A Question for rahul k. parikh

Sat, 16 May 2009 21:05:07 -0400

Doc, I wonder about something. Maybe you could help us out. Are you a paid consultant or on the advisory board of any drug company? If not now, have you ever been? Are you a paid speaker for any drug company? If not now, have you ever been? Have you ever taken any research money in the form of a grant, or any other form, from a pharmaceutical company? Do you own stock in any pharmaceutical company?

We just want to know who we are taking advice from. I look forward to your reply.

As for me, I work in a pharmacy. I have attended drug company dinners in the past as well as taken gifts of pens from big Pharma. I admit it. After seeing the light, so to speak, I have gone pharm-free. Have you?

Why Your Doctor is Like a Monkey

Thu, 14 May 2009 19:05:57 -0400

Pharmaceutical companies have trained healthcare providers. It is almost Pavlovian now. I don’t know when it started, but it was many years ago. When a drug sales rep walks into a medical office, he/she had better be bearing gifts, if an audience with the doctor is desired. The best gifts seem to be food. Walking in empty handed is a surefire way to get kicked out.

Look around your doctor’s office and you’ll probably see coffee mugs, pens and pads of paper (the inevitable Post-It notes) with the names of drugs all over them. Probably there is a clock on the wall and perhaps a calendar that has a drug name on it. When they dressed up mucus in a bridal dress and made a plush toy out of it, I thought that went too far! The folks that brought you Mucinex are responsible for that. Yes, there is a groom too and little mucus children. Has your doctor just prescribed one of those drugs for you?

In the book, How We Decide, the author, Jonah Lehrer, describes studies that have been done, in the 1970’s, with monkeys and rewards. These are the Schultz experiments, if you are interested. He sounded a loud tone and waited a few seconds. Then he squirted a few drops of apple juice into the mouth of the monkey. Initially the monkeys only got a dopamine (happy neurotransmitter) hit when they got the actual reward. In this case it was apple juice.

Soon the monkeys got the dopamine response after just the tone. The monkey could predict the reward.

I don’t know this, but I imagine that drug companies hire psychologists to figure out how to get the doctors, nurses, and pharmacists to jump through hoops. Just seeing the drug rep probably inspires some kind of dopamine response. Did I mention that they hire people who look like models to do this job? Yup.

My point is that some of the same reward principles seem to be at work with the healthcare providers as is the case with the monkeys.

I work in a pharmacy. I was recently invited, by a drug company, to a complementary dinner. This was so they, the drug company, could teach us, after dinner, how to process their coupon! A coupon?

Why does a coupon have to be so difficult that an in-person training session is required? That is my first question? Can’t we just scan it at the register? Like for a bottle of Tide or something. I assume it is because there would be no tracking that way. They wouldn’t know which doctors are prescribing their precious product. They want to be able to reward him/her with something even more glorious than a steak dinner, I imagine.

If a doctor offers you a coupon, beware. There’s probably a cheaper drug that would do the same thing. If you don’t know, try looking it up online or asking the pharmacist. You can usually get a straight answer from the pharmacist about this.

You, the consumer, are paying for these dinners. It is a ridiculous practice. This is but one of many reasons that medications cost so much in the U.S.

It was a steak dinner. Steak is a food that will potentially raise our cholesterol levels and increase our likelihood of needing to buy still another one of their medications. Healthcare providers are patients too. They are prescribers and consumers. Brilliant.

I thought about all these things when I was trying to figure out how to get my doctor to fill out some insurance forms. This one is a specialist. He has a fancy office in a fancy neighborhood and he seems to be the least likely to fill out paperwork.

This is paperwork I need to have filled out in order to get reimbursed. I am not asking him to lie or do anything illegal or questionable. I actually paid this guy $15 to fill out my paperwork. He said that was his fee. I paid it and it still didn’t happen. He left half the spaces blank. He faxed it to the insurance company partially filled out! What was the fee to fill it out all the way?

The other day, I went over there with a gift box of muffins. The receptionist sat up a little when I walked in. She said she would get my insurance form back to the appropriate party right away. She actually got up and brought them back there.

I think, without food gifting, that would not have been the case. And, yes, the forms were filled out. Finally.

I want a heterosexual civil union.

Sat, 11 Apr 2009 14:04:00 -0400

I’m not Christian and I don’t want a marriage. Everyone talks about how marriages are meant to be between one man and one woman per the bible. Well, I don’t read nor follow the teachings of the bible.

Yet, if I want the legal rights that go along with marriage in the US, I have to get married.

According to Wikipedia, in some jurisdictions, such as Quebec, New Zealand, and Uruguay, civil unions are open to opposite-sex couples.

My opposite-sex life partner cannot get on my health insurance plan at work. If my partner were of the same sex, they could. This is discrimination too. The ACLU says to forget about fighting it because I could get married if I wanted to. But I don't want to.

I’m all for same-sex marriage. I just think that whether gay or straight, we should be able to choose whether we want a civil union or a marriage, in whatever state we reside.

PercyFlage's Open Salon Blog

A Question for rahul k. parikh

Why Your Doctor is Like a Monkey

I want a heterosexual civil union.