'Serious danger' when doctors are paid by pharma

An editorial in the Boston Globe, which recently reported on 60 Massachusetts doctors who took $580,000 (US) in payments from drug companies over four years, calls for the practice to be banned outright.

The danger posed by this practice is serious: Research shows that getting money from the pharmaceutical industry can cloud doctors’ judgment when evaluating studies and side effects, as well as when they are prescribing medication. In addition, when reputed doctors rely on company material to promote a new drug to their colleagues, they also help broaden its use. Sometimes, the presentations end up encouraging the use of a drug for purposes beyond what it has been approved for by the Food and Drug Administration.

Massachusetts General Hospital, Brigham and Women’s Hospital, and McLean Hospital - all of which also employ doctors who have received money from Eli Lilly this year - will prohibit their doctors from receiving speakers’ fees from the pharmaceutical industry starting today. Other hospitals in Massachusetts and around the country should follow their lead immediately.

Efforts by Eli Lilly to set up an online registry of such payments are not enough, the editorial says. Merck plans to set up a similar registry in the coming months.

While transparency is a good first step that exposes doctors’ financial relationships to the broader medical community, it is unlikely to affect how patients view their doctors. More important, it will not address the subtle ways the payments influence and interfere with patient care.

Patients trust doctors as stewards of their health. They revere them as scientists who can exercise sound, independent judgment. Allowing doctors to promote drugs for pharmaceutical companies takes advantage of that trust and reverence. It also compromises doctors’ most important work: treating people who are ill.

The Lilly registry details $22 million (US) in payments to American doctors in just one fiscal quarter -- providing, it seems, a slice of just how big an issue this is.

Meanwhile, the University of Wisconsin, which has been rocked by revelations of the close ties of many of its researchers to medical device companies and ghostwriting, has backed off plans to ban its professors from collecting fees from the companies whose products they are supposed to be researching.

University of Wisconsin officials have watered down proposed conflict of interest rules, allowing orthopedic surgeons and other doctors who implant devices to earn large sums of money making presentations for medical device companies.

The new policy would keep in place a ban on UW doctors giving talks about medications for drug companies.

Not addressed in the policy is the university's own relationship with the drug industry, which has come under scrutiny in a series of stories this year by the Journal Sentinel.

The university receives several million dollars a year from drug-makers to sponsor doctor education activities, some of which have been criticized as promotional efforts to sell expensive brand name drugs.

But it is the exemption for the device-makers and the ban on drug-only talks that is riling up doctors at UW as part of a high stakes ethics battle simmering at medical schools across the country.

At issue is whether doctors should be free to hire themselves out as promotional speakers and consultants to drug and medical device makers and how much financial influence those firms should wield at academic medical centers.

"It's the subject of animated hallway conversations and nasty e-mails," said a UW doctor who asked not to be identified. "The fever pitch is high."

The university declined comment.

Comments

[j.doncaster]

Here's the problem in a nutshell (excerpt from the article)

"Patients trust doctors as stewards of their health. They revere them as scientists who can exercise sound, independent judgment"

This is a slant and not a statement of fact. When will the violin be put away?

The fact is that sick people are desperate and scared. They will take their chances with whoever is available. This is not reverence, for pete's sake. It's legalized gambling and kissing the dice.

[sandy]

I whole heartedly agree with the comment above I do not have a doctor and I no longer trust them any of them or the medical community as a whole. Something has been lost I can't quit put my finger on what it is. They are dirty that is what I know and the patient is not the primary concern any longer...money is.
It is a trap that will catch us all eventually me too. For now I am staying as far away from doctors as I can get the science is bad the drugs are downright dangerous.
As for the ethics you will have no shortage of things to write about.