Is an unconditioned medical information possible?
The medical publishing environment has been recently shocked by several chilling stories. Too often, physicians routinely rely on poor quality information, home-made by pharmaceutical companies; industries have also an enormous influence over continuing medical education (CME) programs, sponsoring and orienting workshops, journals, and distance learning. Medical knowledge is biased at an early stage, since most clinical trials are substantially controlled by Big Pharma. Doctors cooperate in producing biased clinical guidelines, reviews and conference reports, accepting any kind of gifts from the industries. The individual physician is the ideal target for this kind of marketing strategies: as doctors have been busier and busier, they are more and more exposed to the allure of gifts and grants offered during the salesmen visits. On the other hand, medical societies and professional organizations have heavy financial entanglements with the industry: companies sponsor symposia and CME courses; frequently, satellite meetings are better attended and cited than scientific sessions. How did it happen? As the influence of money has grown medicine ceased to be among the most respected professions. Doctors seem to be less confident in medical knowledge, not opposing to industry promotion and to patients’rising medical consumerism. What can be done now? Disclosure of financial ties with industries could be a first step but it hardly would be enough. Postgraduate medical education should be based on teaching of the methods of critical appraisal of all the best evidence. Only governmental institutions and agencies should plan, finance and manage projects granting CME credits. Scientific associations must be self-supporting. The promotional strategies of pharmaceutical companies should be guided by clear, comprehensive, rigorous policies and standards, and carefully monitored by regulatory agencies.
L’Autore propone una riflessione sulla responsabilità del medico nei confronti della industria farmaceutica la cui spesa pubblicitaria è estremamente elevata e in un’alta percentuale riguarda investimenti promozionali nei confronti dei medici. Le conoscenze che vengono messe a disposizione dei medici sono dunque condizionate assai precocemente alla loro fonte cioè da chi le somministra. La fonte industriale è, allo stesso tempo, alla base della vita economica delle società scientifiche. L’Autore pensa che si possa uscire da questo labirinto incentivando l’attività di ricerca clinica, facendo diventare i medici protagonisti autonomi di progetti di studio e forzando le imprese ad agire in modo socialmente responsabile.