Association between gifts from pharma group to drug prescribed by French doctors

I will try to get more info on this. Each company has MR (Medical Representatives) they meet docotor every week on one day and present their schemes and offers.

The exact degree may vary, but it happens everywhere.

Usually the laws and regulators allow prescribers tons of discretion, which is often subject to abuse that costs time/money/outcomes to somebody else.

There was some reporting around these parts recently that generics don't really undergo any kind of efficacy studies, they are assumed to just work, and there's really not much oversight whatsoever.

The last I've seen drug-related marketing, the message was the exact opposite, with the message being pushed by the Social Security system, since they're the one that would pick up part of the bill if people take the prescribed drug and not the generic.

However, it's not scientific ability that makes a good doc. Scientific ability is really not a criteria for adjusting your trust in a particular practitioner. I'd even say it's often that supposedly doctor-scientists (academics) are the worst.

It's similar to how we developers will often keep working on a problem until it's solved. That's especially true in incident response, where the same people tend to keep working on an issue until it's solved, rather than saying, "Oh, it's 5 pm, I'm going home; somebody else can figure out why the site is down."

That's not to say doctors have the right balance now; they definitely have a macho-culture problem where people tough it out when it isn't necessary or beneficial. But it's definitely not as simple as I thought at first.

Plenty of great theories have been crushed by evidence.

And it's a great investment. Because prescribing habits tend to persist after training, for many years. Sort of like Kuhn argued for science.

Then they maintain their incumbency and reduce a lot of their costs without a huge hit to revenue.

And if you’re a new pharma company with a truly awesome product, good luck getting anyone to prescribe it when you didn’t buy them a round of golf a decade ago because you didn’t exist.

So far from the breadline on objective criteria, yes. Far enough that people wouldn't do anything to work in another specialty or do something where you have a better lifestyle, no. So GPs are usually not doing that by choice.

The downside is that the French GP will never take you on time for your appointment, but you will feel that you are taken care of, unlike in the UK system.

I came once just for a quick health check before start a new sport, and I got an electro-cardiogram (to check for heart murmur, for free obviously), simply because I never had one in my life. They will often ask if your vaccinations are in order, how do you feel, things like that.

If you want GPs to do good work, you have to offer them some incentives. Incentives have been insufficient since a long time in France, and in Europe generally. Which is why we are short on GPs.