I worked in the industry and it’s not really like that (at least the ones following rules).
Certain hotels and resort chains are banned for those types of events (Ritz Carlton, etc). All payments are “fair market value” based on the doctor’s typical compensation rate (say $500/hour for oncologist). All payments are reported to the government under the Sunshine Act.
To be honest, it’s not that lucrative for the doctors at all. They could be making more money elsewhere.
Not really. The speakers are paid for their time and get a free meal. But those in the audience get a free meal, which you can't bring a non-medical person to, and which most doctors could easily afford on their own.
Medical students and residents will attend these, because they can't afford to eat those meals.
Now, the device industry... that does not operate under the PhRMA rules.
The one drug I've ever given a talk for (sugammadex, trade name Bridion) is an excellent drug that has a unique mechanism of action for which there is absolutely no equally-efficacious substitute. It is expensive, at around $90 a vial cost to the hospital, but it can and has prevented overnight ICU stays that would have cost the hospital far more. I was a big fan of the drug even before it was released in the US, so I didn't need a bribe to do the talk. But if they're going to pay someone, I saw no reason it shouldn't be me. I didn't say anything I didn't already believe.
Back in the early 2000's I drove for a proto-doordash (no apps, cell phones, or GPS, just two way radios and a local map book) food delivery service. The best jobs were always the pharma reps buying $500 of lunch for a 5 person doctors office. Could walk away with $100 in tips from a lunch shift.
I dated a girl who went into pharmaceutical sales. They're basically bribed. They get kickbacks in some form or fashion.
They get invited to speak a medical conferences by drug company reps, those conferences just happen to be at luxury retreats.