7.22.2009

Sutton's Law of the Impunity of Profit

The heated discussions about the resistance of the pharmaceutical and drug companies to reduce the cost of exorbitantly priced medicines in the country have actually opened a bigger can of worms. The issue has unearthed a long disregarded (mal)practice among medical doctors and medical representatives to deceive, consciously or unwittingly, the patients in particular and the public in general -- all in the name of profit. A senseless and unmindful profit!

This is Sutton's Law at work --
"go where the money is!
"

The Sutton's Law is often cited in medical schools to teach and train new physicians to spend resources where they are most likely to pay off. This is classical economic principle of maximization, as well as conventional management rule of efficiency. We all want the highest yield and return and output for every input and resource we have invested. No problem with that, if done in fairplay, transparency and with a sense of justice, and not through deceptive marketing, irresponsible sweet-talking, and deliberate coaxing. Interestingly, Sutton's Law is named after the legendary bank robber Willie Sutton (1901-1980), who when asked why he robbed banks, allegedly claimed to have answered -- "because that's where the money is!"

Pharmaceutical and drug companies have all the resources and money that medical doctors seek (all professions seek for it by the way), and medical representatives indeed act with all skill and adroitness to rake in all the profits, at all cost! Go where the money is, because that's where the money is!

The Chief of the Medical Mission Group Hospitals and Philippine Health Services Cooperative Federation, Dr. Jose Tingco candidly wrote about the manipulation between medical doctors and medical representatives:

"The first to manipulate him (doctor) would be the transnational drug companies. Even in his internship year, when he has just begun to write prescription medicines, the drug companies are already hot and heavy on his trail. They bribe him with commissions on each capsule that he prescribes. They shower him with little colorful plastic ball pens and doodads. They treat him to sumptuous meals and little snacks. They sponsor sports fests and bowling tournaments and drinking sessions. They tempt him with leggy, sexy med reps. During residency, they sponsor training trips for him abroad. All in exchange for prescribing their brutally high priced medicines!"

Dr. Tiongco further shared: "The exploitation goes even more high gear in private practice. Here the med reps take notes of how many patients he has and classify the doctors along the number of patients he/she sees a day and the number of prescriptions he/she makes; Grade A, being the highest. And the perks become more or less depending on his level of classification. The perks become heavier: cars, appliances, shopping trips to the malls, medical equipment and yearly trips abroad to attend specialty conferences, even training seminars. If he is a subspecialist and practicing in Manila, they sponsor lecture tours in the provinces to bolster his reputation as well as sell their high priced drugs. The run of the mill doctor in the provinces gets a yearly airplane ticket to Manila to attend the various specialty conferences and a free four-day stay in a five star hotel. If he has a good practice (Grade A), he will probably be fetched at the airport by an unfortunate medical representative bearing his name on a piece of cardboard, who together with his car, is assigned to him on a 24 hour basis. This med rep is responsible for the doctor's entertainment during his entire stay and even for the procurement of female company, if the doctor so desires!"

This is impunity of profit!

We beg and kneel before our medical doctors and medical representatives -- stand firm, and be upright, ethical and honorable! Stick on your Hippocratic Oath to keep the people from harm and injustice. Do not sell your soul!

The businessman and industrialist Henry Kravis found his secret of success: "If you don't have integrity, you have nothing. You can't buy it. You can have all the money in the world, but if you are not a moral and ethical person, you really have nothing!"