My father got his M.D. in 1930; I got mine in 1958. Insulin and penicillin came into being during his early years of practice. In my first years as a psychiatrist, tranquilizers and antidepressants changed the landscape of mental health. As doctors, Dad and I both welcomed Medicare in 1965; later on as patients we became grateful beneficiaries.
I remember him explaining “ethical pharmaceuticals” — a term that distinguished companies like Merck from hucksters of “patent medicines.” The scandal at Merck about the arthritis drug Vioxx came after his time — he would have been appalled.
Recently the line between ethical drug companies and hucksters was blurred by GlaxoSmithKline, which paid a record fine for its bad acts. Until this Glaxo case, drug firms took fines and some bad publicity in stride as a cost of business; now the companies and Wall Street are getting a new message.
Medicine is a profession — a calling, not a business. In Dad’s lifetime it was unethical for doctors, hospitals and pharmaceutical companies to advertise. Now it is legal, and presumably ethical, to peddle prescription drugs to patients who get doctors to swing at the advertiser’s pitch. Doctors earn much more for prescribing, testing and treating than for explaining. Insurance pays for the expensive drug. How many doctors will take the time to suggest a cheaper generic drug with an excellent track record?
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