Thomas A. M. Kramer, MD


Medscape General Medicine. 2004;6(1):e31 

In This Article

The Bottom Line

The pharmaceutical industry is no more evil than any other industry. They are for profit. Their goal is not to help us provide the best care for our patients, nor should it be. That is our job; their job is to make money for the stockholders. They do this by marketing their products, and this constitutes giving practitioners sales pitches in various forms. We are the ones that are supposed to have the training and the expertise to take the sales pitches and use them for the benefit of patient care. We may need to be more directive of graduate medical education to make sure that physicians are adequately trained to deal with the industry and its marketing, but there is no question that this is in our job description.

The concept that drug companies could or should provide unbiased information is absurd. Its origins, however, come for the most part from us as opposed to them. We are to blame by introducing the concept of the "unrestricted educational grant" and pretending it has some legitimacy. We make them go through the motions of pretending they are giving money for educational programs that are objective and free of bias, but they remain for-profit corporations, not foundations, and this is not what they do. As a result, we force them to behave subversively and to find covert ways to get something for this money. Thus, the bias must be sneaky and hidden. This can be done by omitting information in discussions or even saying things as if they were absolutely true that are deserving of a great deal of qualification. They find speakers and institutions to participate in this process of developing programs to the corporation's liking so that they will be paid to do it again. Once, I watched a speaker present data highly critical of a product that was made by the company that paid the grant for him to come and give his talk. Needless to say, he never worked for that company again.