Will younger doctors be more resistant to drug company blandishments?

A week or so ago, I gave a talk to about 120 senior citizens at Brandeis University's Lifelong Learning Institute. The crowd was largely receptive to the topic -- how American consumers have been routinely misled about the safety and effectiveness of new drugs and treatments. They asked intelligent questions, and one retired psychiatrist even stood up to say how much he regretted having taken money from a drug company -- in the form of a free junket to a tropical locale -- to hear speeches about how wonderful its SSRI antidepressant was. He wouldn't do that now, he said, and he was sorry he had done it then.

But there were at least two people in the audience who didn't like what I had to say at all. In my talk, I had suggested a number of needed reforms, including passage of the Physician Payment Sunshine Act, which I've blogged about here. I even suggested that until that bill is passed, consumers might ask their doctors if they are getting any payments from drug companies that could possibly skew their prescribing habits.

During the Q&A, one man, who said he was a retired doctor, said that if a patient of his ever asked a question like that, he or she would be shown the door. Another doctor, a retired ob-gyn, took issue with what I'd said about the industry's longstanding practice of misleading consumers about new drugs, going back to the hype over hormone replacement therapy (HRT) on up to the current aggressive promotion of cervical vaccines like Gardasil. He accused me of exaggerating the dangers of HRT and practicing "sensationalistic journalism."

Rather than engage in verbal fisticuffs. I merely cited the recent studies showing that HRT increases the risk of breast cancer in women and repeated my concern that parents of young girls now targeted for the Gardasil vaccine in this country and Cervarix in the UK may not be getting the full story about the risks and benefits of these vaccines in treating cervical cancer. (For more on this issue, read Schwitzer health news and Gooznews).

But what struck me (and others in the audience) was the inability of these two doctors to understand that the winds of change are blowing and that the way they once practiced medicine -- with absolute deference from patients who viewed them as gods -- is a thing of the past. Consumers are waking up to the fact that doctors are human and thus susceptible to the same human frailties that tempt all of us. Money talks and can taint a doctor's judgement as much as it can anyone else's.

This was a major theme of Side Effects, and in the talks I've given since the book came out, I have stressed the need for full disclosure of financial conflicts and called for a ban on researchers receiving consulting and speaking fees from drug companies. Which is why it was so good to see the editorial in The Boston Globe last Thursday calling for much the same reforms. (The editorial followed an excellent article by Liz Kowalczyk earlier in the week).

Change is never easy. But I'd like to think that the newer generation of doctors are more savvy about the ways in which drug makers try to influence their judgement -- and a little more understanding of their patients' desire for transparency.