Drug Company Influence In The Va ?

[saginaw]

Can anyone tell me who would be the most appropriate govt or non-govt contact to pursue the following matter through?

Last year I had a pretty uncomfortable relationship developing with a care giver at my local VA who had a pretty unseemly (in my opinion) focus on the depression med Effexor. This doctor is the head of the mental health unit at this outpatient clinic. He had a little flyer that he'd personally printed out showing a hierarchical layout of most common antidepressants with Effexor at the top of the 'tree'.

He had originally agreed to see me in an initial visit in response to my questions regarding another medication. Almost immediately he was dissuading me from any consideration of the other med, and steering me very avidly toward Effexor. I cannot quite describe his manner except to say that he reminded me very much of a channel tv infomercial vendor. Effexor, Effexor. He was almost giddy about it.

Even then I wondered if he might have ulterior motives for pushing this single medication, but I dismissed any suspicion on the grounds that he was so highly placed in the clinic that he wouldn't possibly risk exposure of something like this.

So recently I discover in the papers an investigation into the questionable ethics of this rather widespread relationship between doctors, often very prominent doctors, and the drug companies. Well beyond coffee cups and inkpens or even ski vacations, these doctors are getting caught taking under-the-table cash to avoid both the taint of unprofessional conduct, and federal taxes! The chief medical correspondent of one of the media giants (cnbc, cnn, fox, or something or other) was caught redhanded.

I suddenly wondered again if this doctor I'd seen, for a genuine inquiry into the possibility of another medication, might simply have been 'selling' me Effexor. If this is possible I'd be greatly pissed! Heading up some of the investigations was the office of Sen. Chuch Grassely of Iowa. I sent him two letters concerning this and have yet to receive any response over a month later. I must be just another cracked-pot Veteran I guess.

Now where? I've not entirely comfortable taking something of this level to the patient advocate whose office is in the same building. She's a great person, and has been very square in the past. But I wonder if I'd be unwise to pursue something of this magnitude "internally".

Thanks so much for the great forum!

[john999]

You need some evidence that this doctor is profiting illegally from pushing Effexor to VA patients. How to get that evidence? Go to the I.G. but I doubt they will do a damn thing with no evidence. The patient advocate is probably sharing in the skim if there is any. You have no evidence that your doctor has violated ethics or the law. You need to become a detective on your own and get evidence. I am not saying your doctor would not do something illegal, but you need to nail him with evidence.

We had a psychologist at the VA that was running a home for homeless vets and charging them for food and shelter, and also getting money from the VA to support the Vets. He is in jail now. He got caught from another illegal racket he was doing. The VA never caught him. He was exposed by the local press.

[Pete53]

Welcome to Hadit:

I doubt that you will ever be able to be sure if the Doc was in the bag or just a strong proponet but that relationship exists thought the Medical Industry. Many of the Docs at Hospitals and VA are hired guns for the pharmacy. Whether he was genuine about effexo or not probably will never be proved.

If you feel strongly about this issue I would thing that the VAIG is the place to complain too.

Good Luck

[purple]

I have no doubt that big pharma has a huge influence (both legal and illegal) with VA docs. Being able to prove it is another thing because the VA is so good at CYA.

I recall sitting in prime care waiting for an appt--had been waiting for a very long time of course--and in walks a big pharma rep (they are so easy to spot!)...told the desk person who they were and they were ushered directly to the back...no waiting!!! I despise seeing these reps at the VA.

[saginaw]

This stuff is tricky. And no wonder it often falls into a legally grey area. Commercialism is always going to be an especially tangled relationship in medicine because for the average non-scientist (99.99 percent of us) any assumption of 'caveat emptor' just does not apply! We are involved in an an extraordinarily trusting relationship with a caregiver. He/she controls an overwhelming balance of information in the "exchange".

When that relationship is reduced to a commercial exchange, and unless the doctor is a legitimate saint operating under the direct gaze of God himself (perhaps 00.01 percent of them), then the patient is going to lose every single time. For some reason, the advocates of creating a totally 'free market' in medicine, advocates who quite seriously see nothing wrong with doctors on the payroll of drug companies, just don't understand this.

[PE1]

Maybe he's taking Effexor himself too.

[Commander Bob]

You don't want to burn too many bridges behind you, saginaw, reporting vague concerns could contaminate your relationship with him. Although, it sounds like he has contaminated the relationship with you already. Can you request to change doctors? I looked up Effexor on wikipedia. http://en.wikipedia.org/wiki/Venlafaxine Nothing notable or unique about the drug. You post that this MD works at an outpatient clinic. My first impression, and IMHO, I doubt that he is receiving payola for writing scripts for Effexor. Again, this is only my opinion, I don't know the details. If you think that something is odd with your doctor's enthusiasm re; Effexor, then ask him about it. Has he tried other drugs out on you? The hand made flyers he passes out sounds a bit odd. From what I've read about Effexor, it's no panacea or wonder drug. How old is he? IMO, most MD's love passing out pills... Have you tried it? Does it work? If yes. then how much of yourself do you have to give up to get relief?