December 2003

Why 'Big‑Pharma' doesn't like you

by Dr. Robert Manna

If people knew the way the system really worked, they'd be disgusted.

Big‑Pharma has as many lobbyists in Washington as Congresspersons and Senators combined. 625 were employed in 2000, and more than half of them were either former members of Congress or others who previously worked in Congress or in other federal government positions. Big‑Pharma contributes hundreds of millions of dollars to political campaigns. While the mean Fortune 500 company profit margin is 4.5%, Big‑Pharma's is 18.5%.

Then, there's the army of their front line soldiers. There's one of them for every four medical doctors in the United States. The highly paid pharmaceutical sales rep, armed with bits and pieces of out‑of‑context data from his or her company, a shopping bag full of free drugs, and a gold expense account, takes a seat in the M.D.'s waiting room. The staff doesn't let him or her wait too long. After all, this is the same swell guy or gal who took the entire staff out to lunch last month.

Drug sales reps have one purpose. They work to build trust with doctors, sell doctors on the benefits of their company's drugs, and keep the doctor prescribing that brand over the competition's. The more that happens, the more money they make.

Surprisingly, doctors get much, if not most, of their pharmaceutical knowledge this way. The drug rep may even talk to a doctor about possible "off‑label" uses for the drug. He or she may be invited to attend a seminar in some exotic locale ‑‑ put on by the pharmaceutical company, all expenses paid.

Reps give spa treatment days, birthday parties, fancy dinners, and all sorts of favors. A doctor may be invited out for a round of golf by a Big‑Pharma sales rep. The rep might bring the doctor's entire staff lunch that day. That means something very special to the $22,000‑a‑year staffer, who thinks the drug rep is an awfully nice person who does this kind of thing out of the goodness of his or her heart. The rep may bring dozens of free pens, and little note pads with the company drug's name on it.

Reps can easily check on how their free lunch service is working. They have sophisticated computer systems to see who's prescribing what, and how often. But, in life (and especially with Big‑Pharma sales reps), there is no free lunch. Drug reps give favors to M.D.s, but they expect favors back. And, they get them! It's just human nature. You scratch my back, and I'll scratch yours.

Is this the way M.D.s should make their "health care" decisions? How is a doctor to remain unbiased in his or her medical judgment in the face of these pseudo‑relationships?

So, the prescriptions are written. Eleven for every man, woman and child in the U.S. every year. Depending on who you listen to, Big‑Pharma drugs now account for being the third or forth leading cause of preventable death in the U.S.

While the sales‑driven drug rep shows up at his or her kid's football or soccer practice in a new $45,000 car, America gets sicker and sicker. And, the American doctor has a positive feeling every time he or she writes a prescription for Neurotin because the rep said so many good things about it during a golf game or while out to lunch.

The American belief that health comes from a pill gets a little stronger with each "kiss" of the pseudo‑relationship between Big‑Pharma reps and doctors.

We "alternative" doctors are among the few flies in the ointment, and Big‑Pharma doesn't like it. We spread a different message that serves to take money out of their pockets. We actually understand that health is the natural state of humans, and we have the guts to tell people that in our offices. We get them to think for themselves and not blindly reach for the pill bottle. We have the audacity to put our "crazy" ideas in our ads.

Most M.D.s know that there is often something inherently wrong with the philosophy of their care. Because they're human, they will always be swayed by drug reps and their free lunches. But, every time WE tell a patient the truth, or write an article, or put out an ad that tells the truth about health, we make an impact. And, yes, we'll run into the occasional angry M.D. who'll scream bloody murder, but that doctor is in the minority. The rest are quietly learning something about chiropractic that they didn't know before.

Today, I had a new patient who was referred by her M.D. She told me her doctor had stated, "I don't refer to chiropractors, but you need to see this one." The M.D. gave the lady my name.

This M.D. never got a free pen from me. I never gave him a free lunch. In fact, we've never met. What I did do was give him a strong dose of the truth. That doctor's wife found me with one of my ads years ago. I allowed her to live at a highest potential, without crippling neck pain, when nothing in her husband's arsenal would do.

I guess that hit home with him.

(Dr. Robert Manna, a chiropractor in Rome, Ga., is owner of The Killer Ads, Inc. (www.thekillerads.com), a company that creates innovative ads for the chiropractic profession. He can be reached at 706/233‑9000 or killerad@bellsouth.net).