HOW DO YOU SPELL HIPPOCRATIC OATH?

If this particular article fails to bring on loud retorts in defense of the sacred medical profession, we can’t possibly imagine what will. The matter we’re about to lay on the table deals with relationships established between physicians and the pharmaceutical companies, regarding what benefits may be forthcoming in return for prescription writing, excessive or otherwise.

A browse of the internet on such subject makes it abundantly clear that the drug manufacturers are known indeed to provide gifts (lacking a more suitable label) to doctors for having pushed their wares, due to age-old overly aggressive marketing habits. Still, we see no concrete statements to the effect that direct kickbacks are being paid.

Nevertheless, supposing we take a look at what can be readily accomplished with our 21st century technology. When picking up a prescription at any pharmacy, the doctor is expressly identified on the label, which means his name and address have also been lodged in a computer file. Reporting sales of products X, Y, or Z back to the drug companies, naming the initiator in each case, can be duck soup.

While living in Thailand for a great many years, we observed that every hospital and medical clinic carried huge quantities of pharmaceutical products. We further found that any direct charges for routine doctor services were either relatively minimal if not nil, with the profit derived from the small pile of prescriptions the patient carried to the stock room to be filled. Since the national mentality in said country is predicated on believing a doctor’s words to be the gospel according to St. Whoever, no person dares not to fork over the funds for the list of drugs dished out. In this case, the revenue comes from direct sales, but requiring a rather massive inventory investment. Accordingly, the drug producers can’t be other than blissfully pleased.

Our stateside system differs, of course, in that medical clinics don’t normally house drug stocks, letting the independent pharmacies carry the inventory burden. Theoretically then, the only profit is earned at the retail level, with the prescribing physician’s task a mere ordering service for no added remuneration. Correspondingly, medication issued from stores within hospital walls and charged to a patient’s account would produce revenue for the institution only.

However, can this always be true in real life practice? Might direct (or at least camouflaged) percentage kickbacks not be due the doctors?

Even if such condition may exist today, and we’re frankly inclined to harbor such suspicions, this wouldn’t necessarily imply that prescriptions are being written with an eye only on resulting rebates. In any such case, the physician would be on the borderline of a Hippocratic Oath violation.

In all due fairness, therefore, we shouldn’t jump to unwarranted conclusions. Still, it is common knowledge that doctors are extensively trained to combat illness with drugs, drugs, and more drugs. They spent long years in medical school having this point driven home. Even though many offer useful lip service to careful dieting, tobacco use restriction, ample exercise, and other natural cure methods, the underlying indoctrination back at dear old Siwash can’t be easily forgotten.

Fundamentally speaking, we feel that the prime fault has to lie with the pharmaceutical companies, whose sales promotion methods have irretrievably branded them as having resided in Satan’s bailiwick for as far back as any of us can remember. Besides, they have no Hippocratic Oath to hold them in check.