Doctors Under the Influence — CBS

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The discussion to promote the Physician Payment Sunshine Act has gone Prime Time on CBS Evening News along with stories running on CBS and Newsweek questioning the ethics of physicians working with pharmaceutical and device manufactures.

In a very unfortunate case, a family who lost their doctor due to suicide and is suing the pharmaceutical company Pfizer for selling Zoloft.  Apparently their physician accepted speaking fees on behalf of Pfizer, the maker or Zoloft.

They quote an unpublished study by the University of Quebec that showed alleges that drug company payments are as high as $57 billion a year, covering consulting fees, speaking fees on drugs, and medical seminars on the benefits of drugs. 

This is quite a high number given the size of the industry. This is a huge exaggeration and quite unlikely to be anywhere near what they are quoting.  But hey, this is CBS news and anything goes.

Apparently Senator Grassley is “also looking at the money drug companies pay doctors for academic research”.  He is investigating some 20 top medical schools — including Harvard, Stanford, and other Universities.

They quote the Grassley statement a week ago about Joseph Biederman, MD, "who’s research has led to huge increases in bipolar diagnosis in children and the prescriptions to treat those children”. He is being asked why he allegedly failed to report $1.6 million in fees from drug companies. Dr. Beiderman noted to CBS that some of the industry money he accepted was "not personal income" and "his life work is devoted solely to rigorous and objective study".

This is an apparent attempt to make the industry as whole look bad.  According to Senator Grassley "it raises a flag to me that they may have something to hide", it raises a flag that the university doesn’t care."

According to Senator Grassley, fixing this problem is complicated because "some" relationships between doctors and drug companies are legitimate and necessary to achieve breakthrough therapies.  Senator Grassley says that the answer is more public information.

American researchers are ill prepared for this type of political and media on-sought.

I favor some type of disclosure bill for direct payments to physicians, but this type of political and public humiliation of our top physicians makes me question the long term use of this type of information. As we see more disclosure, are we in for endless floggings in the press of American’s top researchers.  This will only undermine researchers and manufactures integrity at the expense of patient care.

The parents of Candace Downing, are dealing with a great loss, and their anger is understandable, but I am not sure that it is not misplaced. In the 90’s many of the AIDS activists were angry at the pharmaceutical companies working to develop drugs for AIDS but failing in trials.  There are many other broken parts of our healthcare system including re-imbursement that prevents physicians from spending the necessary time with patients and families to really explore more complicated solutions to complex problems.

Are Perks Compromising MD Ethics? (CBS News)

Doctors Under the Influence? (BusinessWeek)

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