This is about one doctor and one gonna-be-a-doctor.
Naomi is my daughter-in-law. She is a doctor of osteopathy and doing her residency for cheap money in Medford, Oregon. She is writing prescriptions.
Lena is my neighbor. She is a medical student at the University of Texas Medical Branch. She is married to Barry who is an airline pilot. She is a Registered Nurse, but got so sick and tired of being bullied by MDs that she decided to become one.
Lena and Barry met in Alaska. Lena is from Moldava. Her mother, had a full career as a medical doctor in Moldava. Now, grandma is the primary caregiver for Lena and Barry’s five year old autistic son.
Both of these girls told me the same thing with a question in their tone. Their schools had told them to treat pharmaceutical reps as rattlesnakes. They were told they had to sign an ethics code that would be in force for their entire careers. They were to take nothing. No gifts. No meals. No pens and pads. They were supposed to swear that their ears would be closed to any words from the reps, that they would never let them into the office. No donuts for the staff. No movie tickets for the receptionist. Nothing.
They both asked, “What do you think about that, Jim.”
Here is what I told them both. “That is ridiculous. You are going to be a wage-slave who works your 40 hours and go home. The days of fee for service is heading for the dead end. You’ll make very good money without the headaches. There will not be a four car garage with a Jaguar, Mercedes, Chevy Truck and a Range Rover. Your house will not be 6,000 square feet. You won’t own a condo at the south shore of Lake Tahoe and a beach house on Monterrey Bay. That is what dentists are going to be able to do.”
I asked them where they got their drug information and they both told me advertising in the journals with some embarrassment. “You are not going to come home from work every night and read about drugs. I know you want a life. The drug reps are the best educated on their drugs in the world. They are the best educated on the drugs that may be elbowing their way in. In five minutes, they will educate you about what the drug does, how it does it and if there is anything to be worried about. What more do you need?”
They were listening intently. I went on. “Modern doctors get most of their drug education from the drug reps. Why not? They will give you the highlights in minutes and the highlights are all you need.”
Then I got serious. “Beyond the highlights, you can pick out a friendly pharmacist in the community and lean on her. She will fill in all the gaps for you. You won’t be able to help it. You will favor her store. It’s a trade/trade.” They both liked this idea.
“Modern doctors have about 50 drugs that they prescribe regularly. They know a lot about those 50 drugs. If you want to go beyond and are not satisfied with the drug rep’s rap, call your pharmacist partner.”
They liked this. Then came the big one. “We shouldn’t accept gifts though, right?”
“Why not?” I said.
This is what I told Naomi. “Darling, you make resident’s money. Cody is getting ready for law school. Life is not that easy right now. When the Pfizer rep invites you and Cody for the weekend at a nice hotel on the coast in Cannon Beach, all expenses paid, and all you have to do is attend a two hour lecture on their newest drug, DO IT! In the end, you are the doctor. Nobody will force you to write for this drug. You can make your own mind up.”
Naomi wanted to know if she really could depend on a pharmacist. This was an entirely new concept, a revelation. She told me recently that she found her pharmacist partner. A mature man who had plenty of time and likes it when she calls.