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Drug firms' gifts get under doctors' skin

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March 19, 2008

THOSE WHO defend drug company gifts to doctors often express incredulity that doctors could be bought with pizzas, Post-it notes, or pens ("Drug firms' freebies are wrong target," Letters, March 12). Physicians' many years of training and professionalism are cited as rendering them immune from such blandishments.

As a practicing physician, I wish I could agree. Unfortunately, one doesn't have to go far to see how naive these views are. Simply ask drug reps themselves. Sharam Ahari found out during his years at Eli Lilly that even the smallest of gifts helps create a sense of gratitude and indebtedness.

Ahari wrote in a recent medical journal, "It's my job to figure out what a physician's price is . . . but at the most basic level, everything is for sale and everything is an exchange."

It may sound cynical and commercial, but it works for physicians just as for anybody else. When someone does something nice for you, no matter how minor, it is human nature to feel grateful and to want to reciprocate.

In my experience, a drug rep may come in to chat about a new insomnia drug, like Lunesta, leaving me with a brochure, pen, and business card. The next time a patient comes in with insomnia, I find myself thinking, why not give Lunestra a try?

The gift ban proposed in the state Senate may be one of the most important pieces of healthcare legislation in years.

Dr. DANIEL J. CARLAT
Newburyport
The writer is assistant clinical professor of psychiatry at Tufts University School of Medicine.

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