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Comment by socialdemocrat | Hacker News Reader

Many focus on the doctor, and surely his moral compass was off. But from a birds eye perspective the primary problem here is companies paying doctors to recommend certain pills and procedures.

This can make a doctor which was semi-decent and quickly turn him into a greedy immoral person.

I don't think it should be legal for companies to pay doctors to promote their products. Do anyone disagree?

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My wife is a resident. She used to intern at PCP clinics and was invited by her supervisor (a physician) to one of the dinners hosted by pharma companies (Sanofi, if I remember correctly). The dinner was a feast. The doc invited everyone in her clinic and their immediate family members. We had Shirmps, Lobster, Wagyu beef (I know it's a redundant word, but that's how it's known in the US), lamb to our fill. Sanofi rep footed the bill (and asked us to sign our names on a sheet when we arrived).

Experiencing that dinner and seeing my host family mom (a practicing psychiatrist in the US for a private psychiatry hospital) getting food every week from pharma reps, makes me feel disgusted about the connection between doctors and pharma companies in the US.

I have MDs in the family too, their continuing education classes are sponsored (free) and with feasts provided as well.

Lawyers have to pay for our required continuing education classes. Sponsored courses and retreats are clearly a conflict of interest for MDs.

Also, as lawyer, I remain shocked and saddened to see how US medical providers have abandoned patient privacy in the wake of the US opioid crisis. Patients prescribed any controlled substance are now put on registers that almost any state actor (or local police) can review at will.

US MDs have thrown their patients under the bus because they (or their colleagues) were (lazily/blindly/greedily) writing too many opioid prescriptions.

How are doctors responsible for laws passed by state legislators (who tend to be lawyers) requiring doctors to use PDMPs?

Ask the AMA. Docs should have stood fast or at least forced more patient privacy protection. As it is, some health providers require patients to sign broad privacy waivers before issuing prescriptions for controlled substances (including ADHD meds).

My GP didn't even think it was an issue -- here sign this. I couldn't believe what I was reading. I refused and didn't get the meds I needed -- resulting in harm to put it mildly. I am lucky that I am not suicidal because it got pretty dark for me, after a few weeks I had to crawl back to get the meds I need.

The doc invited everyone in her clinic and their immediate family members.

Wow. That's a violation and could get the company the smack-down. No way that family members should be included, even if they pay for their own meal.

"The Code provides that it is not appropriate to include a spouse or guest at a meal in connection with an informational presentation, regardless of who pays for their meal, unless the spouse or guest would independently qualify as a healthcare professional for whom the informational presentation is appropriate."

Congress disagrees. They tried to get that into the ACA but it was a few votes short. They had to settle for more transparency in payments to doctors: https://openpaymentsdata.cms.gov/

That is a tricky one. I agree with the all the problems people point out from the current system. However I also want my doctor to know about all the possible treatments not just the ones that were in vogue when he was in school. That means learning about all this. Doctors - like everybody - have their lazy side and won't always keep up. Continuing education is a part of this, but manufactures reps marketing is another way to get doctors to learn something they might not otherwise.

Again, it isn't perfect. I don't have answers, just a knowledge about how complex things are.

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