Free lunch

This week's CMAJ editorial is a kick-in-the-pants for most practicing physicians. We get roasted for accepting perks from drug companies. And, mea culpa, this week, I had supper at Grand Rounds courtesy of one of our pharmaceutical reps.


The Globe and Mail commentary on how cozy some of us are with pharma reps quotes Prof. Arthur Schafer, "They (physicians) deny that they're influenced - all of them do deny that they're influenced."

Well, duh! Of course we deny we're influenced! If we admitted that we're influenced and yet continued to accept freebies, the cognitive dissonance would fry our brains. It's like those people who talk on cellphones while driving (you know who you are). Despite evidence to the contrary, those drivers have to deny that they are driving while concentration-impaired, otherwise they'd have to change their behavior.

(Quirks and Quarks podcast about cognitive dissonance here.)

(Star Trek fans only: Check out this classic, campy demonstration of the detrimental effects of cognitive dissonance.)

I rarely see drug reps in my office, but I admire their skill in getting the job done. They are universally intelligent, courteous and personable - essential behaviour to develop personal relationships with docs. That personal relationship is the key to exerting influence without burdening the poor doc with inconvenient thoughts of unethical behaviour. As the CMAJ piece points out, pharmas' business is to make money, not educate doctors.

Who am I to talk? This week, I sold my soul for some Greek ribs and a Caesar salad.

Let he who is without sin throw the first dinner roll.