Thursday, November 1, 2007

The Framing Problem, and Physician Bribery

First, and apparently (but not really) off the subejct--if you do not know about the Rockridge Nation website and blog, you should. Here is a great recent piece on children's health insurance:

http://www.rockridgenation.org/blog/archive/2007/10/26/schip-and-the-rigged-health-insurance-game

The point of this "progressive" website is all about framing. As linguist and Rockridge founder George Lakoff has written about for some time, political discourse in the US has deteriorated because one side of the political spectrum has been amazingly successful in framing many issues in such a way that the words used to describe the issue pre-determine the conclusions. There cannot be an honest political debate because one side of the issue never gets under the spotlight for discussion. For that reason we must be extremely careful of the language used to frame any policy discussion, and to be sure that it enhances rather than retards understanding of what is at stake.

Now, back to Pharma. I thought of the framing issue yesterday when two headlines came across the ether:

Name and shame 'bribed' doctors
Tamara McLean, Herald Sun (Australia), Oct. 31
http://www.news.com.au/heraldsun/story/0,21985,22679124-5005961,00.html

Drug firms try to bribe doctors with cars
Sarah Boseley, The Guardian (London), Oct. 31
http://www.guardian.co.uk/print/0,,331116619-103681,00.html

(Both these stories relate to the recent Consumers International report, which I will address in a second posting.)

Did you say "bribe"?

I thought--in HOOKED, I refer all the way through to "gifts" given to physicians by pharmaceutical companies. The companies themselves try not to go so far as even to say "gifts"--they call the small stuff with company logos, like pens and mugs, "branding items" or "reminder items," and they try to label all the big stuff as some sort of "education" or other.

These recent newspaper headline writers, apparently emboldened by the tough new report from Consumers International, had no problem calling the practice by a more proper, accurately descriptive name. (Dictionary.com tells us that "bribe (noun)" means: money or any other valuable consideration given or promised with a view to corrupting the behavior of a person, esp. in that person's performance as an athlete, public official, etc. All we have to establish for "gifts" from the drug industry to physicians to become "bribes" is that the commercial influence has the view of "corrupting" and that the behavior of a physician is analogous to that of a public official with regard to public trust. I offer arguments in HOOKED to show that those things are so.

So, if the goodies dangled before physicians by the drug companies are in fact bribes, why have we been giving them a free ride for so long and using euphemisms?

(I cannot help adding as a footnote that when I showed my wife the headline from The Guardian, her reply was: "So--they are not trying to bribe doctors who don't have cars?")

1 comment:

Anonymous said...

I suspect that any pharma company whose gifts were termed "bribes" or as "corrupt" would sue for libel in a blink of an eye. That is doubtless why you and other like-minded commentators have not used these terms.