Doctors and drug companies
YOUR MAY 14 editorial "Side effects in the Senate" calls for a two-year moratorium on direct-to-consumer ads on new drugs as part of a so-called firewall "between the public and potentially dangerous drugs." However, any drug is dangerous when it is not prescribed appropriately or not taken according to the doctor's instructions. What your editorial ignores is that before the patient is exposed to any adverse drug effect, both the Food and Drug Administration -- in determining that the drug is safe and effective -- and the patient's physician -- who writes the prescription -- have come between the pill and the patient. No doctor worth his or her stethoscope would be cowed into prescribing an inappropriate drug merely because a patient saw an ad for it on TV.
Also, there are educational benefits to the consumer from learning about new treatments from such ads, which are always accompanied by a caveat to "ask your doctor" or a number to call for more information.
Finally, the First Amendment protection of free speech, including commercial speech, guarantees not only the right to speak but the public's right to hear. The Waxman-Markey bill to be considered in the House calls for an even more Draconian three-year ban on ads for new drugs. Hopefully, it will meet the same fate as the failed Senate provision, for the good of public health.
Dr. GILBERT ROSS
Executive director
The American Council on Science and Health
New York
THE HEADLINE on the May 18 op-ed by Scott Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, asks: "Does a drug firm's free lunch influence doctors?"
When I learned my economics, we were told "there's no such thing as a free lunch." Thus, the question answers itself: The drug firm expects something in return. We can all guess what that something is.
RASHI FEIN
Professor emeritus of the economics of medicine
Harvard Medical School
Boston
SCOTT LASSMAN'S May 18 op-ed "Does a drug firm's free lunch influence doctors?" is a tired restatement of the rationale pharmaceutical companies have been using for years to justify their sales and marketing practices. What is not stated and should not be forgotten is that pharmaceutical companies are not primarily charitable or educational institutions. As publicly held companies their primary responsibility is to maximize their profits for the benefit of shareholders.
I would ask Lassman: If the education of physicians for the overall benefit of helping patients is so important, why do pharmaceutical companies relegate this task to their sales and marketing department rather than to their research scientists?
The continuing education of physicians with the ultimate goal of improving patient care and health outcomes is an extremely important task. However, it should be accomplished through peer-reviewed research and independent scientific presentations rather than through slick marketing brochures handed out over lunch.
Dr. MICHAEL GOLDSTEIN
Division of Medical Oncology
Beth Israel Deaconess Medical Center
Boston 
