Dear Mom, I am in Atlanta at my annual medical conference, getting my brain packed tighter than Santa in Spandex with up-to-date medical information. Everything doctors know seems to go out of date faster than goat cheese on hot pavement.

As they were last year, America’s pharmaceutical companies are also here at the conference, treating the doctors like belles at the ball. They shower us with free gifts, wine and dine us at expensive restaurants, and have brought in celebrities to teach us about complex medical problems such as emphysema and how to get an autograph from a major league baseball player. The only thing missing this year are the Dallas Cowboy cheerleaders; they were at last year’s conference because some pharmaceutical company figured every conference can be improved by cleavage, but did not come back this year.

The pharmaceutical companies have said that the huge cost of research for new drugs is why those drugs cost so much, but if this conference is any evidence, marketing to docs also adds a lot of cost. Thanks to its unrestricted ability to charge the public whatever it wants for medications, the pharmaceutical industry can spend billions of dollars inventing new drugs, billions for drug advertising on TV, pay some of their CEOs enough millions to gag a pro basketball player, be more profitable than any other American industry, and still have billions left to lavish on doctors!

We cannot turn around in Atlanta without pharmaceutical companies trying to give us gifts, feed us at the Ritz-Carlton, or introduce us to some celebrity. This is all part of the estimated $13,000 per American physician per year the companies spend trying to influence doctors’ choices of prescription medicines for our patients (not that a doctor would be influenced by any of this free stuff, of course, because we are better than that). Here is a list of some of the good stuff:

. a big golf umbrella from the nice folks who make the allergy nasal spray Nasacort AQ (about $68 per bottle). This was very helpful because it is raining drug company freebies on us from every direction;

. a cool backpack for each doctor at the conference from Schering Plough, which makes Claritin (about $2 per pill). Schering Plough is spending millions to lobby the U.S. Congress to extend its patent on Claritin, so you might have thought the company had nothing left to buy presents to “lobby” doctors to prescribe Claritin. Hah! The company not only had enough money left for the backpacks, but had enough to pay major league baseball catcher Gary Carter to sign autographs for doctors. If Claritin’s patent gets extended, next year Schering Plough should be able to afford to buy doctors complete luggage sets and hire the entire New York Yankees team to sign autographs;

. Loni Anderson has come back to teach doctors about emphysema and the emphysema drug Atrovent (about $17 per inhaler). Unfortunately, she was only at the conference for 90 minutes and I only saw her walking out. This was a major blow to my education, and very disappointing, since I missed her last year, too;

. A nice Cross pen from the manufacturers of Rhinacort AQ (about $75 per bottle), who must hope doctors will have a hard time writing for Nasacort AQ (the competitor passing out the umbrella) with a pen that says “Rhinacort” on it;

. An educational poster session about treating high cholesterol, complete with a dessert buffet and Graham Kerr, “Galloping Gourmet,” all at the Ritz-Carlton. I passed because poster sessions have the education value of clam dip;

. A big Rand McNally road atlas, from the makers of the prostate medicine Flomax (about $2.30 per pill), who said the atlas was to “assist (doctors) in traveling to local medical programs.” They are so thoughtful!

Many of the doctors here, including this one, pass on all of this stuff because we cannot stomach accepting gifts we don’t need when the cost of those gifts adds to the cost of our patients’ medications. See, you raised me right. But we could take these gifts and more if we wanted to; the American Medical Association’s guidelines for physicians on accepting gifts from pharmaceutical companies are so weak that if the guidelines were a bladder they would need Depends. The delegation of family doctors from Maine at this conference proposed a new rule to ban all of this free stuff at the next annual conference. Then we would all have to buy our own umbrellas, but at least our consciences would be out of the rain.

Anyway, if nothing else I hope that Loni Anderson and her emphysema info are at my conference next year. Otherwise, I am going to have to read about emphysema in some darn book, which will be a lot less interesting (and not nearly as good for my patients).

Love,

Your son, the doctor

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, an is on the staff of several hospital emergency rooms in the region.