There was intense press interest for a recent policy paper in PLoS Medicine called "Following the Script: How Drug Reps Make Friends and Influence Doctors." Some of the highest profile features on this paper were in USA Today, Wired, and United Press International.
The paper was unusual because it was authored by a former pharmaceutical sales rep collaborating with an academic physician. The authors documented the various techniques that sales reps use to influence physicians' prescribing behavior. "Physicians are susceptible to corporate influence," wrote the authors, "because they are overworked, overwhelmed with information and paperwork, and feel underappreciated. Cheerful and charming, bearing food and gifts, drug reps provide respite and sympathy; they appreciate how hard doctor's lives are, and seem only to want to ease their burdens."
The problem with such close relationships between doctors and drug reps is that there is now a wealth of evidence suggesting that acceptance of gifts and use of promotional information may lead to inappropriate prescribing.
But what can patients do to find out whether their physician is being showered with gifts and wined and dined by drug reps?
Thanks to the campaign group No Free Lunch, whose mission is to "to encourage health care providers to practice medicine on the basis of scientific evidence rather than on the basis of pharmaceutical promotion," patients can now search a No Free Lunch database to find a physician who has pledged to be free of drug industry influence.
The database is a superb idea. At the moment, it only includes US doctors, but there are plans to extend it globally.
The recent launch of the database got me thinking. Why not create a No Free Lunch directory of medical journals that refuse to publish adverts for drugs or devices? I put the idea to Dr Bob Goodman, Director of No Free Lunch, who found the idea intriguing but joked that it would be a very short list! Sadly, he's right. PLoS Medicine and Open Medicine would be on the list, but I can't think of any other general medical journals that ban drug advertising. If you know of any, please do drop me a line.