'Tis the season of giving and receiving. Recently, a friend of mine told me that she needed to visit her psychiatrist to get a refill of her anti-depressant. Oh big yawn, so what? Well, it turned out that she hadn't seen this psychiatrist in...a year. Now all the continually medicated know that a doctor's office visit is required every three months or so in order to renew a prescription, so what gives? Turns out that my friend was getting free samples, sufficient to keep her anti-depressants during this period of time from her internist. So what's up with the free samples. As the American Medical Association publishes on its webpage in its Ethical opinion E-8.061, "there has been growing concern about certain gifts from industry to physicians." http://www.ama-assn.org/ama1/pub/upload/mm/369/e-8_061.pdf
Here's the rub, what difference does it make to the consumer that my friend bypassed the system? And what's the big deal if her internist gives her a drug originally prescribed by a psychiatrist? What benefit is there to the internist, if any? Before you draw any conclusions, take a look at the webpage cited above.
Drug costs: The hottest topic since Medicare got involved. Well, why don't doctors get out there and work harder for lower drug costs? Why is access to affordability of and availability of medication not a key issue for every white coated "healer?" Read the opinion. For doctors, "the use of drug samples for personal or family use is permissible as long as these practices do not interfere with patient access to drug samples." What? In other words, doctors aren't paying for meds that they can get free samples of. Who knows, maybe that explains why the internist had samples of an anti-depressant, maybe someone in his family also needed the meds. Still, why should I care? Maybe we should all just shop around for sample issuing dox to get the best prescription plan ever, free (less the cost of the co pay for the doc visit). For the rest of us, the cost of the drug being freely distributed to the doc and freely distributed to my friend, $7 a pill.
The irony of doctors NOT standing up and in unison arguing on behalf of lower drug costs is suddenly a lot clearer. Hey, E8.061 runs through some other things that dox shouldn't do, like accept cash incentives directly. But when all is said and done and you read the Clarification of Opinion 8.061 on the second page, the magic words "ULTIMATELY, IT IS THE RESPONSIBILITY OF INDIVIDUAL PHYSICIANS TO MINIMIZE CONFLICTS OF INTEREST THAT MAY BE AT ODDS WITH THE BEST INTEREST OF PATIENTS."
We've come a long way from the notion of FIRST DO NO HARM.
