Gift Bans: Everyone knows "there's no such thing as a free lunch."
PA Governor missteps to the right at lunchtime
I wrote to my Pennsylvania Governor Josh Shapiro about a disappointing move on loosening the gift ban for top officials. It's not just a small thing as people are led to believe. My message:
The gift ban should NOT have been loosened, it should be made far more strict and broad than it already was.
While the gift ban under Wolf banning free lunches may be characterized by some as “extreme” — just think about it for a moment.
JAMA Network: Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries August 2016
Receipt of industry-sponsored meals was associated with an increased rate of prescribing the promoted brand-name medication to Medicare patients.
If you buy someone lunch, you’re also buying time with that official. Time that can be spent on influencing and sales techniques to persuade the official of who knows what.
If free lunches were so nominal and irrelevant, why do shrewd pharmaceutical companies spend so much money on buying meals for doctors who are hardly likely to be scraping for lunch money? It’s because this tactic is not irrelevant. Free lunches are incredibly effective marketing tools in persuading people. It’s harder to turn down a gift lunch.
We’ve all heard the old adage that states “There’s no such thing as a free lunch!”
So I don’t buy the gaslighting of minimization of the gifts issue. We can’t be expected to believe that political appointees are some how immune to what has an effect on even doctors. Truth is, nobody is immune to cognitive attack tactics. We can only mitigate their effect with sensible guardrails like: gift bans.
BMJ 2018: Even a $13 meal paid by pharma increases doctors’ opioid prescribing, study finds (Published 22 May 2018) by Owen Dyer
Even a single modest meal bought for a doctor by an opioid manufacturer’s sales representative—a common practice in the US—is associated with slightly increased opioid prescribing by that physician in the next year, new research shows.
Pa. Gov. Josh Shapiro loosens his predecessor’s notoriously strict gift ban for top officials by Stephen Caruso of Spotlight PA and Kate Huangpu of Spotlight PA | Jan. 20, 2023
Top officials for Pennsylvania’s governor are now allowed to accept an occasional free lunch while on duty. In one of the first notable changes of his new administration, Democratic Gov. Josh Shapiro announced Friday that he has loosened a gift ban that was put in place since the start of his predecessor, Democratic Gov. Tom Wolf’s, eight-year tenure.
NBC News: Doctors Fall for Free Lunches From Drug Companies, Study Shows "Our findings indicate that even payments of less than $20 are associated with different prescribing pattern." By Maggie Fox, June 2016
Those who got four or more meals relating to the four drugs prescribed Crestor nearly twice as often as doctors who didn’t get the free meals; Bystolic more than five times as often, Benicar more than four times as often and Pristig 3.4 times as often, the team found. Even one meal where the drug was discussed led to higher prescribing rates, the analysis showed. “Furthermore, the relationship was dose dependent, with additional meals and costlier meals associated with greater increases in prescribing of the promoted drug,” Dudley’s team wrote.
ProPublica: Steak Dinners, Sales Reps and Risky Procedures: Inside the Big Business of Clogged Arteries. Text messages, a whistleblower lawsuit and an internal investigation reveal the lengths to which Medtronic, the world’s largest medical device company, allegedly “groomed” doctors to overuse its vascular products in patients at a veterans hospital. by Annie Waldman Feb. 16
Federal agents separately opened an investigation into the same unit in the facility, looking into allegations of kickbacks. More than 40 pages of expense reports from Medtronic, revealed in the whistleblower case, show sales representatives treating Dole health care workers to hundreds of meals over several years — lunches at Dempsey’s Biscuit Co.; business meals at the Scotch & Sirloin steakhouse; dinner at Chester’s Chophouse & Wine Bar, price per attendee: $122.39.
I actively participated in campaigning for Josh Shapiro for Governor. I did a phone bank with Indivisible, and postcards to voters with National Nurses United. Almost nobody wanted the qanon insurrectionist to become governor. But Josh Shapiro needs to stop with the missteps and listen to the people who got him elected.
I ate lunch at home today.