Doctor Bob Goodman doesn’t want to be a walking billboard.
His desk at the academic medical centre in the heart of New York is overflowing with pens. Paxil, Zocor, Lipitor; the names betrays the origins of these gifts. Dr. Bob Goodman’s colleagues sent him these ‘freebies’. In exchange, he sent them pens embossed with the name of his one-man organisation: ‘No Free Lunch’.
Goodman resists pharmaceutical companies’ attempts to entice him to push their pills. According to the Journal of the American Medical Association (JAMA) a total of 80,000 sales representatives spend US$8,000 to 13,000 annually, per doctor, to promote their products. Goodman lists the perks: ‘Invitations to dinners in expensive restaurants, pop concerts, key basketball games, holidays at luxury ski resorts. Sometimes even the flowers for your wife on Valentine’s Day are paid for by a sales rep. Truly, at times it makes you want to die of shame. Especially if you realise that the cost of the meals paid for by the pharmaceutical companies is ultimately included in the price of medicines.’
When Goodman opened a clinic four years ago, out of principle he wanted to ban sales representatives. But there was a problem. No sales reps meant no free samples, which could be given to patients without medical insurance, and the clinic was located in a relatively low-income area. That was when Goodman started No Free Lunch, which raises funds to help subsidise medication for poorer patients by selling pens, buttons, mugs and T-shirts.
Although thousands of pens have been distributed, his organisation remains rather unpopular among his colleagues. ‘Doctors think they aren’t influenced by their contact with sales reps,’ Goodman suspects. ‘But of course you’re influenced, just as politicians are less independent when they take gifts from companies. If it had no effect, the industry wouldn’t spend so much money on it, right? When doctors prescribe a medicine too quickly, the results can be very unhealthy.’
The medical centre where Goodman works as an internist has a restrictive policy that keeps pharmaceutical sales reps away as much as possible. They are not allowed to distribute medicines or other goodies and must wear a clearly visible badge stating that they are a salesperson.
Goodman has a more willing ear among students – and not just his own students at New York’s Columbia University. Most medical students are spectacularly unprepared for the sales-rep phenomenon they will face upon graduation. Many get the impression that the gifts simply go with the territory. ‘Mind you, I’m not against the pharmaceutical industry,’ Goodman emphasises. ‘I prescribe their pills to my patients. But I want to safeguard the ethics of our profession.’
No Free Lunch, P.O. Box 151, Audubon Station, New York, NY, 10032, the United States, bob@nofreelunch.org, www.nofreelunch.org.
