The scandal involving foreign pharmaceutical companies bribing Chinese physicians has widened. It was only a month ago that four executives from GlaxoSmithKline were detained by Chinese officials for pay-offs. French pharmaceutical maker Sanofi Pharmaceuticals is now being named as well. Seems 
the issue of Medical Ethics is rampant.
On August 8, 2013, writer Denise Roland for The Telegraph detailed the latest accusations of bribery in an article entitled: “Sanofi dragged into China bribery scandal with media report.”
Apparently, “An anonymous whistleblower,” came forward detailing payments made to physicians in 2007, “to 503 doctors across 79 hospitals in Shanghai, Beijing, Hangzhou and Guangzhou.” The amount of the bribery was about $290,000 in U.S. dollars. The whistleblower was fairly credible, and is believed to have once been a Sanofi executive.
Being a physician in China carries little of the prestige that it does in the west. The average physician’s salary is only about 19 percent higher than society in general. In addition, most physicians find their working conditions unsatisfactory. The pressures on them are enormous. Being a physician in China has apparently become a miserable experience; the pharmaceutical companies know that.
A chief physician in China makes about $480 a month. If we play with the numbers a bit, and assume a new physician makes about $400 a month, a bribe of almost $580 (the total bribe divided by 503 physicians), makes for a pretty sweet deal.
Why bribe a physician? For starters, there are a lot of people in China. More prescriptions mean more pills and more pills mean higher sales and that finds its way to stock prices and bottom lines.
However, the situation is ethically more complex than that.
The Achilles tendon
The pharmaceutical companies know that physicians are unhappy. The companies understand that at the end of the day, many Chinese physicians return to their homes and their families and say, “What’s the use?”
The bribes are not the equivalent of an American physician accepting hockey tickets from a Pharma sales rep (which carries its own ethical problems); it is far worse. The $580 represents a significant amount of money; it is enough to shift attitudes and to influence treatments.
We don’t know if the people handing over the envelopes whisper: “There’s plenty more where this came from.” Nor do we know how many patients have been intentionally misdiagnosed in order to push more pills, but I do know that at least three pharmaceutical companies have gone after the “Achilles tendon,” the physician who is under-appreciated and over-worked.
Defending China?
Though I understand the myriad of problems that China creates and perpetuates, I must defend their anger in this case. Physicians have no business accepting bribes. Not in the U.S., not in China, not anywhere. Drug companies have no business doling out bribes; not in China, not anywhere.
There are those who left-handedly defend foreign pharmaceutical companies operating in China; they say that the only reason this crackdown is occurring is because the government wants physicians to favor Chinese companies. That may be true, but that is not the point.
There is a slippery slope in regard to bribery. It begins to change a person no matter who they are or where they live, but when it comes to medical doctors, we enter a new dimension.
These are not victimless crimes. How many procedures or courses of treatment will be instituted because a doctor is being bought? Will there be any deaths or injuries because of bribes?
Chinese physicians probably have legitimate gripes against the system, but those gripes need to be addressed within the system; not taken out on unsuspecting patients and certainly not manipulated by “Big Pharma.”
Will the lawyers defending the pharmaceutical companies also defend the physicians who have taken the bribes? We all know the answer to that. The physicians will be identified, shamed and possibly lose licensure.
The opportunity to commit fraud usually leads to consequences. Unfortunately, this is one case where I doubt the consequences will be applied with equal vigor.
YOUR COMMENTS ARE WELCOME!
