A study published Friday in the JAMA Network Open finds a link between those counties in which physicians receive the highest number of gifts and payments from pharmaceutical companies and the rate of opiod overdose in those counties. Scott E. Hadland, Ariadne Rivera-Aguirre, and Brandon Marshall, et al., Association of Pharmaceutical Industry Marketing of Opioid Products With Mortality From Opioid-Related Overdoses, January 18, 2019, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2720914.
Herewith the findings:
In this population-based, cross-sectional study, $39.7 million in opioid marketing was targeted to 67 507 physicians across 2208 US counties between August 1, 2013, and December 31, 2015. Increased county-level opioid marketing was associated with elevated overdose mortality 1 year later, an association mediated by opioid prescribing rates; per capita, the number of marketing interactions with physicians demonstrated a stronger association with mortality than the dollar value of marketing.
In other words, the rules of conflict of interest apply, even to physician relationships with pharmaceutical companies. While the physicians will always believe that they are doing what it best for their patients, the subtle influence of “stuff,” including cash, cannot be dismissed even in those with the noble goal of caring for the health of others. Nobility cannot trump the power of the mind’s need to respond in a positive way to those who help us, give us stuff, or, are just plain nice to us.
We can talk until we are blue in the face about how the medical profession answers a higher calling. Even those in the highest of calling suffer from human foibles. Nearly all of us suffer from the weakness of taking stuff from other. We just have a need to quid their pro.