I am just starting up my medical practice here in McComb, and on slow days I get more drug reps than patients. For the uninitiated, a "drug rep" is an employee of a pharmaceutical company who visits my office with the purpose of convincing me to write more prescriptions of their product.
There are many thorny issues to explore in this subject, and I will touch on all of them over time. But today I want to tackle the subject of gifts.
Drug reps usually come bearing gifts. They give me something free, which theoretically makes me better disposed towards them and more likely to give them more of my time. Gifts come in many forms but professional ethics dictate a price limit. So they bring cheap stuff -- a few books, post-it notes, a clock or two, all with the name of their drug emblazoned on it. And they bring pens. Lots and lots of pens.
There are people who have the time to worry about such things who argue that accepting pens is a kind of bribery. That when I hold the pen in my hand and see the logo there that it kindles a fire in my soul to write prescriptions for that medication with the passion of a spurned lover. I like to think that the pens aren't worth that much and are not enough to sway me from prescribing the appropriate medication instead of the one on the pen.
I think ethics is very important in medicine. But there is no need for us to be so fastidious that we fuss over every tiny potential for error. I believe in robust ethics -- that is, an ethical outlook that can tolerate the little scrapes and bumps in the road that are normal to life. If my moral code is so weak that I would sacrifice quality patient care for a nice pen, then I have no business living in the world. Sure, the reps want me to write their product. And yes, the pens remind me of their product. But I cannot be so ethically feeble that a simple pen will cause me to disregard all my medical training, as well as my ability to make a rational decision.
If I am that weak, God forbid that someone should present me with a bribe of real value, say, a freshly smoked Christmas turkey, and then ask me to blow up a bridge, because I might do it. A pen is to a prescription as a turkey is to a bridge, or something like that.
Luckily, I am a bit less suggestible than that. I try to be always mindful of the influence of advertising. Accepting a pen is a way of playing ball with the drug reps. They talk to me, and give me useful information about their products. And they also bring free samples, which helps my patients. I think the benefits of the information and the free samples outweighs the drawbacks of accepting a trinket as a gift. And if you've ever gotten a free drug sample from your doctor, I'll bet you do too.