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smithy

filthy largess

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have just come from another speciality to psychiatry and my god! There are drug reps round every corner. I had read it would be bad but nothing prepared me for this.

I am left wondering if its just my unit. Please let me know your current experiences.

Cheers

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have just come from another speciality to psychiatry and my god!  There are drug reps round every corner.  I had read it would be bad but nothing prepared me for this.

I am left wondering if its just my unit.  Please let me know your current experiences.

Cheers

i think thats just your personal experience. i am in psychiatry for more than one year and hardly see a rep. it is worse in other fields specially medicine. you would be lucky enough to have a chat with a rep and get a pen and pad as complement. i know people in other specialties enjoy a number of 'favours' from these guys.

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Smithy -

Join http://www.nofreelunch.org/ !

I think it's sooooo patronising that drug reps think their gifts will change prescribing practice. Tragically I'm happy to accept textbooks, memory cards and pens - but I don't see the connection between a soggy coronation chicken sandwich and Venlafaxine!

Critical appraisal means that we can (hopefully) tell a good bit of research from a terrible, self-promoting one. Some reps give out the Maudsley guidelines which I think is a MUST have for GP,medicine,A&E and psych.

I would hardly describe that as filthy largess though - those drug lunches can be a real pill!

Good luck in Psych - at the risk of some hyperbole I think you've chosen the best speciality in the world :D

BTW - this should probably be on the 'Becoming a better psychiatrist' board.......

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Just had to post some stuff from the American No Free Lunch site:

' * Organize a No Free Lunch activity at your school. Whether it’s through other student organizations interested in this issue (e.g., AMSA) or as a No Free Lunch chapter,[highlight] we will be happy to help out with any activity ideas and provide resources! (and of course, pens, buttons, and coffee mugs!) [/highlight]

* The American Medical Student Association’s (AMSA) PharmFree Campaign aims to educate and train its members to interact professionally and ethically with the pharmaceutical industry, and the PharmFree webpages contain information particularly useful for students. Join this campaign!

* Host speakers (or speak yourself!). We can provide the speakers, speaker kits, and other presentation materials.

* Hold 'Pen Amnesty Days.' Students and physicians can exchange their drug company pens for No Free

Lunch pens (no questions asked, of course). Remove those drug company pens from circulation, spread

our message, raise consciousness.

* Run 'Pledge Drives.' Encourage students and physicians to take 'The Pledge' and become drug-company free. And of course, take the pledge yourself!

* Set up a No Free Lunch booth. Anytime there's anything happening with booths (best of all, drug company booths!) and even when there’s not. Exchange pens and ideas, get pledges, have fun. We’ll provide the pens (and t-shirts for booth workers).

* Talk. Is this issue currently part of your medical school curriculum? If not, talk to course directors (Pharmacology, Ethics, “Introduction to the Patient,” etc.) about introducing it. We have lots of curricular materials to facilitate this. It is imperative that this issue is addressed before students start clinical rotations, where chances are they will experience first-hand the temptations of pharmaceutical industry fruit.

* Find out if pharmaceutical companies provide financial support for medical student activities/ organizations at your medical school. If so, organize a discussion to address the relationship between pharmaceutical companies and medical students.

* Become aNo Free Lunch Member , and make our voice louder!

* Help! For students who are interested and have a little bit of free time, there are opportunities to help out with No Free Lunch operations. Contact us!

* Role model. Unfortunately, physicians have served as rather poor role models for students and trainees.

This is an opportunity for students to turn the tables and role model for their teachers: Ask (respectfully, gently, naively) about your attendings’ or preceptors’ acceptance of gifts, about whether they think it influences their behavior, about what they think their patients think about it. As a medical student

(innocent, idealistic), you have unique power in this regard, and they might just listen to you—Give it a

try! To those old fogeys who are still getting their information from industry reps, tell them about computers, the World Wide Web, and the many ways physicians (and students) can obtain unbiased, accessible drug information efficiently and quickly. Maybe they’ll even thank you for it! '

LOVE that they'll provide pens and coffee mugs! Whatever happened to the bad old days when conferences where held in the Bahamas?

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i have to be honest that i am so filled with envy when i watch the GP lunches which take place alongside the psychiatric trainees`s post-teaching lunch.

they get a choice of continental or indian while we get dry sandwiches probably prepared by the rep....the GP`s have it good man

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Good for the guys who simply will not eat lunch brought by drug reps nor use their pens/ notepads/ mousemats/ mugs etc. It's a matter of conscience.

As for me, I eat the meals & use the items gladly; these things do not inform my prescribing practices. And I will gladly listen to the objective evidence / data on the drug; albeit critically.

I imagine same goes for most psychiatrists.

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Good for the guys who simply will not eat lunch brought by drug reps nor use their pens/ notepads/ mousemats/ mugs etc. It's a matter of conscience.

As for me, I eat the meals & use the items gladly; these things do not inform my prescribing practices. And I will gladly listen to the objective evidence / data on the drug; albeit critically.

I imagine same goes for most psychiatrists.

Fascinating that you say this. Do you honestly believe you are not in any way swayed when you are bombarded with details and data over a sumptous meal with wine about how well a particular drug is doing. Could you really honestly put your hand on your heart to say even unconsciously or subconsciously you are not affected? You are a psychiatrist after all think about it?

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Fascinating that you say this. Do you honestly believe you are not in any way swayed when you are bombarded with details and data over a sumptous meal with wine about how well a particular drug is doing.

WARNING!! - personal opinion follows: I believe there are psychiatrists who can go to a meal and still think objectively. But I have also seen consultants who scrabble for pens and sandwiches and set up regular weekly appointments with reps to gratefully guzzle any free items - even REALLY bad textbooks! These are the same doctors who suddenly start to prescribe newer drugs with fledgling track records - and it is sooooo obvious that this is to maintain their relationship with the reps!

It depends on the kind of person you are and the dr you want to be. I think it is insulting to suggest that we are swayed by a mouse mat or memory card. Greed is a human condition - but good drs are able to sublimate!

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The whole point to my argument was not to insult anyone but to ponder how we might be affected in what we do due to influences around us. It is part of basic psychology.

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I hope no one on here is insulted by this thread - I certainly haven't taken offense!

I hope most of us are at Kohlberg Stage 6 - which is why we became psychiatrists!

I do understand that there will be drs who are swayed by free food - we need to gently point them in the right direction......... the cafeteria!

:o

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No drug lunches for me.LD in London is as lefty as they come

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[Fascinating that you say this. Do you honestly believe you are not in any way swayed when you are bombarded with details and data over a [highlight]sumptous meal with wine[/highlight] about how well a particular drug is doing. Could you really honestly put your hand on your heart to say even unconsciously or subconsciously you are not affected? You are a psychiatrist after all think about it?

what?! Sandwich+crisps+orange juice.... ::)

Meanwhile, .reiss has answered precisely:

'WARNING!! - personal opinion follows: I believe there are psychiatrists who can go to a meal and still think objectively. But I have also seen consultants who scrabble for pens and sandwiches and set up regular weekly appointments with reps to gratefully guzzle any free items - even REALLY bad textbooks! These are the same doctors who suddenly start to prescribe newer drugs with fledgling track records - and it is sooooo obvious that this is to maintain their relationship with the reps!

It depends on the kind of person you are and the dr you want to be. I think it is insulting to suggest that we are swayed by a mouse mat or memory card. Greed is a human condition - but good drs are able to sublimate!'

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When it comes to food I am a very greedy man. You haven't seen greed like it; I'm talking 3 packets of sandwiches plus the extras they bring, born out of my impoverished condition as a medical student (my initial excuse!).

Whenever there was a free drug rep lunch I'd be there 1st to make a head start and occassionally nod away to the drug reps. Because I was always there first lapping up the free food the reps got to know me. I have also attended a couple of lavish meals, initially billed as trainee social nights, they clearly served as an opportunity for the reps to befriend us. I suspect I now have a 'rep friendly' aura.

A few months ago I was having a really busy day and I had a call from reception saying there was someone to see me. Feeling quite important I went to see whoever it was. It was one of the reps who had treated us to a meal a while back and he'd come to talk to me about some product. Owing to his efforts on the aforementioned night out I felt obliged to sit there and talk to him. I was bored to tears and dying to get away to continue my jobs but he was particularly difficult to move away from and I had a real sense that he also felt I owed him one.

I don't think I was remotely influenced by his pitch (although I couldn't rule it out), but I felt like I had for the past 18months been selling a small part of myself. I am capable of ignoring reps should they come to the ward but how do I state my new stance at free lunches without being rude? I am keen to distance myself from the reps now as this incident made me think of the other good reasons why accepting 'hospitality' isn't the right thing to do.

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'largess' is spelt 'largesse', from the French

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The spelling on this site is shocking generally.This is relatively minor

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The spelling on this site is shocking generally.This is relatively minor

ouch!

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