Not sure why people downvote it? Just because you don't like to hear it, it does not mean this is not happening.
Doctors get paid cash and hospitality benefits (and in my country they don't even have to declare it).
Pharma companies get sales reports from regions and reward doctors based how given region performs.
Nothing is done about it, because pharma pays well to maintain the status quo.
It seems like there are quite a lot of relatives/family members of doctors on HN. My wife is a doctor (and she hates most f what she sees in the way the medical field is run/operating these days), but I try to be impartial about judging them. The general emotion toward doctors on HN or any other Reddit forums is like they can't do no wrong or they are not evil or that they are smart (smarter than average) people (example that I just ran across today on Reddit's front page: https://i.redd.it/bjhk6ozyj7x61.jpg). That assumption/belief is very different from the reality. After observing and hearing so many stories about doctors (I have quite a lot of doctor friends/acquaintances in the US), my conclusion is that most of them are complicit in some of the things that is wrong with the US medical system these days.
A quick anecdote - my wife used to volunteer at a clinic in Chinatown. The doctor always get invites for lunch/dinner from medicine companies and she'd sometimes invite my wife to attend. I was extended an invite to one of them (the doctor knows me via my wife). It was hosted by a rep from Sanofi for the staff of the entire clinic (about 6 people) plus their SOs (including myself and the doctor's husband). There were a total of ~10 people at the dinner and the doctor gets to pick the restaurant so she picked one of the most expensive hotpot restaurants in Chinatown. We ordered lots of grade A beef slices and other expensive goodies. The rep, who is white, curried favors with the doc and the nurses/staff members all evening (to the point that I felt cringe at one point when she says something like this to an asian nurse, "I really like your Asian skin and hair; it's so smooth and glowing"). My estimate is that the dinner bill came out to at least $2000. That dinner, according to the doctor, happens every year with this particular company. Of course, I had to sign on a sheet (roll-call if you will) to acknowledge that I attended the dinner (I presume it's for the rep to reclaim expenses). I can only imagine how much/many drugs from Sanofi that the doctor is prescribing to her patients throughout the year.
Another anecdote - my host-family mom is a psychiatrist (the doctor type; not the other psychiatrist kind). She worked for a private mental institution near Philadelphia. There, they have about 20 mentally-challenged patients, 4-5 nurses and my host-family mom. I have accompanied her to there a couple of times and spent ~6 hours while she was touring and meeting with the patients. Both times, a rep from a medicine company brought lunch for the host-family mom and all the staff. Once was just pizza. Another time was some sort of sandwich and stuff. According to my host-family mom, that's pretty typical and they have about two or so such lunch from medicine company reps every week.
> It seems like there are quite a lot of relatives/family members of doctors on HN.
Lots of actual doctors on HN. It's true, pharmaceutical companies do market directly to doctors. The most positive form of marketing for patients is when they provide doctors with free samples of drugs they were going to prescribe anyway.
In my country generic drugs are not always the most reliable option and having more trustworthy alternatives really helps. This isn't drug marketing speaking either, there have been actual newsworthy scandals involving "mismanagement" of taxpayer money meant to pay for the production of basic hypertension drugs.
> Another anecdote - my host-family mom is a psychiatrist (the doctor type; not the other psychiatrist kind).
In the US, a psychiatrist is a medical doctor, MD or DO. The other kind is a psychologist, who are not medical doctors, and can only prescribe in a small number of states.
Assuming the details of your story are accurate, that dinner violates a number of norms and industry standards.
Reps can pay for dinners where clinical presentations are made (educational events). Budgets are supposed to be capped and reasonable. Non-physicians are not allowed to attend.
Not saying your story isn’t true, just saying there are already rules around not doing those things.
Oh, and your sign in sheet will record how much was spent on your meal and it’s should be on the Sunshine Act website that is publicly accessible.
It's a generalisation that I'm not sure is helpful. There's an unhealthy lobbying from pharma reps - true. But the scale of the problem depends on the country on the clinic, and on the doctor.
"how physicians prescribe medicines" is in my opinion a bit shitty way to describe it to be honest, because there's also the whole scale from outright fraud and pushing addiction, all the way to offering a specific type of what would be prescribed anyway. (With pharmacies offering substitutes and generics)
There are also regions which try to counteract this with, for example, forcing prescriptions to list the active ingredient rather than a brand of medication. (with fun sideeffects like meningitis vaccine taking ~6 lines to describe)
"We have serious problems with pharma influence" - yes. "how physicians prescribe medicines" - unless you qualify that with more information - it's FUD.
It's not only in the US. In EU it's the same with some countries worse than others. There are doctors which do not pay for their vacation and prescribe almost only expensive medicines because "they are better as generics". This corruption is helped by the fact that a lot of doctors work in small clinics so they are easier to bribe.
> It's not only in the US. In EU it's the same with some countries worse than others.
[citation needed] [details needed]
Sure, there is some effect and there is high influence over specific doctors (https://bmjopen.bmj.com/content/7/9/e016408 for a good start). But the sweeping generalisations are not the quality of contents I expected here.
