Doctors and the Rx Scandal Circa 1966
As long as there are human beings and money, there will be greed and unethical behavior, no matter what the profession.
This past August, I was walking through the commercial building of the Ohio State Fair in Columbus, and a copy of an old Life magazine caught my eye. It showed multicolored pharmaceuticals all over the cover, with the silhouette of someone drinking from a glass in the background. The headline read, “Doctors and the Rx Scandal,” followed by “How some MDs short-cut ethics and profit from their own prescriptions.” The most surprising part to me was that the issue was dated June 24, 1966—50 years ago, and a year before I graduated from high school!
The article begins by saying that more than 10,500 doctors “are employing doubtfully ethical means of making extra money out of the prescriptions they write for their patients.” It goes on to say that the estimate of more than 10,500 doctors is very conservative and that the problem is growing among the 225,000 physicians nationwide.
The article says that in 1407 in Genoa, Italy, the city rulers declared, “We fix and ordain—to prevent any pharmacist from having temptation or reason for sinning, and to keep them from raising prices higher than is becoming—that no pharmacist may keep shop in partnership or agreement with any physician.” Wow, over 600 years ago!
The Life article is primarily about physicians who own their own pharmacies and, when writing prescriptions, encourage patients to fill them at their pharmacies. Repackaging of pharmaceuticals was also rampant, and some inspections of pharmaceuticals uncovered less-than-sterile environments.
There was no mention of currently abused drugs; of course, some of them hadn’t been developed. There was no mention of patient addiction, as most of the drugs would be considered noncontrolled substances today. In some cases, physicians packaged OTC drugs and sold them at their pharmacies after they had written prescriptions for them.
The article didn’t say much about pharmacists as collaborators to all of the above, but it did discuss pharmacists’ complaints to the government that physicians were unfairly stealing pharmacists’ business and that physicians should not be allowed to hold interest in pharmacies.
Pharmacist-physician collaborations were a problem in the early 1990s. Some physicians were ghost owners of pharmacies or had a significant agreement with a pharmacist, including kickbacks. Everybody was happy except the poor patients who were often paying too much for prescriptions. In these cases, the physician’s script pad had the name of the pharmacy printed on it in case the patient forgot about the apothecary 1 floor down, or the patient was advised that the prescription would be ready downstairs!
Regulations have mostly eliminated these practices, as several collaborations between physicians and pharmacists were uncovered and either prosecuted or dismantled with heavy fines or license suspensions or revocations. My guess is that, in 1966, these unscrupulous practices were coming to light, and the investigative reporter of the Life article found what seemed to be unethical behavior at the least.
As long as there are human beings and money, there will be greed and unethical behavior, no matter what the profession. If the opportunity presents itself, somebody will do their very best to make an extra buck at the expense of someone else. Health professionals, law enforcement officers, lawyers, and a host of other professions have been involved in unethical or illegal activities at one time or another. What is often overlooked is that most individuals in any profession are hardworking, honest, and ethical, but their reputation can become tarnished by a small minority of outliers. This is true in 2016, as it was 50 years ago! Some things never change.
Cmdr Burke is a 40-year veteran of law enforcement and the past president of the National Association of Drug Diversion Investigators. He can be reached by e-mail at firstname.lastname@example.org or via the website www.rxdiversion.com.