As a doctor there are, simply speaking, three courses of action available when faced with sick patients: surgery, medication or wait and see. There’s also the fourth option of hiding in the toilets, but the nurses quickly become wise to this one.

Wait and See...

In surgery, waiting to see if the problem resolves itself isn’t always popular with patients, as they feel that if they’ve made all the effort of arranging for someone to feed the dog, they’d rather something was done. Surgeons scoff at the wishy-washy medics who prefer to use tablets to sort things out rather than cutting. This doesn’t mean that surgeons don’t like to dabble in the dark side of prescriptions though—a few of them are rather keen on dishing out the latest drug on the market, which just happens to coincide with which drug company has provided lunch at the weekly surgical meeting.

 

Enter the Drug Companies

For a few crisps and some doughnuts, a drug company gets ten minutes or so of the surgical team’s time to push their latest product. These drugs are more expensive than the current ones available, and when you look closely at the evidence they often can’t even be proved to be as effective. The problem is, it’s presented as scientific research rather than what it really is: promotional material

The doctors who sit in on the drug rep’s patter are the same doctors that scoff at Miss Miller. We admitted her a few days ago with recurrent stomach pains, and rather than operate it was decided to wait and see if it got better on its own, which it did. 

Miss Miller's New Homeopath

“I think it’s down to my new homeopath” she says on the ward round, just before we discharge her. Several of the doctors suppress a laugh, while the consultant guffaws in her face. 

New–age rubbish,” he says. “These things just get better on their own, given time. Homeopathy? Huh! No reliable evidence that it works at all.”  The other surgeons agree and walk off shaking their heads. 

“I think it works,” Miss Miller whispers to me. 

Well, if it makes you feel better, there’s no harm in keep taking it,” I reply, and run to catch them up. 

I’m just in time to catch the instructions for the next patient and, no surprises, the consultant—apparently no longer concerned about reliable evidence—has prescribed the new drug we’ve just spent lunchtime learning about. 

I’d like to think I’m not affected by drug company marketing; that I prescribe medicines sensibly. I’d like to think that I wouldn’t allow myself to be bought by a few sandwiches. I’m still relatively junior though, so we’ll have to wait and see…

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