ZUBEIDA Mustafa’s op-ed piece ‘Physician heal thyself’ (May 2) has highlighted the unethical practices of the pharmaceutical industry and Pakistani physicians being willing partners in this. It is because of the huge profits at stake that the industry uses all sorts of ‘novel’ marketing techniques to bribe doctors.

One of the latest ploys I came across was a pharmaceutical company giving made-to-order three-piece suits of a famous local brand to doctors.

At the root of the problem is the fact that ethics has little or no part to play in the practice of medicine in Pakistan. Ethics is neither part of the medical curriculum nor do junior doctors see it being practised.

When medical students and juniors see senior professors go on pharmaceutical-sponsored trips or drug launches in exotic locations, what is there to stop them from following in the footsteps of their seniors? The pharmaceutical-company-sponsored ME in psychiatry (that Ms Mustafa refers to) is a good example — by allowing such seminars to be blatantly sponsored by a pharmaceutical company (the company’s logo was on the invitation card) and for senior psychiatrists to take part in it gives a message to junior trainees that it was acceptable.

The pharmaceutical industry is profit-driven. But it is also extremely competitive and needs to sell as much of their medicines as possible to stay ahead of their competitors. In this cut-throat business, physicians become an important soft target. Hence, the inducements on offer — from pens and calendars to diaries and stethoscopes, and from books and laptops to iPads and cars. Then there are sponsorships for conferences and seminars in foreign countries, not only for self but the spouse as well. Every year scores of Pakistani physicians attend conferences abroad at pharmaceutical companies’ expense.

Has anyone tried to find out how much each of these trips cost and where does the money come from? All gifts and sponsorship from the industry to physicians are nothing more than legalised bribery. They have only one motive — to develop a relationship with physicians so that she/he can be manipulated to prescribe their medicines.

There is ample research to show that the more contact physicians have with the industry, the more likely they are to prescribe that company’s medicines.

However, to expect the industry to come up with a ‘conscientious approach’ (as Ms Mustafa suggests) is naïve and simplistic. Would the industry bite the hand that feeds it?

The industry has one and only one motive — to maximise its profits. There is no moral or ethical imperative to this.

Physicians’ primary responsibility is towards their patients which must always be objective and impartial. They need to be aware of conflict-of-interest issues and need to decide whether they want to practise ethical medicine or otherwise.

If they decide on the former, then they must disentangle themselves from the industry. If they decide on the latter, then they can continue to scratch each other’s back — as they have been doing for decades.

DR. MURAD MOOSA KHAN Karachi