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Serious Side Effects
PREFACE: As medicine continues going "high-tech," plenty of "low-tech" conversations still go on. One of them: How should health care professionals and the pharmaceutical industry relate to one another? It was exactly seven years ago, in the March/April 2002 issue of this journal, that the subject was tackled by four Narrative Matters authors with differing viewpoints. In the years since, some aspects discussed then remain the same; others changed or are changing. Several academic medical centers have created guidelines to insert firewalls between the medical profession and the drug industry. But as Jonathan Han writes, in his physician practice, the new guidelines produced unintended consequences for needy patients—and a new dilemma for their doctors. Next, recent medical school graduate Melinda Morton details her attempts—still fresh in her mind—to turn down free "drug lunches" during her student clinical experience. Adding to the current mix is a 2008 task force report on the subject from the Association of American Medical Colleges and a revised voluntary marketing code issued by the Pharmaceutical Research and Manufacturers of America (PhRMA) to reinforce "responsible interactions" that went into effect earlier this year.
ON A SUNNY FALL MORNING Mr. Waite limped into my office carrying a newspaper. Grinning, he pointed to a front-page article and announced, "You’re famous now!" As a family physician practicing in a hardscrabble steel-mill town, I accepted his greeting and assessment with trepidation.
It was September 2007, and I hadn’t seen Mr. Waite in more than a year. Although he still had the strong handshake and calloused hands that had built a successful construction business, he was now a frail sixty-two-year-old. A few months before his last visit, I’d diagnosed him with prostate cancer, and he’d started radiation
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