Little gifts, thoughtful gestures: How the brand-name drug companies led us doctors on

They never write. They never call. How could we have been so blind?

In the beginning, it was different. We were in medical school, just learning to tie our scrub pants. We were anxious, afraid, naive. The drug companies were there. They waited just inside the hospital doors. Gave us our first stethoscopes, with "Eli Lilly" stamped proudly on the front. Complimented our white coats. Called us "doctor."

Soon we were spending every day together -- donuts at morning rounds, free lunches at noon, pizza in the lounge when we missed dinner. More pens than we could ever use. Big heavy textbooks we could use to impress the residents. Good times.

Later, when we were out in the world, starting our own practices, they were there. They brought scratch pads, coffee mugs, tongue depressors, sticky notes -- everything you need to run an office. And the pens -- countless pens, pens in every drawer, in every pocket of every white coat, each with a drug name stamped on the side. We looked like NASCAR drivers, splattered with logos for new drugs.

Drug reps visited us every day, bearing treats and information about their latest products. They said they were helping us. We wouldn't have to spend hours after a busy clinic going through the latest research. We got our news from the source, the people who made the medicines. They invited us to informational dinners, and handed each of us a hundred dollar bill on the way out for "educational expenses."

We knew it was wrong. The attention, the calls and letters, the gifts -- it all felt so right, but it wasn't. We weren't on the same side, not really. We wanted to help people. They wanted us to prescribe their drugs.

And we did. By the ton. They claimed their drugs were the best, promised they would save lives. And they did. But the cost was high.

Soon it all started to fall apart. We noticed the little things. No more dinners. No more visits. Just the occasional trinkets, and, of course, the pens. A plastic refrigerator magnet is no substitute for a relationship.

In the end, it was the insurance companies that ended it. They stepped in with their generic medicines. Turns out flashy new drugs aren't any better than older, tried and true versions. Whatever we prescribed, the pharmacy would replace it with something cheaper. Guidelines popped up, steering everyone toward medicine that didn't cost a fortune.

Then one day it all stopped. It had gotten so bad even congressmen could tell it was wrong. They passed rules banning the gifts, the wining and dining, even the textbooks. It's funny how you know it's over. For most of us, it was when we had to start buying pens.

We figured the drug companies were gone, and would never entice doctors again. Once again, we were naive. Oldest story in the book -- they hadn't left, they were seeing someone else.

The rumors soon started. Drug companies were hanging around the institutes and universities, anywhere medicines were studied. We pictured them getting to know the researchers -- laughing at their jokes, touching their hands during meetings. Before long they were in every research facility across the country.

And they didn't bring trinkets. Pens became laptop computers, dinners became trips to luxury hotels. Research doctors were paid to test certain products, to recommend them for new diseases, and to give speeches saying how great they were. It was big money, and some doctors were raking in millions.

The rest of us doctors? Cast aside, thrown over for bigger fish. It happens. You learn. Maybe we won't be so naive -- and so greedy -- next time.

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Mark DePaolis is a writer and physician who practices in Brooklyn Center. He is a regular contributor to "Almanac" on Twin Cities Public Television and a source in MPR's Public Insight Network.

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