He backs upthis contention with the following arguments 1 Would companiesspend total of 21 billion yes, that is billion on marketing,of which percent is aimed at physicians, without evidenceshowing that it pays off in increased sales and profits? 2Wont tens and even hundreds of thousands of dollars ayear in income compromise at least some professionals? Kassirerreminds us of the income pressure on physicians these days frommanaged care and liability insurance.

DuVal in writing this review. He also describes howthese dollars flow to individual physicians in the form of expensivegifts, free dinners at the best restaurants, free vacations,consulting fees, and honoraria for speaking to other physiciansat fancy restaurants or continuing medical education CME lecturesat desirable resorts or for writing articles, commentaries,or editorials for medical journals often written by the company.The gifts begin small and bigger as the breadth of the physiciansreputation and usefulness to the companys marketing effortgrows just like endorsements by football players or movie stars.The book contains the kind of bill of particulars one wouldexpect at legal proceeding or congressional hearing.

Health Affairs, 24, no. Physicians can also argue that the variouscompanies gifts and payments to goso far. The amount of money at stakeis well beyond what any professional group of which have beenpart would consider harmless. Regardless of how many physicians arebiased or prompted to produce tainted information by thesepayments or how far the taint penetrates medical practice.

He also asserts that evenone wellcredentialed physician who signs biased journal articleor commentary, gives biased sponsored lecture, or allows hisor her bias to taint practice guidelines can affect the actionsof thousands of physicians. But can the average patient believe that professional consciencewill protect him or her in the face of such big money?

Is Kassirers case convincing? He does repeatedly notephysicians vehement insistence that their professionalismis beyond being tainted by these gifts and payments to goso far. Whats this? The authora professor at the Tufts and Yale Schools ofMedicine and former editor of the New England Journal of Medicineassertsthat these companies employ 87,000 drug salesmen and investenough in this marketing effort to pay 30,000 to every practicingphysician in the country. Stan Jones Editors Notes Stan Jones stanatstanjudyjones. com is former health policyconsultant, based in Shepherdstown, Virginia. Book ReviewsDrug Company Gifts To Physicians Harmless Perks?

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