No to 'face-to-face' visits by scientific representatives in doctors' offices. Better public meetings, to guarantee more independent information. This is the proposal of Silvio Garattini, pharmacologist at the Mario Negri Institute in Milan, in an article in the magazine 'Il Bisturi', who conducted an inquiry into scientific information 'under accusation' after the scandal and the investigations by the judiciary in Bari. "It is depressing - he says - to observe the presence of informants in the waiting rooms. The visit of the informants should take place outside the outpatient activity, also in order not to detract from the limited time available for the patients. Even in hospitals it would be advisable for the presence of informants to be limited to a few hours, perhaps on certain days of the week". “Every morning – underlines Garattini – around 30,000 informants belonging to the pharmaceutical industry leave their homes to meet between 8 and 10 doctors during the day. Therefore, every day there are about 300,000 contacts who tend to make known the effects of drugs in order to request prescriptions”. For the pharmacologist, it is a “bombardment that is difficult to resist, even regardless of the presence of more or less transparent 'incentives'. It is evident, in fact, that the purpose is represented by an increase in sales, otherwise the enormous expense for promotion would be inexplicable: about a third of the price of each drug. The diagnosis is clear to everyone. But, as often happens – says the doctor – the therapy is the most difficult part”. For Garattini, there are two useful measures. “First of all – he explains – it is necessary to increase independent information, currently a very small, insignificant fraction. And then not to allow visits by informants during the doctors' outpatient activity. Whistleblowers should be prevented from entering hospital wards and the information they propose should be given in public seminars with the possibility of cross-examination. These are simple proposals, dictated by common sense, which could change - he concludes - the relationship between doctors and pharmaceutical reps with the result of more critical information, capable of creating doubts and not only often unfounded certainties. Maybe if someone started setting a good example, the 'contagion' could spread”.
