The ACC’s CEO Jack Lewin may have put forth the single best and most concise argument against industry funding of medical societies. Here’s what Lewin told ProPublica:
The “circus element” of the exhibit booths doesn’t unduly influence attendees, Lewin said. “I don’t buy a soft drink just because of the advertising… I buy it because I like it.”
Now we know that Lewin actually supports industry funding, but any thoughtful reflection about this statement will lead to the inevitable conclusion that people do buy soft drinks because of advertising and that the circus atmosphere of exhibit booths does influence attendees. Neither Coke nor Medtronic are idiots and they certainly don’t waste their money.
In fact, every defense of industry funding relies on this sort of double think:
- Advertising doesn’t affect me.
- Money can’t influence my medical decisions.
But it’s not true. It’s not even possible, because it’s impossible to fully understand and appreciate our ability to deceive ourselves. And it’s for precisely this reason that we rely on the scientific method to achieve an accurate understanding of our world and ourselves. And it’s for precisely this reason why medical societies like the ACC, if they want to retain the aura of scientific integrity, need to divest themselves of industry influence.
It shouldn’t even need to be said. Here’s how one well-known physician responded to Lewin’s statement:
“If it weren’t influencing the doctors, they wouldn’t be doing it,” said Dr. Gordon Guyatt, a health policy expert at McMaster University in Ontario.
Larry,
JAMA published a brief article a few years ago that articulated the social science perspective on gifts and behavior. I found it thoughtful and worthwhile reading. The citation is Dana J, Lowenstein G, A social science perspective on gifts to physicians from industry. JAMA.2003;290:252-5.
Of course advertising influences behavior. But the cost of attending medical meetings, which is often an out-of-pocket expense, also influences behavior. To imply that association meetings are simply thinly disguised pharma circuses and thus provide minimal scientific education to attendees is as small-minded as denying that the effect of advertising. I am always offended when we are given no credit for the ability to consider the source.
Gayle: John Mandrola argued a similar point on his blog:
http://www.drjohnm.org/2011/05/reflections-from-hrs-2011-the-largesse/
I don’t intend to imply that all the content at these meetings are biased, or that medical professionals have no ability to sift through the evidence and consider the source.
But as Karen’s earlier comment notes, the effects of advertising and gifts are often quite subtle, and although any single example is likely to be trivial, the cumulative effect is likely to be overwhelming, and even the most critical individual can be influenced in ways that can not be neither fully understood nor prevented.