Author: 'Ken' 'Gillman'
Position: Doctor
Institution: Pioneer Valley Private Hospital
E-mail: kg@matilda.net.au
Additional Authors: 0
Submitted Date: March 01, 2006
Published Date: March 1, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

In response to Lacasse and Leo's article, McCarter's letter suggests that any expenditure on advertising by pharmaceutical or medical device manufacturers be matched by contributions to an unbiased education fund administered by the FDA, the NIH, or both. He is correct; medical education is a huge industry through which these firms, at one remove, attempt to influence medical practice by the sponsoring of meetings and more.

I heartily agree with McCarter, and further suggest that the government is by no means the only route via which change might be brought about. There is no possible impediment, in principle, to two other similar courses of potentially paradigm-changing action.

The first would be a system whereby patients have the choice of entering clinical trials only when they are run (and the data controlled) by independent doctors. They can be informed of this idea via the many existing patients' rights organizations. The funding would be at 'arm's length' from pharmaceutical companies via levies or taxes and directed through independent research agencies, such as those that already exist.

Secondly, my view is that doctors could lead the way, via their various colleges. They have the opportunity to choose to agree only to provide postgraduate educational credits etc. to educational activities arranged by doctors, and as above, funded at arm's length. The same would go for clinical trials. Obviously most money would come from drug companies profits and taxes in the end, and it is really a question of how long the arm is. Such arrangements would shift the balance favourably away from the current excessive pharmaceutical company influence.

These suggestions remind us that individuals' decisions and actions do have the power to bring about great changes, it is not necessary to wait for government action.