we know marketing effects us – so clearly it effects docs

What I really do not understand since prescribing medictions is such a big part of a physicians job – why they do not do it better.  Many doctors say it is because patients request a drug.  So what!!  Let’s learn to say no or inform the patient of a better alternative.

Reuters reports that 150 academic researchers touring the U.S. to make recommendations on diuretics and best and cheapest practices for blood pressure medicine have reported a 23 percent increase in patients who get the recommended drugs, “twice the increase in the U.S. over the same period.”

“‘We thought it would make a bigger difference, but it did make some difference,’ said Dr. Barry Davis, of the University of Texas School of Public Health in Houston, who worked on the study, published in the Archives of Internal Medicine. … In 2002, Davis was one of the researchers behind a large study comparing different blood pressure medicines. He found that the older, cheaper drugs — so-called thiazide-type diuretics — did better than newer medications, and at a fraction of the price. But although the results soon made it into national guidelines, Davis was disappointed to see that this didn’t seem to have a dramatic effect on doctors’ prescriptions.” With $4 million in National Institutes of Health funding, Davis and colleagues toured to tout the use of the cheaper medication. Others say so-called “academic detailing” is a way to fight commercial interests in the lucrative world of pharmaceuticals (Joelving, 5/24).