Pharma company bribery of doctors: US vs China

Excerpt from an article by Prof  Zhang Weidong, Tianjin First Central Hospital, in the Journal of Thoracic Diseases:

In China, it takes a compulsory five years for a medical student to complete his/her undergraduate education, compared with only four years for other training programs for professionals in financing, marketing, or managerial posts. Thereafter, they find that the 5-year undergraduate training in medical sciences is not sufficient to provide a promising future for their career given the ever-developing medical technology and improving methodology in the medical community; nor would it even qualify them for an opportunity to get a job in a hospital, given the more than one million medical undergraduates nowadays surging out of university gates each year in China. To improve their chances they need to obtain an MD or PhD degree, spending six more years of their lives for the whole process, probably with their aged parents striving in the faraway countryside to earn the hefty tuition they have to pay.

Still, after these arduous years of examinations, probations and training, as well as the life-long learning in their careers, all their work does not translate into a reasonable income and acceptable social position in contrast with their friends with non-medical occupations. Few physicians in China can earn an income greater than $40,000 USD per year. Even salespersons who sell a popular brand of Chinese Dim Sum or tea-pickled eggs can be much richer than you. One may loudly declare that they think nothing of this disparity, always being proud of themselves as an erudite scholar and physician, but when it comes to the travel expense and registration fee for international or domestic meetings, most physicians can’t afford such expenses out of their own pocket and the offer from Pharma who are “honored to sponsor” them is very attractive. What follows? It is an established conception among Chinese people that one has to do “something” for “something” you receive—you know it.

In an extreme case unraveled recently in China, Pharma representatives were found to stay in the physicians’ office, sitting unscrupulously beside the physicians as the latter interviewed and examined their patients and served as the latter’s “assistant” who “helped” by typing electronic prescriptions. Very likely, this role made their sales assignment easier and probably succeeded in obtaining a large bonus from their company for over-fulfillment. For allowing the representative to be their “assistant” the physicians received some benefit.