Connecting The Dots of Healthcare

Headlines in multiple newspapers proclaim “Doctors admit to bribes!” Read on, and you discover that, HORRORS, Doctors allowed a healthcare sales representative to BUY THEM A LUNCH. Goodness Gracious!!!! What will be next? Candidates running for public office being given obscene amounts of money by people who would like to see them elected for self-serving motives!!!!?????

REALLY! When you invite someone to a business lunch, it’s not the same thing as slipping them cash under the table! A conversation, over a meal, is a way to get some time with a physician that otherwise might not occur. (Of course, even if it is planned, with a physician schedule it may not even occur.) However, in the course of my consulting, I’ve known sales reps to provide meals to entire office staffs because the office staff demanded it in order to perhaps have a physician attend the lunch. How much influence do companies who sell to or through physicians have with “free lunches?” Or pens, or mugs, or donuts? Or large denomination, unmarked greenbacks in a plain brown envelope?

I was in the OR of our hospital this morning. A box of muffins was on the staff lounge table. There was a sticker on the top of the box from a company, I’m sure. Well, I’m not really sure, because even though I ate a muffin… I didn’t really examine the top of the box. Did this vendor get any credit for the muffin I ate? Had I known who provided me the muffin; would I have made a sale for him/her? Are doctors NOT influenced AT ALL by “gifts” or maybe a little… or maybe… for a really cool gift, even more… or perhaps FOR AN OUTRIGHT BRIBE… a lot? Or can some docs be bought off by a notepad and a 29 cent pen? When a physician says “it doesn’t influence me at all” you know that’s not right. Because if it didn’t have any influence, marketers woudn’t do it! And besides, marketing is all about influence… that’s the name of the game. People want to position their product/service so a potential buyer thinks of you when they think of solving a problem or addressing a need… that’s why it’s called “positioning!” And there’s nothing wrong with marketing to make people understand value a business provides…. but BRIBERY is another matter… or is it?

Consulting with Homecare Companies in So. Florida always brings the story of a rep asking the doctor… “So what can I do to get you to refer us to a patient?”….and the doctor puts a hand out for an outright bribe. THAT goes beyond the pale. But where is the line? How much is OK? How much is TOO MUCH? The AMA has guidelines published in 1991, and revisions published  and even more revisions  published on the ethics of gifts to physicians. It’s kind of like getting a legal opinion… exceptions, circumstances, variances, etc… and exactly how many angels can dance on the head of the pin? But it’s not all black and white… a lot of gray.

Personally, if it smells, I don’t go with it. But my standards of ethics may be different than another doctor, or a salesman. Going out of your way to differentiate yourself and your product/service and meeting needs of a buyer is an element of any effective sale. But that’s not a bribe. Or is it? Are we to let elected lawmakers (who get their fair share of “gifts”) set our standards? What would our patients think? What would we think? What would my mom think? (Moms are usually unerringly accurate in their ethical assessments… but Mom’s today are also in medical sales and are represented by all the “dots” of healthcare too….)

What do you think? What’s “too much?” What’s “OK?” What’s “business?” What’s a “BRIBE?” Have a horror story we could all wince or laugh at? I’d write more but I’ve got to meet this guy who wants to take me to lunch….