docs being on the formula companies' "payroll"

[hubris]

*

[annettemarie]

Originally Posted by funshine

I'm getting rather rambly. My general points:
1. I'm concerned that we're making assumptions about the nature of the interactions between formula companies and physicians.
2. I'm concerned about the assumptions we're making about the intents of the physicians.
3. I hear a lot of anger expressed and wonder if patience and calmly-presented education might be more beneficial to other patients at these practices.

1. Formula companies give free crap away because it works. Every time a doctor looks down at the little growth chart with enfamil's name on it, they remember the enfamil brand name of formula. If doctor's would stop accepting these freebies, it would go a long way in telling formula companies that they shouldn't be pushing their products to medical professionals.

2. I would suggest you take a look at the following links:

Pharmaceutical companies offer doctors and hospitals money, equipment and other perks in exchange for promoting bottle feeding.

Nancy Masaitis, director of the mother-baby program at Bess Kaiser Hospital in Portland tells of a handout that come companies distribute to clinics. "It says right on it that a couple of bottles of formula a day keeps a good milk supply. That is completely false. Supplementing with formula, especially in the early months, is what reduces a mother's milk."

In return for operating as middlemen for the formula industry, doctors and hospitals receive perks ranging from free medical bags and conference sponsorships to unlimited supplies of free formula. Last year, for example, Northwestern Memorial Hospital in Chicago received unlimited free formula, as well as $210,000, in exchange for granting brand exclusivity to Mead Johnson. The contract specified that Northwestern Memorial give all new mothers discharge packs containing Mead Johnson formula samples and coupons.

http://www.zipmall.com/bab-bott.htm

To promote artificial feeding, formula manufacturers spend millions of dollars securing exclusive distribution deals for formula samples, at a yearly average of $6,000 to $8,000 per doctor. They donate $1 million annually to the American Academy of Pediatrics in the form of a renewable grant that has already netted the AAP $8 million. The formula industry also contributed at least $3 million toward the building costs of the AAP headquarters.

Formula manufacturers play hardball to get hospital business. Take the example of Canada, where Mead Johnson secured an exclusive contract with Toronto's Women's College Hospital that pays the hospital $1 million the first year and $350,000 per subsequent year for a decade.

"The breastfeeding mother gift packs companies give mothers," Smith says, "often contain breast pumps that are "uncomfortable and usually ineffective--along with bra pads and formula samples. These are very popular with mothers and nurses." And, for a new mom, sleep-deprived, and struggling to meet her baby's needs, tempting.

http://www.findarticles.com/p/articl...st/ai_76614506

Interestingly, the study found that most important factor influencing whether a physician was knowledgeable about breastfeeding was whether the doctor herself, or the doctor's wife, had breastfed children. This is apparently not news to the formula companies, who make sure that every physician who treats pregnant and post-partum women and is expecting a baby is offered a full years' supply of formula for free.

http://www.promom.org/bf_info/why_low.htm

* A majority of pediatricians believe that breastfeeding and formula-feeding are equally acceptable methods for feeding infants. [2]
* Physicians and nurses in the U.S. routinely receive gifts, office supplies, meals, a year's supply of free infant formula for themselves or a relative and even pricey vacations from the infant-formula marketing representatives who haunt their offices.[3]

http://www.007b.com/early_weaning.php

I also shared many other links in this thread a while back:
http://www.mothering.com/discussions...d.php?t=276859

2. I base my opinions on statistical truth. Anecdotes are not the same as documented evidence.

3. If I sound angry, it may be because I am angry. I am angry that we have deregulated formula advertising, and that we allow companies to bribe women when they are most vulnerable with "free" gifts. And I am angry that doctors and hospitals, who have pledged to "first do no harm" accept these gifts, allow them to influence their decisions, and, in turn, share those decisions with mothers and mothers-to-be.
I believe that this is where you are making assumptions. Just because I am angry here doesn't mean I walk around beating pregnant women over the head with statistics or studies.

[GeorgiaGalHeidi]

1. Doctors that are in actual practice are sometimes LITERALLY on the formula payroll. They help assist with or actually do the "studies" that the company then uses in its ads...

2. They can actually act as consultants, maybe being featured on the "ask a question" section of websites or forums. Not to long ago, Nestle had two certified nutritionists on a message board panel there to answer questions about their great formula.

3. The formula companies basically fund the AAP. They make the organization, the buildings, etc., etc., possible, and don't think that does not affect the AAP's judgment. They gave about 3 mil. for the new AAP headquarters. The official AAP news letter that goes out to peds is filled, and I mean FILLED with countelss formula ads, "official AAP" booklets often are paid for by a formula company, and their logo is included therein, and when push came to shove over the national ad campaign the head of the AAP sided with the formula companies, without even consulting with the AAP's breastfeeding section...How could the formula companies have such influence over the AAP, oh yeah, that's right, they fund it.

4. Formula companies are relentless in gifting stuff to docs. ANd, no, I do not mean free pens, books, lunches, and magnets, which they have plenty of to give, but they sponsor very ritzy CME conferences. THe kinds the docs wanna go to-the beach ones, etc. THey give huge free lavish banquets and dinners, stuff not at, say the LLL CME conference...THey just want to get the doctors in the door so that they can get 'em.

My husband is also a doctor, but he is a ped. THe formula rep is always asking him and the other doctors to come to the free lunch...the lunch is good, and free, but during it, he gives them a big talk on the latest ____ or ___ or ___ regarding the formula. Before that omega-3 supplement crap came out, that guy told DH all about it, to which he replied, "that is in breast milk, why would anyone need that..." If you ever need an enfamil pen, the AAP breastfeeding book, a nice free lunch, or some bad advice, go to the hospital, ANY day, with my DH.

THat formula rep should not be allowed in the hospital doors, let alone, giving free crap to the doctors and medical students. Those lunches...may seem like just lunch, but doctors do not get ONE iota of BF education in med school. If they do not get it on their own or have a wife or girlfriend to set them straight on it, they are subjected to it during the free lunch, and who knows how many take that bogus crap to heart!

[Zamber]

A friend of my family has a husband who is a doctor, and when she became pregnant he was offered a year's supply of free infant formula. Fortunately, she choose to BF and turned the offer down. She also acts as an information watch dog for him and trys to educate him on things like BFing because they don't teach that stuff in medical school. It's up to the doctor to learn these things on their own.

[hubris]

Don't get me wrong. I'm on board with you on being appalled by the methods that I have seen employed by formula companies. I get pissed at formula commercials and the "breastfeeding success" packet nonsense and formula-company-sponsored magazines that have fat formula ads between the first and second pages of breastfeeding "support" articles. And I know that medical schools provide little to no education to physicians re: breastfeeding. As I mentioned, my DH is an MD. He owes the majority of his pregnancy/birth/child development/breastfeeding/etc education to me.

I am absolutely NOT denying that the formula companies are up to no good, nor am I saying that I think that it's OK for physicians and hospitals to accept and/or distribute samples, "educational" materials, and other formula-company-related garbage. I'm completely in agreement with you there.

My post was in response to the fact that often people seem to assume that a physician is accepting kickbacks without knowing that particular physician's situation.

I know that anecdotal evidence is fairly worthless, but thanks for putting that out there. As somebody who spent much of her academic life studying or doing research, I'm a stickler for good, solid, recent data from reputable sources. That's why I asked for info to back up these allegations.

My plea for understanding for physicians, however, is based on the fact that we don't know that EVERY physician is accepting money or other compensation from formula companies. I do know that my mother's hospital is not. It is definitely not good for any practice to be receiving/handing out formula company products, but when we assume that the practice has "sold out" its patients and automatically address the physicians at that practice with anger and accusations, it doesn't help our cause. Not all doctors are bad guys. There *is* a chance that that particular physician is not receiving perks and is simply acting out of ignorance or a misplaced sense of helping patients. No, ignorance is not good, but neither is it deserving of our scorn. Pity, maybe? The problem with ignorance is that ignorant people don't know they're ignorant or how to go about changing that state. It's our responsibility, IMHO, to hunt down ignorance and gently correct it.

Some of the comments and letters I have seen here, directed toward physicians, are written in an angry, confrontational tone of voice. We practice gentle discipline for our children, why not for the adults in our life?

Thanks for the informational links, I'll be reading through them. Again, I want to emphasize that I was never saying that formula companies aren't doing devious things or that some physicians aren't in bed with them (whether it's legal or not), just that we should not assume that all physicians are purposefully acting out of self-interest and intentionally hurting/misleading their patients, and that we should approach them with that in mind.

[julie128]

I asked a nurse at our ped's office, and she said that they do not receive any money for giving out the samples. This is even worse in my book b/c they are acting contrary to the AAP and not even receiving compensation for it. Selling out without actually selling themselves.

[bri276]

parents are docs. mom's a ped. she's totally pro-breastfeeding, ebf'ed my sister and I, only fed me formula ONCE in my life. but when she has low-income families who are ALREADY established ff'ing she'll give them the sample rather than throw it out. she would never give it to a bf'er or a preggo though. I think it would be kinda mean to throw them in the trash when there are hungry babies.

[Quirky]

The latest AAP statement on breastfeeding includes "disruptive hospital policies and practices" . . . and "commercial promotion of infant formula through distribution of hospital discharge packs [and] coupons for free or discounted formula" among the obstacles to breastfeeding. See link

One of the references for this statement states:

To be consistent with national health goals and ACOG policies and recommendations, physicians providing prenatal care should encourage breast-feeding whenever possible. The parents' choice to breast- or formula-feed their infant is the consequence of a complex decision. The physician's role is to provide information objectively so that the parents' decision can be made on an informed and factual basis. Clearly, the physician must support parents' decisions. However, the distribution of formula or vouchers in the physician's office during the antepartum period places the physician in the position of advertising or promoting a specific product and of potentially contributing to the failure of some patients to nurse their infants. We urge physicians not to distribute formula or formula vouchers to their pregnant patients, and encourage local and national obstetrics organizations to consider devising and discussing a policy statement discouraging such practices.

Source study

That's a 1993 article from Obstetrics and Gynecology, the journal of ACOG, by the way. So, what's the excuse 12 years later for ob/gyns handing out formula and formula-related freebies? Here's a 2000 study in the same journal on the effects of formula advertising in hospitals/doctor's offices:

Although breast-feeding initiation and long-term duration were not affected, exposure to formula promotion materials increased significantly breast-feeding cessation in the first 2 weeks. Additionally, among women with uncertain goals or breast-feeding goals of 12 weeks or less, exclusive, full, and overall breast-feeding duration were shortened. Educational materials about infant feeding should support unequivocally breast-feeding as optimal nutrition for infants; formula promotion products should be eliminated from prenatal settings.

Don't you find it somewhat ironic that we, the laypeople lactivists, are held responsible for educating doctors on breastfeeding rather than the other way around? Is your doctor going to refund your payment when you educate him or her about something that should be within his or her area of expertise? I don't see a whole lot of good reasons for doctor ignorance on the matter of breastfeeding. Ob/gyns and pediatricians have a professional responsibility to stay current with the latest information in their field. Breastfeeding is a centrally relevant issue to ob/gyns and peds. It doesn't take a whole lot of research to learn that the AAP statement on breastfeeding and ACOG recommend against handing out formula samples and freebies.

I'm an attorney. Cases get decided all the time that affect my clients and how I will argue a case. I'm the one responsible for researching them, not my clients. That's why they pay me the big bucks. (Not - I'm a public interest environmental attorney ). I would be professionally negligent - and could have sanctions imposed upon me, up to and including losing my license to practice law - if I failed to stay current on my legal research and it affected the outcome of a case. And the area of law I practice does not involve matters of sickness and health, life and death for humans (although it does for animals). Why should doctors be held to a lower standard?

Oh, and those "free" samples? One of the reasons formula is so expensive for everyone else. No such thing as a free lunch. Formula companies build in the costs of advertising, coupons, and free samples into their product pricing. Every time a free sample is given away it perpetuates the system.