If you haven't read parts 1 and 2, please go back and do so as this, the final installment will make a lot more sense if you do.
Now what about those trips we were all supposed to be taking on the drug companies' tab.
Well, I actually did take a few.
The most blatant of them all occurred courtesy of a big drug company that made a blood pressure pill. The fact that I can't remember what that pill was should at least clue you into the fact that my prescribing habits were not heavily influenced by the trip.
Or that I didn't take my fish oil and Instant Einstein back then so I no longer remember.
My dad, who was practicing at the time, my mom and I who had just graduated from my residency were flown along with about 6 other doctors and their families from the area to join a "national congress" of physicians in Palm Desert, California.
The trip was all expenses paid and included a cross country flight for all of us to California and then a puddle jumper from San Diego to Palm Dessert.
The hotel was at least 500 bucks a night, still the most expensive place I have ever stayed and of course the drug company picked up the tab.
It was tremendously exciting for me and I actually believed the purpose of the trip was to educate me.
So did my dad.
We sat among some of the greatest medical minds of the time for 3 days and learned, learned, learned.
Looking back on it this trip, if Dan Rather would have gotten a hold of this we would have definitely been painted out as bad guys.
Also looking back on the trip I am not sure what long term useful info I got from it and it did not affect my prescribing habits one iota.
So please don't think that the crummy pens they leave for the doctors these days sway their decisions.
The other trip I remember was a bit less lavish and occurred a few years later.
Now we drove to the not quite so exotic location instead of flying, but the hotel was very nice.
Again, 3 days with the great medical minds of the time learning about high blood pressure. I can remember one of the guys who spoke was n the Joint National Committee for Hypertension, an expert panel that convened every few years to decide whose drugs got used by the majority of docs across the country.
It honestly did not occur to me that he was on the payroll of the people sponsoring the conference.
I really was young and naive.
Over time I became far more jaded. I started listening to the pitches of the drug reps with a jaundiced eye and questioned their data and the construction of their studies.
I eventually became a human guinea pig. I started to take a few doses of any pill I was going to give out to my patients to see if it killed me first.
While it did not in most cases kill me (Ok in no case or I would be writing with a ghostly hand at this moment) I did begin to experience some of those "impossible" side effects that were not in the package insert.
You know things like poor memory, extreme fatigue, depression, upset stomach and a personal favorite, just feeling like crap.
Funny when I combed through the little hard to read package inserts that came with these drugs, I often couldn't find these side effects.
But my patients found them and experienced them.
I usually just felt lucky that I didn't have to stay on this crap for any length of time.
Then I had my own health problems, (high blood pressure) discovered the ingredients in Super Omega 3 cured my problem, and the rest as they say is history.
So when I get the hairy eyeball or nasty letter from some authoritarian traditional doctor out there who is convinced I am nuts or worse I ask 2 simple questions.
Have you ever taken any of this stuff you prescribe and would you like to be on it for the rest of your life?
Invariably if they are honest the answer is no to both of them.
A few years back I was at a very big medical conference with over 2000 doctors.
The speaker asked, "Who in the audience takes fish oil?". Fully, 90% of the room raised their hands.
The next question was, "Who tells their patients to take it?" Only about 10% raised their hands.
Go figure.
Or better yet go get the best fish oil around and stay on it for the rest of your life!
See you at your 120th birthday party. We'll have a shot together.
Doc
P. S. be sure to join me tomorrow when I pull back the curtain again on how medicine really works in "Why medical research sucks".
P. P. S For those of you who are doctors I highly recommend Placebo Journal as a source of daily inspiration.
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