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Docs Offer Second Opinion on Drug Firms

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Thumbing through the latest Journal of the American Medical Assn. over morning coffee, I stumbled on some interesting letters about the influence of drug companies on doctors.

Seems that in a JAMA article a while back, a doctor from McGill University in Montreal took a look at the way drug companies sponsor medical lectures, often with yummy meals or travel expenses thrown in. His finding: Some physicians alter their prescribing practices after such lectures, increasing their use of products from the drug company sponsors.

His report apparently touched a nerve with some physicians.

Several docs shrewdly pointed out that it’s not as if the medical journals themselves are devoid of such tawdry influence. Peppering JAMA’s pages are pharmaceutical advertisements consisting of somber prescribing information as well as more moving images. (There’s your middle-aged couple lovingly embracing [Viagra]; five grinning men standing by their surfboards at the beach [a drug to treat enlarged prostate glands]; a smiling woman tending roses in her garden with her bandanna-wearing Labrador retriever [an angina drug], to name just a few.)

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One doc notes it’s rare to find a medical conference that doesn’t have drug company sponsorship of some kind, and that docs aren’t dolts: If they change their prescribing habits, it’s probably because they’ve learned more about the drug and are more comfortable with it now--not because of a free meal and a day at the zoo.

But a doc from Europe wrote disapprovingly: “During my sabbatical visit to the United States, I encountered physicians who managed to have lunch provided by pharmaceutical companies on most of their workdays. Others only attended seminars or lectures in [continuing medical education] that included free meals.”

The whole issue is complicated, and some medical associations have guidelines for what they consider acceptable--or totally beyond the pale.

Definitely beyond the pale in the opinion of one correspondent were the following drug company-sponsored events:

* A day at an amusement park for docs and their families, consisting of a 30-minute medical presentation followed by lunch and the rest of the day to enjoy the rides.

* A family pizza dinner at a children’s game center, with a 15-minute presentation to physicians, while “spouses and children play games and ride bumper cars.”

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* A day at the zoo for physicians and their families. The day started with a 45-minute presentation, then an Imax film, then lunch and an afternoon at the zoo.”

Let the Manufacturer Color Your Contacts

Here, meanwhile, is one warning we didn’t imagine anyone would need: Don’t tint your contact lenses with food coloring! According to the American Optometric Assn., kids are actually doing this, inspired by the cool look it imparts. Hip, perhaps, but food coloring, which isn’t sterile, can cause eye infections, the eye doctors warn--to say nothing of eye irritation caused by the chemical in such products.

Finally, following our item last week on knuckle-cracking, we learned of a local angle. Back in the 1970s, Dr. Robert Swezey, a Santa Monica rheumatologist, investigated the possible link between this irritating habit and the development of arthritis. He went into a nursing home, quizzed residents about the knuckle habits they’d had in their youth--and found no link between knuckle-cracking and arthritis.

Swezey enlisted the help of his son, then a 12-year-old knuckle-cracking kid. He got Swezey Jr. to collect data on the knuckle-cracking habits of his schoolmates. Swezey Sr. rather hoped it would inspire young Stuart to become a doctor, he says. But Stuart ended up, among other things, a writer.

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