The Business of Drugs

I went to my first drug rep dinner the other night at Smith & Wollensky in Houston’s Highland Village.  The high-end steaks and 20+ bottles of wine left nothing to be desired by the nurses and physicians in attendance.   Research shows that being wowed with a nice meal influences later decision-making.  Yes, I could see how the memory of one of those juicy steaks could prompt a doctor to select a particular medication.

Special thanks to Joe Gibes for bringing to light how pharma business practices stymie important medical treatments.  I worked in business for over 7 years, and I saw two types of businesspeople.  One type focused on presenting the merits of the product and gave the buyer room to evaluate it and make a decision on a purchase.  This person would refrain from the pressure sales pitch and would frankly state what the product could and could not do.  Sometimes this went so far as recommending a competitor who sold a product that fit the customer’s needs better.  The other type of salesman I encountered had a different approach.   Marketing techniques were more about allurement rather than presenting one’s ware.  These folks were jovial types always given to conversation, but all the backslapping often left the customer with an uneasy feeling.

Business reform in general is needed in our country, but more is at stake when unethical business practices impact the field of medicine.  Since a person’s well-being is in the balance, extra care and protections must be employed.  I often hear medical students comment, “I can’t really do anything about the drug business.  It’s just the way things are.  I might as well enjoy the free meal.”  But don’t we owe it to our patients to remove any taint from medical care when their very lives are concerned?  Our Savior was a humble man, and there is no doubt his humility opened the door for His effective healing ministry.  Such a disposition sets an entirely different tone for healthcare, which our medical system desperately needs.

Thanks, GAVI!

In a world full of inequities in health care including a child mortality rate in some developing countries that continues to be alarming, it is good to recognize those who are making a difference.  The Global Alliance for Vaccines and Immunisation (GAVI) recently announced that they had entered into agreements with several vaccine manufacturers to obtain vaccines for developing countries at reduced costs.

GAVI is an international organization that attempts to unite donor nations, private donors, developing nations, international organizations, and immunization suppliers to meet the goal of saving children’s lives and protecting people’s health through better access to immunizations.  In the ten years from 2000 to 2010 more than 288 million children were immunized with GAVI-funded vaccines, and an estimated 5 million deaths prevented.

Organizations like GAVI deserve our thanks and support for making a positive impact on the lives of children around the world.

Treatment of HIV-infected Individuals to Prevent Transmission

The interim results of the HPTN 052 study released last week indicate that treating HIV-infected individuals dramatically reduces the likelihood that they will transmit the virus to their sexual partners.  This study of HIV-positive patients whose heterosexual partners were HIV-negative and whose disease was at a stage at which treatment would be considered optional showed a dramatic decrease in transmission to their sexual partners for those treated immediately and was stopped early due to the results.

This study raises some interesting ethical questions.

Are HIV-positive persons who have an unaffected partner now obligated to undergo treatment even if there is not evidence that the benefit of the treatment outweighs the adverse effects for the individual?

If treatment of infected persons is an effective means of preventing the spread of HIV, how aggressive should those responsible for public health be in seeking to identify and treat those with HIV?

What should be done in countries with a high level of HIV that already cannot afford antiretroviral treatment for the more severely affected?  If treatment of all infected people would dramatically reduce the incidence of new cases in those countries where do we get the resources to provide that treatment?

The Philanthropic Principle

And he called the twelve together and gave them power and authority over all demons and to cure diseases, and he sent them out to proclaim the kingdom of God and to heal. – Luke 9:1-2

The Methodist Hospital, Houston, Texas

As I sit writing this article on the 21st floor of M.D. Anderson’s Pickens Tower, I survey the names that dot the skyline of the Texas Medical Center: St. Luke’s Episcopal Hospital, the Methodist Hospital, Baylor (Baptist) College of Medicine—all philanthropic ventures founded by Christians.  Today, their respective denominations are only nominally involved, providing some guidance for chaplaincy programs, some of which include Muslim services.  Granted, these medical institutions are now massive, multi-million dollar operations, yet many of their congregations have significant wealth that could be used to provide funding.  Obviously, they are plagued by the theological waywardness of their respective churches, but other more traditional churches lack involvement in health care in a similar fashion.  In speaking with a pastor of a large Baptist megachurch, I learned that they had stopped investigating opportunities to build a charitable medical clinic because of the fear of lawsuits.  Financial and physician resources were at their disposal, but such a ministry was a risk they were not willing to take.

During my year at Trinity in 2008-2009, I made several trips to Lawndale Community Church in downtown Chicago.  As many of you know, Lawndale has built an extensive medical clinic for the people of that neighborhood.  Though drawing its membership from some of the poorest of people, Lawndale has made it a priority to spread the Gospel through practical programs ranging from sponsoring a pizza parlor to providing medical care.  In Christian circles some mention that poorer patients look for opportunities to win cash through lawsuits, but Lawndale views medical outreach as a necessary risk in their pursuit of Christian goals.

 

Baptist Medical Centre, Nalerigu, Ghana

Today, unfortunately, we face the trend of Christian groups pulling out of medical care.  American Christianity now boasts some of the largest churches ever, with extensive programs and services that include multi-site ventures and online attractions.  Few, however, see medical care as a main function of the church.  Take the Baptist Medical Centre (BMC) in northern Ghana, for example.  BMC, like other Christian hospitals founded by Americans in Africa, is facing the withdrawal of American financial support for its mission.  Part of the reasoning behind the separation is to allow Ghanaians to mature in their leadership of such projects.  This is certainly a proper goal.  However, much of the termination in sponsorship is based on the idea that hospitals siphon off funding that could be better used in programs that are specifically evangelistic.  The fact of the matter is that chaplaincies in hospitals provide excellent ways to present the Gospel to people who would avoid any other Christian ministry.  The Muslim population is one of the major groups BMC serves, and these people would never enter a Christian building otherwise.  The fact of the matter is that pastors (not to mention Christian doctors and nurses) stationed at the hospital have a constant opportunity to communicate the hope and healing of Jesus.  No pastor hidden behind church doors here.

Conflict between two philosophies of health care in America has reached a fever pitch.  The medical field is marked by a battle between health care based on government oversight versus medical services maintained by profit found in the marketplace.  I recommend we reconsider medical care based on philanthropy as a third option.  There is great wealth to draw from, and health care is tailor-made to work hand and hand with the Gospel of Jesus.

For more information about Christian philanthropy and medical care, visit these websites:

The Faile Foundation of the Baptist Medical Centre, Nalerigu, Ghana

Lawndale Christian Health Center, Chicago, IL

Baptist Medical Dental Fellowship

Christian Community Health Fellowship