Medical Journals: Nature Reviews in Gastroenterology and Hepatology : Quid Pro Quo and the Pharmascolds
This week, Stephen B. Hanauer, M.D., Chief of Gastroenterology at the
The concept of quid pro quo—getting something of value in return for giving something of value—has been a concept for ages. Yet, there are exceptions to this concept all over. For example, “physicians, medical organizations, and hospitals are intensely scrutinized over any and all potential conflicts of interest.” So why do Congressmen and Senators continue to receive millions of dollars from parties lobbying for their own vested interests pertaining to healthcare economics?
Even more interesting, when politicians and public officials retire from government, they usually “obtain lucrative positions in the private sector that they previously regulated.” So why are physicians restricted from speaking on drugs for which they do research? Why are doctors not able to consult with companies on devices and drugs they regularly use for their patients?
The physician industry relationship is no different than politicians and lobbyists. We have registered companies and physicians, and all they need to do is report and disclose what they do. Restrictions on gifts and meals apply the same. The huge difference is that while lobbyists can take years to work on certain issues, industry can save the lives of millions almost instantly with breakthroughs in research and medicine.
Why are physicians, academic or not, not allowed the quid pro quo concept, and why do the pharmascolds scrutinize them for consulting work that contributes to the development of drugs, devices, or other technologies? As Stephen B. Hanauer, M.D., and Editor-in-Chief of Nature Reviews Gastroenterology & Hepatology put it, physicians “are best qualified to contribute to such research and to educate others with regard to the application of these discoveries.”
Ultimately, healthcare is dependent upon the innovations and interactions between physicians, hospitals, researchers, and industry. “No more, or less, than for politicians, government officials and lawyers, do potential biases and conflicts of interest with industry pertain to the engagement of physicians and their societies.” Thus, the consulting work and other payments from industry to physicians are “ethically acceptable exchanges that should be declared.”
It is encouraging to see editors willing to take a stand for the value of collaboration especially in this era of political correctness.