I am intrigued by this notion that the physician is some sort higher being that is free from exterior influence and is an implicitly moral being, or at least moral from the standards of a Western society. This seems to be both in contradiction and alliance with our current notion of what Carl Elliott flags as a new world without doctors (92-93) and rather one that caters to health-care consumers and not patients. We, as the patients seem to think that our doctors are above corruption, as do the doctors themselves, as we saw last week in the Katz and Dana articles. Even Oldani’s article opens with this notion, although he does not spend explicitly on it beyond the opening quotes from doctors and drug reps.
Why, then, are doctors “incorruptible”? Is it because they have implicitly identified themselves as “good people” because they have committed their education and professions, in many cases to the detriment of their own lives, to improving and enhancing the lives of others? Is it the sanctity of the Hippocratic oath? Most likely, and although this is not different than any number of other careers, there appears to be a special type of reverence reserved for this profession. This is not a silent reverence; the doctors themselves are aware of it and, as many of the authors over the last few weeks have pointed out, feel that they deserve a reward as a result of the devotion that keeps on taking, from years in medical school to overtime and stress in the hospital setting.
I think that these conceptions all feed into one another and result into this idea of the doctor as a compassionate, moral, honorable being that is steps away from perfection. And while this week’s articles focused more on the role of the drug rep as a “drug pusher”, I think that the conceptions held by doctors and by society are essential to the success of the strategies that drug reps use, as can be seen in the strategies and rationale as outline in the table in the Fugh-Berman and Ahari article (622-623). Once we see these strategies laid out in front of us, they almost seem to be obvious ways of corrupting the incorruptible being that society has constructed.