Couple of weeks ago I went to the docs due to an infected injury on my arm. All cleared now.

I Was prescribed Antibiotics as expected. The Doctor also wanted to prescribe me some pain killers.. I explained to the doctor that I didn’t need the pain killers as the pain was very mild and could be alleviated completely with paracetamol.

The doctor got quite upset, stared at me and said ‘Do you not want the medication?’

I explained that I would take the antibiotics but saw no point in the pain killers as A: I wasn’t in pain and B: I didn’t see the point of paying for two prescriptions.

He refused and gave me both. I simply told the pharmacist that I only wanted the antibiotics, which they agreed to.

Made me think though.. are Docs on commission with drug companies?

Yes

Typical sloppy NHS. In the good old days, if you were a problem patient they at least went to the trouble of administering a massive dose of painkiller intravenously.

Yes. Doctors are on commission. Don’t be stupid!

Have you considered that the Dr was acting in your best interests based on years of study and experience?

are Docs on commission with drug companies?

Hell yes!

Everyone wants a little bit of cream with their pie.

was it a specific branded drug?

The practice does get ‘a cut’ if it is a dispensing practice and you get the prescription from their dispensary. If not, and you get the drugs elsewhere, then no they don’t receive any financial benefit

Edit: All PCT’s at present, and whatever finally ends up replacing them, have quite strict guidelines for prescribing and practices are regularly assessed on their performance in relation to those guidelines and can be penalised if they over prescribe

Doctors get lots of incentives, from drug companies and from the NHS, eg for hitting targets on immunisations and flu jabs.

Please do one of you tell me where they get this commission from, I’m intrigued.

Maybe the GP was working from experience that although the pain wasn’t that bad at the time, he didnt want you coming back again the day later for painkillers… which would take up more NHS resources and cash.

“Doctors get lots of incentives, from drug companies and from the NHS, eg for hitting targets on immunisations and flu jabs.”

Really, again please explain… drug reps may visit a practice and try to influence a GP to prescribe his drugs, he may do this by taking him out for lunch etc, but no GP gets a direct commission from a drug rep FFS.

As for hitting targets, yes they get QOF payments to the practice, ok this is classed as additional income, but it is targeted around health needs not about lining the pockets of a GP

Doctors get lots of incentives, from drug companies and from the NHS, eg for hitting targets on immunisations and flu jabs.

handing out painkillers is not on that list AFAIK

Docs on commission with drug companies

The correct answer would be…No..?!

Long gone are the days of financial incentives from drug companies – any gift they give you (from trade stands etc) has to be specifically related to the drug, and worth less than £5!

Not sure where the GP was coming from acting like that, but I assure you, the less prescriptions we write, the better off we are!

DrP

Why on earth would a GP be on commission for a generic drug anyway?

Just a general query as I did wonder..

Thanks for all the helpful replies..

Why on earth would a GP be on commission for a generic drug anyway?

There’s pence to be made, whole shiny pennies! Yeah makes little to no sense and the issue being clouded now as others wade in with unrelated information.

It was a genuine simple question.

Some people act as though I have no right to ask it.

I don’t take issue with asking the question, I take issue with some of the misleading and short sighted responses you were given.

It was a genuine simple question.

Some people act as though I have no right to ask it.

The question is perfectly valid. I would perhaps be a bit suspicious if my GP was trying to get me on a course of drugs which were expensive, not 100% necessary and still under patent (but even at that, I’d still think that the GP wasn’t on a kickback, their relationships with drug companies are governed by professional ethics, not really worth risking your career over a few extra £ here and there).

However, for commonly prescribed drugs like co-codamol, diazepam etc, these are all pennies for a box of 100 and the market is pretty much swamped with cheap generics (it’s not often your pharmacist will hand over a box of Roche Valium when you are prescribed diazepam!), so the GP won’t even have a clue what company is about to benefit from what he has just prescribed, since it will depend completely on what brand the pharmacy stocks that you pick up your prescription from.

Should have asked for the valiums too. 🙂
Paaaaarteeeeeee. 😈

Personally I would have talked up the pain massively and demanded lots of codeine or better, then keep it in my Camelbak for emergencies or just when I need brightening up 😛

You may have required an anti-inflammatory, and mistaken it for a pain killer.

Ibuprofen and diclofenac fall into that category.

I was prescribed diclofenac and co-codamol for a back injury because the pain was causing spasms which were undoing the healing.

OK a real example of what does happen…

This is from the last time I was in a Practice. Drug rep meets the Practice Manager (as GP’s have much more improtant things to do like see patients)

Drug rep asks what inhalers the Practice prescribe currently. PM checks data and say X and Y. Drug rep says have you thought about using Z as its £30 instead of £60 a go. PM we could look at using Z more often, I’ll speak to the GP’s about it.

Drug Rep, thanks, oh I understand you are wanting to do some training on clinical pathways for the new CCG. Practice Manager, Yes we are. Drug Rep, ok well I’m sure we could sponsor the venue and provide lunch and some of the learning materials. PM ok yes that would be very helpful. Thank you.

Have you considered that the Dr was acting in your best interests based on years of study and experience?

No, not if they’re giving someone painkillers who isn’t in pain.

Funny that, I have a good friend who still works in that field of as a drug rep and he tells me that just isn’t allowed anymore as it’s seen as incentive. He admits it once was the case but they don’t even give out many gifts anymore. Some crappy pens and a mug is about the limit.

Maybe they thought you were in pain.
Do you have, you know, that kind of tormented face??

DrP 😉

Maybe they thought you were in pain.
Do you have, you know, that kind of tormented face??

DrP

mMmmmm for a moment there I suspected you could be a certain local brompton owning GP/sparring partner.

Neahhh cant be.

Drac – Do you mean with regards to my example? Drug Reps can not directly offer cash to a GP/Organisation to use their product, but sponsorship happens quite regularly. I have processed £30k so far this year from Drug Companies that was gifted for the purpose of training and development.

Mrs FD ocassionaly gets taken out for meals by Stryker/DePuy, or they will contribute to course fees so instead of it costing her £1k it will cost £500 as the Drug rep will fund half the course costs.

Doctors get lots of incentives, from drug companies

No they don’t.

A) The doctor would be struck off

B) The medical rep would be fired instantly

C) The drug company would get in all sorts of trouble

My wife (medical rep) can’t even give a doctor a pack of branded post- it notes without incurring the wrath of the regulatory body.

Years ago it was common to schmooze doctors and shower them with gifts but nowadays it’s been eradicated. We get loads of promotional material (leaflets, flyers etc) delivered that the missus is supposed to give to doctors and they’re constantly getting recalled and destroyed because they’ve found some breach of the regulatory body’s code.

Legitimate sponsorship of events does take place as mentioned above but they need to jump through hoops to get them approved for fear of breaching regulations.

Really, again please explain… drug reps may visit a practice and try to influence a GP to prescribe his drugs, he may do this by taking him out for lunch etc, but no GP gets a direct commission from a drug rep FFS

Interesting. Dunno if it’s different in England but my wife is strictly forbidden from taking doctors out for lunch or dinner.

Absolutely no financial incentive for a GP prescribe (unless they own the pharmacy). Quite the opposite in fact – no financial incentive to not prescribe but lots of hassle if you prescribe more / more expensive drugs than your colleagues.

Odd. Rather than all that ^, I suspect it was much more to do with the doc taking his ball (antibiotics) back because you had the front to question his judgement.

He’s the one who’s done the exams and the training, what do you know about how much pain you’re in? How very dare you.

Might have been better to take both slips, but leave the one for painkillers in your pocket when you go to the pharmacist. (Unless they start with a “Co”)

Yes reference your example and as mentioned not even any lunches are allowed. Use to be the norm but far from it now as he claims the same BoardinBob it’s just not allowed. Oh this is in England too.

Mrs FD (hospital doc) was out for an evening on the drug rep about a month ago along with a few colleagues.

The Drug Rep was providing lunch for the GP’s who attended the T&D session.

I’m not suggesting a Drug Rep turns up and says right Doc, let me take you out for lunch…

I suspect something you said or did pissed the gp off for some reason – probably more about them (or the patient they saw before you) than you. Somedays it feels like everyone comes in for a bit of an argument!

Perhaps the GP should have given a script to the O/P for suppositories as he seems a real pain in the arse.

I can only assume that GPs, their staff the drug reps and the drug companies must act within the same anti corruption and bribery laws as the rest of us.

As Boradin Bob says no party would benefit if their unlawful behavior were disclosed.

I can not quite remember the details of my anti corruption course but a drug rep taking a GP out for lunch or dinner would not per se be seen as corrupt. Taking them away for a weekend on their company private jet or taking them out for lunch every week would be seen differently.

It’s not really the bungs from the drug companies you should worry about – it’s when they take a ‘Shipman’ from the local undertaker that you should be wary

Absolutely no financial incentive for a GP prescribe (unless they own the pharmacy). Quite the opposite in fact – no financial incentive to not prescribe but lots of hassle if you prescribe more / more expensive drugs than your colleagues.

This +1

So I think the GP was being a twit.
Sometimes I will give one prescription for the thing which is definitely needed, and a separate one for the plan B drug which can be taken to a pharmacy on a separate occasion if necessary. This means they only have to get/pay a prescription charge for one item, but don’t have to come back if they decide they need the other one.

The Code of Practice that pharmaceutical companies follow is extremely strict and getting progressively more so each year. If you’re really interested, you can read it all here http://pmcpa.org.uk/?q=getcopiesofcode for yourself.

Rachel

How do you explain their eagerness to prescribe anti-depressants then?

lazinesss – plain and simple laziness…

EDIT – sorry but I know quite a lot of people in need of help that instead get anti-depressants. I know they have their place but they should rarely be used instead of active help. (rant over)