Are You Coming to the Drug Lunch?


From Council for Evidence-Based Psychiatry: “This is the question raised at least every 2 months in our NHS psychosis team. Most of us will go without a second thought (I have to admit, I usually do. There are free M&S sandwiches, fruit, biscuits and pastries; ‘That’s all the moral compass I need,’ I like to joke). We have the usual good-humoured argument between the affable-and-popular psychiatrist, and the angry nurse (also popular – we know she usually has the patients’ best interests at heart). ‘I don’t think you can say it’s exactly like having the tobacco industry deliver your anti-smoking training. We just have to listen to a brief spiel and then we can have our business meeting.’ ‘Have you registered it with the Trust?.’ ‘I don’t think we have to‘ (eyes roll). ‘The Trust has rules,’ ‘No, the Medical Director is relaxed on this one.’

Drug lunches make you feel good. The rep is always very personable and apologetic. They give a short-ish presentation which always makes you feel better about the medications. It appears they work better than you thought! The rep’s data are surprisingly impressive and clear. There are graphs and smiling faces. It is what we would all want for our clients. It’s only afterwards when you try to check the sources – which no one really has time to do – you find out they’ve presented a charming parallel universe only vaguely related to evidence. They have given the best possible polish to the literature, it must have taken a team of twenty to find that phrase, that graph, that answer to an obvious question. Shockingly, it’s a sales pitch! But we all think of it as ‘training.’

These arguments happened so often that myself and like-minded colleagues set out to settle them once and for all. Do Trusts have rules? Do they keep records? Are all Trusts the same? In short, does anyone care?”

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  1. It goes back further and is so intertwined. Beer Rounds. There used to be free beer and pizza made available to medical residents on Friday late afternoons. Not the best idea. Even Social Workers were given free lunches or gifts by agencies or companies that wanted referrals. I think the old sawhorse – you scratch my back and I will scratch yours- has been in play for a long, long time. Nurses took over a lot of the nursing home and or hospice discharge planning and I am not sure if it got better or worse.
    I think this played out on all levels in all areas. One just has to look. And yes I am aware because at times I was a participant but eventually walked away as much as I could until I stopped completely.
    The trouble is it is so alluring and if you have a gap of some sort in self regard it creates a filler atleast for some time. And we all our vulnerable to spin and false choices. A 12 step program would fit for many of the professionals involved in the grafting machinations and again those of us who took chemicals and in doing so hurt ourselves and possibly others. IE going through eithdrawal – the anger and rage and who to blame it on and unless in a legal or community good way what good does blame actually accomplish?

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