Years ago a drug salesman recovering from a devastating divorce moved into my modest upper middle class neighborhood. Drub salesmen normally live in more exclusive locations. He appeared to be stoned most of the time. One day we were talking (he was almost manic) and he explained how the business worked. Every month he got a printout of the drugs that he handled that were prescribed by the doctors he visited. He gave them a percentage of the profit for prescribing them. I asked how that was handled. He said, “I invite them to play golf and while playing I hand them an envelope with the cash.”
I recalled how I’d been on a perfectly workable generic drug for a long time but my doctor changed it to a new, just released drug. It didn’t work as well and I had side effects. He wanted me to try it again at a lower dose. I told him that if it didn’t work at the higher dose, why would it work at the lower dose? I wanted the old drug. My take on his body language was that he was disappointed. It puzzled me until that conversation. (It was migraine medicine and it turns out even the cheapest oldest drugs work just fine for me.)
Now, I get the generic every time automatically, so, perhaps something has changed.
While this may have been many years ago (it would have to be greater than 25), that would be an illegal kickback today and the physician and drug rep would both go to jail. With the quite sophisticated surveillance of CMS, I am confident this would not happen today. So I am hoping this is not just another cheap shot at the medical profession that is so eagerly ordained by many on this forum who have nothing better to do than post half truths from bloggers and crap websites and try to convince themselves and others that they actually know what they are talking about.
Excellent post.
That is _exactly_ how the real world works.
In the old days we had a “family doctor” who really did care about everyone in the family, and took the hippocratic oath _very_ seriously.
There are only a few docs like that today, and most of them have boutique practices for the wealthy.