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Despite the seemingly innocent practice of a business lunch, it has become one of the central means of influence that pharmaceutical representatives have over physicians. Before the early 2000s, the situation was much worse when doctors were offered expensive things, vacations, and experiences. It was not money, but it was indirectly a bribe because it would pressure the physician to not prescribe a drug after that company had spent thousands of dollars on him. However, as the industry code changed, lunches became the new way of influence, this time an indirect psychological and social manipulation that was widely accepted by most in the industry.
It is gravely unethical and, as history demonstrates, a dangerous practice when physicians accept gifts and perks from pharmaceutical representatives, no matter how small. In my opinion, the practice should be limited to the pharm rep coming in, making a pitch, and leaving a few samples at most, as this does not directly benefit the physician but may have medical/business use if the doctor independently chooses to prescribe the drug. It is unethical because it is a conflict of interest if the representative offers gifts in exchange for prescriptions. A physician should prescribe based on the patients interests and unique circumstances. However, as studies demonstrate, physicians intentionally or unintentionally prescribe the brand-name drug after being under such influence, even when generic drugs would be just as effective (Saul 2).
In fact, that is the very same practice that has led to the raging opioid epidemic that has taken hold in the United States over the last decade. Reports reveal that doctors were paid tens of thousands of dollars for prescriptions of opioids in 2014-2015. Essentially, the more a physician prescribed, the more they would get paid. However, these were not direct payments, but indirect ones with small gifts and lavish lunches, but also convenient speaking engagements and such that physicians could attend and legally get paid. As a result, it created a system where doctors were bribed to prescribe highly addictive narcotics, which has now ruined the lives of millions of Americans (Kessler et al., 2018).
The issue is not the gifts, but the psychological fact, which numerous studies have proved since the mid-2000s even small gifts can lead to profound changes in physician prescribing behavior. This is dangerous because their professional competency is compromised, not only ethically but potentially medically, as they are prescribing a drug that may be unnecessary for the patient (as was the case with many opiates). Another issue is that while legal and technically everyone is open about it, there is little transparency on the ongoing interactions and transactions. It is an ethics issue and a conflict of interest. When the party, such as a physician, directly benefits in such cases, they become implicit and essentially on the payroll of the drug company. In turn, this can lead to consequences. Influenced by the representatives, doctors can over-prescribe, prescribe when unnecessary, and prescribe brand-name drugs when a generic would work, driving up already skyrocketing healthcare costs. Therefore, all efforts should be put toward legislation and restrictions that would ban the use of gifts and perks by pharmaceutical representatives to entice physicians. Various jurisdictions that have already done so demonstrated a professional relationship can still be maintained between the industries but much more ethically (Saul 3).
Works Cited
Kessler, Aaron, et al. CNN Exclusive: The more opioids doctors prescribe, the more money they make. CNN, 2018, Web.
Saul, Stephanie. Drug Makers Pay for Lunch as They Pitch. The New York Times, 2006, Web.
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