Thanks

The second part: “the pharmaceutical companies keep bombarding us with misleading promotions and we [health professionals] keep believing them.” is a statement of fact except that they don’t fool all of the people all of the time. Currently most health professionals are not aware how vulnerable they are to being misled. Consequently they do not take action to protect themselves. Helping them understand the problem is the essential first step before they will support solutions.

The first part: “Oh poor little us. Those nasty people…” is not our position for 2 reasons. Obviously there are limits to what an individual can achieve alone. That’s why one of the main reasons we formed an association is so that individuals can come together to become influential. Whilst there are nasty people in all walks of life we can’t read minds and we are aware that good people will do bad things when misled, especially by groupthink.

You suggest that a quote from an item in our web library represents our policy. This is like suggesting that a quote from an item in a community library represents the policy of that community. At the top of every item we have a warning statement: “Warning: This library includes all references relevant to drug promotion that we are aware of regardless of quality. Often we do not agree with the contents.” I am sorry this is not clear enough for you. Your suggestions re how to improve our warning statement will be appreciated.

You believe that the blame for inappropriate prescribing lies squarely with the leaders of the medical profession’s professional bodies. Some of our members may agree with you but that is not our joint position. Our joint position is that it is more justified and useful to blame the systems of information, rewards and punishments that influence the behaviours of all the people and organisations involved.

The leaders of professional bodies are elected by their members and thus reflect majority views. Most leaders don’t understand the problems any better than their members. If they do understand there is little they can do about it without being removed from power. They have very limited influence over their members. Most professional bodies produce more information than their members use because most members rely instead on information from industry. Most members expect their professional bodies to produce benefits for themselves from accepting money etc from drug companies.

Blaming people is not a good way to win friends and influence them. We believe we will achieve more by changing the system via the following reform agenda:

1. Improve education for health professionals and the public about diagnostic and treatment decision-making including education about biased influences.
2. Remove perverse incentives and develop better reward systems in order to optimise resource utilisation and health outcomes.
3. Improve regulation relevant to health care including regulation of research and marketing.

However we welcome a diversity of views about the best ways to improve health by reducing harm from misleading health information. Consequently if you still think blaming leaders of professional bodies is justified and useful I would be interested to learn more.

Thank you for your interest. I’m certainly planning a lot more posts.