2009

           According to me, there are 2 professions in this world if practiced with only money in mind will lose its holiness and real purpose of it. One is a teacher and other is Doctor. But the current situation is absolutely pathetic with everybody running behind the money bot teachers and doctors were also not spared. This post is going to be kind on teachers by not taking then into picture and going to  lash out at the doctors and the hospitals who were going against their conscience to get the money forgetting about the nobleness of their profession.

There are some things which are hard to believe in this world. Among them is a doctor getting bribe from the pharmaceutical companies to promote their drugs and medicines. When I first heard it, I am shaking my head in disbelief, but when I searched in net there are lot of things on this and this was a world wide phenomenon. Before going in detail about that with reports, I like to share an example:

         Let us consider that, a child goes for the treatment to doctor and he writes the drug which is given by the company, which requires 2 dosage to cure the disease. If a right medicine is given, it will be cured in a single dose. World wide, if we take, many people were earning salary that is enough for the day’s food. An extra dosage of medicine means their(family) one bogus of meal is gone. Why I have said with child is, those people will not care about themselves much as they care for their child. For them, doctor was a god. Whatever he/she prescribes was right. But doctors using the innocence and limited knowledge of these people giving wrong medicines. At times, it goes beyond this. They are using the patients as specimens to test their new medicines.  

In India:

         This is an artile by Dr.Rema Nagarajan in TOI:

 

A platinum coupon if you prescribe drug ‘X’ to 10 patients. A gold coupon if you prescribe brand ‘Y’ to 25. The more coupons you get, the greater your chances of winning. The prizes: a car, frostfree refrigerators, TV sets, digital cameras and silver coins.

If you knew your doctor was a contestant for these prizes, how confident would you feel that what has been prescribed to you is what you need, not what improves his chances in the contest?

Such contests for doctors are not unknown in India. In one such case, 100 doctors who topped the prescribers’ charts from cities like Ahmedabad, Chennai, Alwar, Belgaum, Ambala and Agra participated in a lucky draw and were awarded publicly by the Gujarat-based Torrent Pharmaceutical.

The same company let some other doctors and their families sample Turkish cuisine and culture in Istanbul as part of an international symposium on metabolic medicine. Another lot from 12 metros splashed around in the best water parks in their cities courtesy the same company.

This company has also not spared expenses in helping ‘educate’ doctors to decide which drugs to prescribe — it took a batch of Lankan doctors on a safari to Kenya for ‘education’. These aren’t allegations — the information is available on the company’s own website. Here’s how it described the Istanbul junket: ‘‘Torrent has once again raised the bar in offering a perfect combination of knowledge sharing and hospitality in the pharma industry’’.

Of course, drug manufacturers are no strangers to handing out gifts to doctors. A pharma representative told TOI his firm’s Delhi operation has earmarked an annual budget of Rs 2 crore for freebies for doctors in the Capital alone. This does not include gifts and trips abroad.

Pharma doles for docs against IDMA norms

In a case of pharma firms doling out freebie for doctors prescribing their drugs, it has been learnt that the Delhi operation of pharma company has earmarked an annual budget of Rs 2 crore for freebie for doctors in the Capital alone. And this is just one company’s budget. There are hundreds of such companies with comparable, and sometimes bigger, budgets.

Should this be legal? Several countries have brought in legislation to crack down on unethical marketing practices, and the penalties are stiff. Drug companies have had to cough up millions as fines in Europe, the US, Canada and Australia. Over 25 medical centres including prestigious ones like Harvard Medical School, Yale University, University of California and the Stanford School of Medicine have put in place strong policies that include zero tolerance for company gifts and free meals.

In India, however, we have vague assurances of self-regulation by the drug industry and reliance on doctors’ ethics. Both the associations of drug manufacturers in India, the Indian Drug Manufacturers Association (IDMA) and Organization of Pharmaceutical Producers of India (OPPI) on paper have a code of ethics for marketing practices with detailed procedure for registering and examining complaints.

However, OPPI Director General Tapan Ray refused to divulge the number and the nature of the complaints or what action was taken.

The Federation of Medical Representatives Associations of India (FMRAI) had sent a complaint against Torrent with evidence to the IDMA. ‘‘Forget about acting on our complaint, IDMA has not even acknowledged receipt of the complaint,’’ says Amitava Guha, joint general secretary of FMRAI.

 

          From the above article we can know that in addition to the amount spent on preparing the drugs, medicial companies were shelling out large amount of money to dcotors as a part of their ‘MARKETING CAMPAIGN’ 😡 Doctors too going against against their pledge of:

       I solemnly pledge to consecrate my life to the service of humanity; I will practise my profession with conscience and dignity; the health of my patient will be my first consideration…  


        

         Another article in DNA news says that:

Consumers International, a global federation of consumer organisations, has come up with a study, “Drugs, Doctors and Dinners” that has found that pharmaceutical companies often bribe doctors in developing countries — like India — to needlessly prescribe their drugs.

This helps boost sales and profits; but of course it can also put patients’ lives at risk.

The top culprits are vitamin supplements, cough syrups and painkillers. For giving these to patients for no reason doctors get goodies as varied and exciting as cars, laptops, club memberships and foreign holidays.

The medical community has admitted that many of its members are susceptible to such offers even though they know that their patients will suffer.

Further, such mis-prescriptions also lead to pathogens that develop resistance to drugs.
There are two core issues at work here.

The first is the perfidy of the pharma companies, which take advantage of weak or lax laws to push their agendas through.

It is already well-known that several drugs that are banned in western countries are openly available over the counter in developing countries — many children’s cough syrups that were named as dangerous in the US can be bought freely in India.

But it is the erring doctors that are the key part of this scam. No one can disagree that it is unconscionable that medics can prescribe medicines for no reason just so that they can get a new car or travel abroad.

We all know that many become doctors because it is seen as a lucrative profession, but the assumption remains that doctors will not willingly harm their patients just to get a few perks.

Overusage of painkillers, for instance, can lead to liver disease and internal haemorrhaging, many vitamin supplements are in fact useless and can be counterproductive, and cough syrups come with many side effects — doctors know this.

Yet, ignorance does not seem to be the problem here. Instead, it is greed. 
Caveat emptor (buyer beware) is of course the usual precaution to take, but when it comes to matters medical, people are naturally concerned.

In the world:

   This is one of the most important report on the practice of giving bribes to the doctors around the world. 

Some of the key points from that report:

True incidents:

  • In 1996, Dr P. Mansfield received funding for travel and accommodation from Sandoz to attend a meeting in Basel,Switzerland with then Sandoz CEO Daniel Vasella and staff to discuss drug promotion especially the promotion of bromocriptine to suppress breast milk production. Daniel Vasella is now CEO of Novartis, which was formed by amerger of Sandoz and Ciba Geigy.
  • Dr Mansfield was provided with food and accommodation during a meeting in Mumbai by the Forum for MedicalEthics Society in 2003 and funded for travel, food and accommodation to speak at meetings in Brasília and PortoAlegra by ANVISA (Agência Nacional de Vigilância Sanitária – Brazilian Sanitary Surveillance Agency) in 2005.

 

 

 

 

   There was a case study conducted with the help of the Malaysian dcotor with the period limit:

         Dr Rafik Ibrahim is an experienced general practitioner in the area of Klang Valley, Selangor in Malaysia. Dr Ibrahim agreed to track all his interactions with drug companies for one month (27th July to 29th August 2007) as a case study on drug marketing in developing countries. In a span of five weeks, and in 17 hours of promotion-related interactions with drug sales representatives, 16 multinational pharmaceutical companies and 9 local generic companies and distributors approached Dr Ibrahim. The list also included 10 of the worlds’ top twenty pharmaceutical companies. The following table is an indication of the types of promotional materials provided by the key global market leaders:

untitled         This is not the only one(there is also example for India and Pakistan). If we go through that report we can see that all the countries were affected by this practice. Each and every country or UN itself has many laws to stop this but none of them were enforced completely to stop this. 

Recommendations by this report:

Key recommendations at the company level:

1. Stop the practice of gifts to doctors

2. Implement rigorous policies on vetting of drug promotion materials and adherence to existing codes of conduct

3. Provide transparent and verifiable information on the precise nature of relationships and associated funding for all stakeholder groups, including health professionals, pharmacists, students, journalists, clinical research organisations and patient groups.

 

At an industry-wide level:

1. Ensure codes of conducon drug promotion extend to interactions with health professionals AND consumers.

2. Invest in innovative partnerships withgovernment and civil society organisations so that corporate funding of disease awareness campaigns, and CME may be channelled via blind trusts in line with specific health priorities of  consumers at a community or national level.

             A open letter from Dr. Paul Cary:

    Dear Mr. Enright,

The American doctor you interviewed last week about her book on pharmaceutical companies and their methods of promoting their products, failed to emphasize the relentless marketing directed at family doctors I have been offered everything from free golf games to week-ends in resort hotels, from free tickets for theatre festivals to dinner cruises. The evening invitations to the most expensive local restaurants arrive once or twice a week, let alone the free lunches which are mine for the asking. The most 1 have to do is sit through a half hour presentation of a company’s product.

In the not too distant past companies sponsored lectures by specialists for family doctors which were interesting and informative with only a passing reference to a company product. Now specialists have become little more than paid ‘shill’ for pharmaceutical companies’. In many cases the slides they use to illustrate their lectures have been supplied by the pharmaceutical company. The topics are all the same as companies are vying for the same lucrative markets. Personally I never want to hear another lecture about cholesterol and the wonderful statin drug I should be using. Their research figures are manipulated to turn a two per cent improvement into a fifty per cent improvement. Graphs are doctored by altering the scales to show substantial improvements where none exist.

The relentless promoting of asthma medications with lecture after sponsored lecture on the subject over nearly five years resulted in practically every child under twelve being prescribed very powerful steroid inhalers at huge cost, when cheaper and milder generic alternatives would have been suitable, or in many cases no medication at all was necessary. Now there is no generic steroid inhaler available in the pharmacies even if I want to prescribe one. Steroids have been available since my medical school days in the sixties, and yet we are paying out fifty to hundred dollars for asthma inhalers containing minuscule amounts of a class of drugs that are forty years old.

The pharmaceutical industry is the monster that is devouring medicare. No wonder provincial politicians want to off load drug costs on the Federal Government. Politicians won’t stand up to the pharmaceutical lobby that is financing their campaigns and employing their constituents, the medical associations are silent because they know their membership would rise in anger if their free perqs were threatened, and the professional medical journals are silent because they owe their existence to pharmaceutical advertising revenue.


Dr. Paul Cary 
M.B.B.S., M.R.C.S., L.R.C.P., D.R.C.O.G.

My own experience and conclusion:

      After saying everything there will be a question in your mind how I came to know this. Last time when I am affected with fever I went to a doctor whose clinic is nearby my father’s shop. He has given the prescriptions and I went to medical shop which is again nearby my father’s shop. Medical shop’s owner was a good friend of my father. He said that your father asked me to give the medicine from appropriate companies and not the ones written by the doctor as he is writing it on the advice of the companies. I couldn’t believe that at first but that’s the thing. When I thought that it’s confined to India or developing countires, its really shocking that it’s there in developed countries also. After all they are also humans. 

     So the only possible solution available in front of us is, not to believe the doctors blindly(Until you dont know about them). Just go to the medical shop you know and confirm whether they are right ones and can be taken. Until the governmnt takes some sternous steps this is the only possible solution in front of us.

    To conclude here is the best thing:

      the root of our problems too often lie not in an absence of laws, but in a failure to enforce them. Until this changes, perhaps all medical clinics and hospitals should carry this warning notice: Don’t get sick

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36 Comments leave one →
  1. sraboneyghose permalink
    April 19, 2009 5:37 pm

    I couldn’t agree with you more…

  2. April 19, 2009 7:08 pm

    Doctors are next to god.God gave us life and it is the doc who saves our life.But for some doc it is business.I will share with you my personal experience.My mom is a govt employees so we all get the CGHS(central government health schemes).Govt of india has provided CGHS with all the facilities,but still the docs take money from the corporate hospitals and send the patients to these hospitals.My dad had stomach ulcer which was treated by the CGHS doc,but this doctor sent my father to a well known corporate hospital for an endoscopy which was not required as he finished his treatment and other doc told him to stop taking medicine.There he was attended by a junior doc who didnt had any experience of performing a endoscopy and did a recoverable mistake and my dad passed away in the hospital within 1/2hrs time and he was just 50yrs.

    To my bad luck i worked for a pharma co,where we used to give doc airfare to write certain medicines.Dr.Reddy labs survives on sponsering docs holidays in US,europe etc.They just keep the stock in the near by chemist and tell the doc to write the drug.

    And also few doctors have a attatchment with the diagnostic center as well.Some doctors sell the drug samples which they get from the pharma co to the patients.

    Here healthcare is worst.Just go to doc for fever,he will do every possible test on you and after seeing the reports he says relax there is nothing in ur report go and do party and eat a pizza.:(

    Having said all these still doctors are god to me,no hard feeling towards doctors,they are all my personal experiences.As you said we should never believe the doctor blindly.

    • April 21, 2009 9:26 pm

      its really horrible Varunavi.. and I am sorry.. that’s the reason I hate it.. if its money means no need to worry much as it can be earned at anu point but when a life is lost it means a lot…

      They can make money but not at the cost of people’s health.. thats what I am trying to say… help them else leave them.. why play with life..

      but I won’t consider them as gods.. there are quite few people who are dedicated but many were not upto it..

  3. April 19, 2009 7:54 pm

    This is a nice article which has been written after a lot of research and gathering good amount of information.

    I think the problem is not in this field alone, doctors are after all a part of the society and reflect the attitude of the society in whole. As long as we believe in greed and corruption as a society, we will have to pay the price for it. The doctors cannot be angels in a society full of vultures!

    Destination Infinity

    • April 21, 2009 9:30 pm

      thanks DI 🙂

      yes.. we can’t expect that but still a life much more than money ..

  4. April 19, 2009 9:20 pm

    I agree with DI. Its not just the doctors, its the mentality.
    Good post!

  5. April 20, 2009 12:29 am

    @ Kanagu : Wait for the next wave. You have doctors prescribing statin drugs to 10 year old children to lower their cholesterol. Even though the statistics show that 50% of heart attack patients have normal cholesterol levels. So it is not even clear if cholesterol even has a role to play in heart disease. Modern medicine is interesting in the sense that it has acquired a mercenary role that has never before been seen and at the forefront of this has been insurance and drug companies which have literally shoved doctors in to greed for more profit.

    • April 23, 2009 6:44 pm

      yes odzer its true… the things will get worse from now on and as I said this is a life issue that concerns me ore… there are a lot of profession we can earn money but its only the doctor profession ill be able to save a life and they are forgetting it 😦

  6. April 20, 2009 8:36 am

    Its all business Kanagu. I was once referred as Customer instead of patient in one of the leading eye hospitals here in Chennai !!! Thats how pathetic the situation is !

    • April 23, 2009 6:48 pm

      it’s really annoying to hear Vimal.. customer… awwww….. 😦

  7. April 20, 2009 9:42 am

    I won’t comment here since it will be too personal a opinion! A good post though! 🙂

    • April 23, 2009 6:51 pm

      Thanks Sakhi.. 🙂
      I love have more comments from you on this as doctor is your profession and let me know what I am saying is true

  8. April 20, 2009 11:15 am

    A well researched post, Kanagu.

    I am married into a family full of Doctors and I have to say that I have only seen the BEST. Like every profession there is going to be some Black sheeps. I have seen many times that people stop considering Doctors as human. It is tough.

    • April 23, 2009 6:55 pm

      Thanks Solilo 🙂

      It’s heartening to hear it. People considering them beyond humans becos they are life savers 🙂

  9. April 20, 2009 12:56 pm

    a thought provoking & well researched post kanagu. It is sad…but then bits & parts.. the world seems to go into hands without conscience!

    • April 23, 2009 6:56 pm

      thanks Verbi… 🙂 good to see you back after long time 🙂

  10. April 20, 2009 6:51 pm

    an eye-opener for me..thanks for researching n making up this post..
    yeah, we better avoid getting sick 🙂

    • April 23, 2009 6:58 pm

      thanks Vinnie 🙂
      And one thing for you, dont go to doctor for your poor memory, more chances of you getting fooled 😉

  11. April 20, 2009 7:40 pm

    Erk.. actually in malaysia, the doctor itself will give us medicine. no politics in clinic or hospitals.

    But ur place.. HMMM….! very bad also. i donno what else to talk about it, since i have no experience. and i dont like hospitals and doctors. :P:P:P OF COZ MEDICINE

    • April 23, 2009 6:59 pm

      Viji, Its prevailing all over the world…. so I am happy that you didnt faced it..

      pls check one of the examples in Malaysia 🙂

  12. April 20, 2009 8:47 pm

    Kanagu, I don’t know what to say ! ‘There are some things which are hard to believe in this world. Among them is a doctor getting bribe from the pharmaceutical companies to promote their drugs and medicines’ – Yes, it happens – and happens all around! Scary and sad! I have heard of so many instances of this happenning.. that it’s scary..

    Very well researched post, Kanagu – very informative!

    • April 23, 2009 7:02 pm

      Smitha.. it’s really sickens me.. becos people were beliving them.. just think those poor people.. they are spending their life savings for medicine, but these guys fooling them makes me angry.. 😡

      Thanks Smitha 🙂

  13. April 20, 2009 10:06 pm

    Very informative and well researched dude….

    yes, the situation seems scary now to think of it!!!

    personally, i have not had any problems till now with doctors…

    • April 23, 2009 7:04 pm

      thanks machi.. 🙂

      My advice will be dont get sick 🙂

  14. April 21, 2009 12:25 pm

    this is absolutely sick! ….”life savers “……i guess they are “life takers ”
    i tell you kanagu………once my dad was admitted to the hospital …..though we never came to know what was the problem……but the doctor, he was so damn money minded , i was akid than and my mother was all by herself taking care of both the house and kids since dad was in hospital and this doctor he told my mother that they need to keep my father in hospital at least for a week and waht more to scare her more he said ” look you have small kids and if anything goes wrong what will you do” and my father told my mother that he feels perfectly fine and he wants to go back home as the hospital was just making a fool out of us. what more my father was wearing an oxygen mask but the cylinder was turned off…………….this is the state of hospitals and money minded doctors( though it does not goes for all as there must be soe who still are performing their duties whole heartily )

    • April 23, 2009 7:05 pm

      it’s real horrible Arpit.. Hope your father is well now 🙂

  15. April 22, 2009 2:04 am

    Pity. We have almost completely lost the *human touch*… God save.

    Well-researched post, friend. Keep writing. Spread the voice.

    Peace. Be well.

  16. April 22, 2009 5:45 pm

    Love this blog I’ll be back when I have more time.

    • April 30, 2009 12:56 am

      Welcome here mrred 🙂

      Hope to have your visit soon 🙂

  17. April 25, 2009 9:27 pm

    Kanagu,

    Great post! 🙂
    ——————————————————————-
    Sakhi,

    I would have loved to read your comments! 😉

  18. April 27, 2009 7:59 pm

    wonderufl post, my friend! I agree with you.

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