What is the consequence when a doctor prescribes drugs that he gets paid for?

It is illegal to do that. If he gets caught, big trouble.

I’m pretty sure your career as an MD is done. I think you loose your license.

Unethical, but it’s not illegal. You can see if your doctor is “on the take” here
http://www.npr.org/templates/story/story.php?storyId=130598927

With the paucity of details, it’s hard to know anything at all about what is going on here. Are we talking about direct payments for sales—like on a commission basis? Or are we talking about being taken on golf outings by the industry reps? There are forms of “payment” that aren’t really pay-offs, but are standard sales procedures.

So if it’s illegal, then the consequences are severe, if my fellow jellies know what they are talking about. But if it’s legal, then the consequences are on the patients more than on the doctor. They might not be getting the best med for their condition.

I will say that all Pharm reps aren’t 100% evil. The way modern medicine is run these days, MD’s have very little time to sit down and do extensive reviews of the latest advancements in medicine. Having someone take the most pertinent information and “distill” into a quick presentation, and then being knowledgable about the subject in order to answer questions about it, is a way to keep MD’s better informed about all of the available treatments out there.

Many MD’s will then do their own research to decide if it’s right for their patients. From personal experience, my father (who is a general/vascular surgeon) has been introduced to some neat technologies through reps. He is now able to do an infinitely better job at treating certain conditions than he was before learning about them. He certainly isn’t getting any kickbacks, except for making his patients healthier and happier—which is the real reason why most MD’s get into the industry. This isn’t to say there aren’t abuses going on.

You can make a hell-of-a-lot more money, with a lot less education, and not having to work crazy hours and take call at all hours of then night, not to mention the incredible stress of having people’s lives literally in your hands. Look at health insurance execs for example… the only real requirement there is to be an unscrupulous piece of human filth with no morals.

@gorillapaws I agree pharm reps can be a useful source of information for a doctor, but too much of that industry is schmooze or spend money to get the doctors loyalty or attention. I don’t feel like doctors research most drugs at all, especially for conditions that are not grave.

@flo I am not sure I understand you question, can you elaborate? If it is a sham clinical trial, as you quote in your explanation, that is really a big problem, might be ilegal, probably definitely unethical. I would assume he could lose his license.

@JLeslie I’m with you for the most part. I do realize there are gross abuses going on, but I just wanted to point out that it’s not 100% bad. I would like to believe that most MD’s look at more than a Phar rep’s marketing material before prescribing new medicines. I think they could do a much better job regulating that aspect of the industry, but I was trying to point out there are some benefits that not everyone may realize.

@gorillapaws in my own family I have had a doctor perscribe two drugs at the same time that are black box warning when prescribed together, and they from the same pharm company, the reps are completely aware, and were supposed to tell the doctors. Both drugs are commonly prescribed, I don’t believe that doctor ever looked at the insert/pdr. Another relative told a doctor her blood pressure was uncontrollably high when she took a drug previously for a procedure, and he prescribed a drug with the same ingredients basically, she knew it would be a problem, we looked it up and the very blood pressure med she takes is contraindicated with the drug he prescribed. Anyone with a medical background should be able to figure out the drug would likely be problem even without reading the insert.

@JLeslie I don’t have all of the the facts, so it’s impossible to make a definitive conclusion, but it does sound like the doctors in those anecdotes made some big mistakes.

@gorillapaws Propulsid and Sporonox (propulsid is off the market now). A girlfriend of mine happen to work for Jaansen, and had mentioned they are contraindicated with each other, and my relatives wife happened to mention to me my her husband was prescribe something for his toe nail fungus. I asked the drug he was prescribed, and I knew he tooma cholesterol drug. The same doctor precribed both, and the pharmacy dispensed it.

The other instance was prep for a colonoscopy, one of the potassium ones, to a blood pressure patient.

My answer to everyone of you is, I am trying to see which country has the most strict laws, in order to point at is as the best example. By the way, even Doctor OZ, peddling specific brands of multivitamins is something.