The California Assembly is about to vote on a bill authored by Senator Mike McGuire that insults the integrity of every practicing physician in California and threatens the sanctity of the patient-physician relationship, which is the cornerstone of effective health care. What’s more, Senator McGuire attempts to hold physicians to a stricter standard than he is apparently willing to hold himself and his fellow legislators.
Senate Bill 790 would put in place severe restrictions around gifts or other financial benefits that pharmaceutical companies can give to medical professionals as part of marketing activities. Among the proposed restrictions is an annual $250 limit on meals served at educational events. The limitation is ridiculous on its face, and it doesn’t even approach the gifts that Senator McGuire and other legislators allow themselves.
Senator McGuire takes annual gifts and campaign contributions from companies of just under $5,000, and his constituents trust that those meals and other contributions will not influence his decision-making. Yet the Senator will not extend the same benefit of the doubt to California doctors, insinuating instead that a tuna sandwich might influence our prescribing habits.
The real problem with SB 790 is that it will limit physician access to critical educational opportunities and important information about medical breakthroughs and new treatments. Some of this information that medical professionals use to successfully treat patients is shared at events that happen to be sponsored by pharmaceutical companies.
Physicians do not limit their ongoing education to reading journal articles. Good physicians read academic literature about advancements in treatment, but also learn from peer educational events run by clinicians and other experts, and, importantly, from sharing best practices and real-life experiences with other physicians. I still go to the hospital for lunch, and I assure you it isn’t about the food (especially since they stopped serving chicken wings). It is about the banter and exchange of ideas with other physicians at the table about interesting patients or challenging patient care issues.
My personal experiences with pharmaceutical companies, like those of many of my colleagues, have been largely positive and productive. Before I even consider writing a prescription for a new drug, I ask the manufacturer to provide me with research on the new treatment. Their research scientists have spent full days with my staff and me answering questions and educating us firsthand about their drug. This sometimes even occurs over lunch, which is often the only free time that physicians have. After listening and giving serious consideration to the risks and benefits of a drug, I have, on multiple occasions, told the pharmaceutical company that I was not interested. That is why I have the “MD” after my name. My medical degree – and education, training and lifetime of experience – demand that I make decisions about treatment and prescription medication just as I make every other medical decision: thoughtfully and meticulously, and with only the best interest of the patient in mind.
Physicians are relationship-builders. It’s in our nature. Because I have a relationship with the drug company representatives who stop by, they are more than generous with their time. I ask questions, tell them about complications I have encountered, and ask for samples to get my patients through the tough times.
But SB 790 is not about what is in the best interest of patients. Instead, it will tie our hands and stifle access to critical information that physicians and other medical professionals use to help patients. In so doing, the legislation could have far-reaching unintended consequences for California patient health.
SB790 is also not about “gifts” from the pharmaceutical industry. It is about the preservation of physician autonomy and patient choice. Any legislator suggesting that physicians could be persuaded to change their prescribing habits based on a tuna sandwich not only impugns the integrity of all physicians, but also reveals his or her own lack of fortitude and judgment. I urge legislators to vote no on SB 790. Let me do my job.
Marcy Zwelling-Aamot, M.D., is a board member of the American Academy of Private Physicians and the Chair of the National Physicians’ Council for Healthcare Policy.