To quote an anecdote from Why I (almost) Never Wear Suits to Work…
“In your lifetime, has more money been lost (or stolen) by people in wrinkled sweatshirts or by men in expensive suits?”
It occurred to me recently that this question could also apply to the damage done by drug pushers on the street versus people dispensing dangerous drugs while wearing lab coats and stethoscopes. There is a great deal of evidence supporting the notion that today's opioid epidemic has deep roots in the wreckless legal distribution of prescription drugs. One needs to look no further than the multi-billion dollar legal settlement with the makers of Oxycontin (Purdue Pharma) to see that the causal relationship is now accepted fact.
Purdue didn’t place pills into the hands of citizens though. This took a network of distributors, doctors, and pharmacists. Many of these are people that we trust. They are subject matter experts that are supposed to look after our best interests. We know that it is only a small segment of these professionals that can’t be trusted. So now it is up to us to be able to distinguish the doctors from the drug dealers. Here, I will provide you with a few clues to look for:
The Company You Keep
Aesop said, “A man is known by the company he keeps.” Since I don’t expect you to follow your doctor home or to the golf course, I simply suggest that you pay attention while you’re in the waiting room. The specific “company” that you’re looking for is the pharmaceutical rep.
A 2008 study estimated that the pharmaceutical industry spent twice as much money on marketing than it does on research and development of drugs. The tip of this sales spear is the pharma rep. In the recent past, their toolkit included fancy meals and tickets to ballgames. Since the passage of a new code of conduct in 2009, they are more likely to use a free lunch. Their mission is simple. They are tasked with making a doctor feel obligated to prescribe their drug more often. Notice how this has nothing to do with how many patients come into the office with a legitimate need for the drug. The pharmaceutical industry's combined marketing budget is huge for a reason...because it works.
When you’re in the waiting room, keep an eye for the comings and goings of people who seem a bit too young and healthy to be seeking the medical care of your doctor. They will likely be unusually attractive, very well-dressed, and pulling a piece of rolling luggage. If every employee knows them by name and treats them like a close friend, understand that this is NOT a good sign for you.
Beware of SWAG
Another sign to look out for in your doctor’s office is little branded “gifts.” In sales, these are sometimes referred to as SWAG (Stuff* We All Get). You see, there may be limits on the dollar amount of true “gifts” that you can give to doctors and their staff, but once you put your company logo in an item it stops being a gift. Now it is advertising.
Look around the office for anything from branded pens and paper to clocks and umbrellas. A good box of logo golf balls can have the same cash value as a dinner out. Ask yourself how many “promotional items” someone can accept until they start to feel a bit beholden to the giver.
Don’t Believe the Hype
I was 20 years old the first time I saw a television advertisement for a drug company. Prior to 1997, the Food and Drug Administration did not permit pharmaceutical companies to push their products through commercials on TV. Every commercial seemed the same. They would try to frighten the viewer with a list of common symptoms that you may already be experiencing. They mumble a list of side effects at the speed of an auctioneer after a direct injection of Red Bull. Lastly, they close with a familiar call to action, “Ask your doctor if XXXX is right for you!”
This last phrase is the one that changes everything. We trust our doctors to examine us for symptoms, consider the possible treatments, and prescribe the appropriate medicines. After all, they studied this stuff for years and have the degrees on the wall to prove it! As soon as your doctor starts letting patients tell them what to prescribe, they have gone from being a physician to a pill dispenser.
Now that we’ve thoroughly discussed the pushers in lab coats, allow me to turn our attention back to where we began. These are the ones in suits. I am not a doctor (I don’t even play one on TV). I’m a financial planner. Like the local clinics, many brokers’ offices are under the influence of powerful forces that profit off of the proliferation of “product pushers,” rather than caring professional advisors. Thankfully, the steps to avoid trouble are very similar to the ones listed above.
When visiting your investment provider’s local office, keep a look out for the product wholesalers. They will look and feel a great deal like the pharma reps described above. If you see one, observe the interactions with people around the office. Check the shelves and desktops for SWAG containing the logos of mutual fund companies and other product providers (keep a special eye out for the golf balls). Lastly, turn off the TV commercials for investment products. If you have a good advisor, they should bring the correct solutions to you. If they are taking your investment product recommendations, they just revealed themselves to be nothing but a dispenser. Act accordingly.
(*the S in SWAG doesn’t always stand for “Stuff.)