Blog | Tuesday, June 19, 2012

Kirsch on kitsch, a physician confesses that pharmaceutical gifts corrupt

I write now in a moment of introspection wondering if I am a corrupt doctor. Why would I even consider that my integrity is in question? I am not on the payroll of any pharmaceutical company. I am not paid to speak to physicians or the public about the latest medical breakthrough for flatulence. I submit squeaky clean billings to Medicare and insurance companies. I do not order medical procedures on patients for personal gain.

My failing, if it truly exists, is an example of the power of the pen. In our office, many of the pens floating around are labeled with the name of a new drug. I assume that these evil instruments are left by pharmaceutical representatives, but I never actually see them make the drop.

They are the 'Adam and Eve' of medical practices; they are fruitful and they multiply. These pens over time have mutated, like bacteria and viruses, and can now exist in a variety of harsh environments. For example, when I am in a restaurant about to sign my credit card bill, the sly server hands me a Nexium pen. Is he a doctor, I wonder? Is he part of the nefarious Nexium network? What's next? Will we see President Obama signing important health care legislation with Viagra pens, which he will then present to the legislators who spearheaded the bill? How can this plague be 'penned' in?

No, I am not overworked or overreacting. Last year, a new set of pharmaceutical industry guidelines, agreed to by 40 companies, was enacted. These companies, aiming to elevate their ethical behavior, have sworn an oath to never distribute any pen labeled with one of their products.

As if this draconian ban were not sufficient, labeled coffee mugs and staplers will also be strictly prohibited. These measures are supposed to make physicians more ethical since we will be now free from the hypnotizing effects of all of the labeled kitsch in our offices. This must mean that up to now that I have been an unwitting tool of pens, pads and post-it notes that have induced me to prescribe their medicines to my patients.

Soon, I expect the pen police to start patrolling doctors' offices. When they arrive for their unannounced inspections, I'll demand to examine their clipboards to verify that they are unlabeled and conform to the highest ethical standards. When they ask me to sign an attestation that my office is clean, I'll pretend to search my pockets and then will ask the inspector to borrow a pen. You can bet I'll be examining it quite closely.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.