Here at Botsford General Hospital in Michigan, we recently had our quarterly Clinical Pathology Conference. It was fascinating. Acrolentiginous subungual melanoma. We saved her life- no metastasis after a hallux amputation and inguinal lymph node mapping and dissection. We rock!! Like all of our path conferences, and, in fact, like many of our academic events, we had a sponsor. It was a physical therapy company in our area. This got me thinking about what has become an old (and maybe worn out?) topic of discussion: pharmaceutical sponsorship.

I know what you’re thinking. “We’ve heard this a thousand times going through med school.” Yeah, I heard it too, but it was never really a substantial issue until this year. During the past two years, I’ve become increasingly involved with drug reps and surgical instrument companies who are dying to get their products into our hospital, and the residents are often the first line for these folks. I’ve noticed that I’ve gained a small measure of influence in this department. As a resident, I’m at least a foot in the door for the drug reps as well as a mode of advertising to a large number of potential customers (all of my attendings and residents from nearby programs). I’d say that’s a different relationship with the pharmaceutical industry than I had as a student. We are often approached by one particular company to use their product, and they are always offering to take us to dinner.

Now, personally, I have mixed feelings about this topic. I’ve heard the stories about past excesses (trips, golf outings, etc) but I know that these practices have been largely curtailed by the industry's own PhRMA guidelines, and these company's sponsorship make many great and beneficial things possible for doctors. My own program has had pharmaceutical sponsors for medical missions to Honduras as participants of the Baja Project for Crippled Children, for example. Our national meetings are sponsored generously by pharmaceutical companies. PRESENT Courseware has several generous sponsors without which our own education would be diminished. Not to mention the lunch inservices!! I’ll never look at pizza the same way again. Even the Residency Rap has sponsors, thank goodness (You've seen the list of sponsors at the bottom of the page in each issue).

Here's how I handle this issue.  I ask myself the following after having been presented with the information by the drug rep: will they send me to Tahiti next year like I’ve always wanted? Just kidding. The best we can do is try to be as ethical as possible. I DO make sure I ask myself if the product they’re marketing has a legitimate application in my practice, is it safe, efficacious, cost effective, and will it have a truly long-term benefit for my patients? That’s the bottom line for me. 

Frankly, I'm pleased that so much of the education that I need to be a better doctor is supported by sponsors.  Their support helps our profession enormously and what we owe them in return is simply our attention and the consideration to use their products when they are the best choice for our patients. For what they give to us, they deserve our attention.

What are your thoughts? Is dinner too much? How about golf? What about trips? How far is too far?  I think the upcoming ACFAS meeting in Las Vegas won’t be as colorful without them. Send in your emails. Have a great week and interesting cases!

Check out the thoughtful letter in the Letters to the Editor below sent in response to our talk last week on Fellowships.  Have a great week!

SEND YOUR COMMENTS TO ME BY CLICKING ON THIS LINK

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