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Big Pharma Targets German Medical School Students

Lubeck Faculty of Medicine's auditorium
Lubeck Faculty of Medicine's auditorium
Christina Berndt*

MUNICH — Pharmaceutical companies know that doctors more frequently prescribe medicine produced by companies whose sales representatives visit them regularly. That very logic means that these same companies are also busy trying to “recruit” future doctors across Germany, according to a recent survey of German medical school deans and some 1,100 med students.

The study, conducted by Cora Koch and Klaus Lieb of the University of Mainz, and published in the German-language GMS Zeitschrift für Medizinische Ausbildung, also found that only two of the 30 universities that replied to survey questions had created guidelines for their staff and students for dealing with the pharmaceutical companies.

"That’s a remarkably low number," says Lieb. "We’re behind the U.S. on this by ten to 15 years."

Koch and Lieb were also surprised by the lack of interest in other dean’s offices in such guidelines, with only six of 30 universities without guidelines stating a desire such rules. The study found that most of the students surveyed were eager to have more information about how to avoid such advances from pharma companies.

"It’s possible that the students objectively perceive the influence of pharma companies on teaching to be a problem, but subjectively believe that they can control the interaction with reps and won’t be influenced," write Koch and Lieb. Hence only 22% of the students felt that medical students shouldn’t meet with reps.

Prior studies have clearly shown that the prescription behavior of doctors is in fact influenced by regular visits by industry salespeople — sometimes to the detriment of patients.

A survey questionnaire Koch and Lieb circulated last summer found only 12% of med students had never accepted a gift from a pharmaceutical firm or attended a sponsored event. Forty percent pronounced the content of such events as "distorted" but nevertheless found them to be informative and helpful. And nearly half of survey respondents were of the opinion that it was okay to accept gifts, also expensive ones, as these had “minimal influence” on them.

*This is a digest item, not a direct translation.

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Look At This Crap! The "Enshittification" Theory Of Why The Internet Is Broken

The term was coined by journalist Cory Doctorow to explain the fatal drift of major Internet platforms: if they were ever useful and user-friendly, they will inevitably end up being odious.

A photo of hands holding onto a smartphone

A person holding their smartphone

Gilles Lambert/ZUMA
Manuel Ligero


The universe tends toward chaos. Ultimately, everything degenerates. These immutable laws are even more true of the Internet.

In the case of media platforms, everything you once thought was a good service will, sooner or later, disgust you. This trend has been given a name: enshittification. The term was coined by Canadian blogger and journalist Cory Doctorow to explain the inevitable drift of technological giants toward... well.

The explanation is in line with the most basic tenets of Marxism. All digital companies have investors (essentially the bourgeoisie, people who don't perform any work and take the lion's share of the profits), and these investors want to see the percentage of their gains grow year after year. This pushes companies to make decisions that affect the service they provide to their customers. Although they don't do it unwillingly, quite the opposite.

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Annoying customers is just another part of the business plan. Look at Netflix, for example. The streaming giant has long been riddling how to monetize shared Netflix accounts. Option 1: adding a premium option to its regular price. Next, it asked for verification through text messages. After that, it considered raising the total subscription price. It also mulled adding advertising to the mix, and so on. These endless maneuvers irritated its audience, even as the company has been unable to decide which way it wants to go. So, slowly but surely, we see it drifting toward enshittification.

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