I apologize for interrupting Boss's fun posts with my pensive tirades about medicine (that I'm sure nobody is too interested in, but are cathartic for me...).
My current rotation is outpatient internal medicine. I see patients who have lots of chronic problems and they usually take lots of medications. Most of my patients are uninsured or government insured and have no money for healthcare. They are typically not compliant with the treatment regimens they are given and that just makes all their health problems worse.
I've seen it over and over--the patient can't afford the drug, but instead of telling the doctor, they just don't buy it and don't come back. At least, they don't come back until the serious complications kick in.
There's a good case made for the economics of the drug industry--if certain drugs weren't so expensive there wouldn't be any research and development funds and we wouldn't have certain great drugs available to us at any price. I recognize that our free market has lots of injustice, but it has successfully produced the most innovative drugs in the world.
So, after seeing a docket of patients complaining of the personal sacrifices necessary to take the drugs we prescribe, I reconciled myself to the frustration as I left the clinic for noon lecture.
At noon lecture a drug representative welcomed me with fancy promotional materials for a powerful antibiotic (she didn't mention that it's one of the most expensive ones available). And then I helped myself to the fully catered lunch, most of which I knew would be left-over and wasted, provided by the drug company representative.
Should I abstain at times like that? There are some who do (not here, but around the country), with no effect whatsoever. The companies can market their drugs the way they see fit, and that has historically been spending obscene amounts of money on physician gifts and "educational" conferences. The conferences usually consist of a meal at a fancy restaurant with a presentation about one of the company's drugs (which they pretend is objective). Regulations now make it illegal (I think) to give out any gift with a value of more than $2. So we get a lot of fancy pens with drug names on the side. Some residents collect them. I'm ambivalent. Writing with those pens feels completely innocuous at times, but at other times it feels like I'm writing with patient blood.