The Milwaukee, Wisconsin Journal Sentinel continued on its track to discredit physicans working with industry by publishing an article about “sixty-nine Wisconsin doctors who were on the payroll of Pfizer.” The article comes in response to Pfizer’s recent list of payments (see here) made to physicians who were speakers, consultants and researchers. The article noted that the Wisconsin doctors made more than $200,000 combined, which is an average of less than $3,000 per doctor. This average was not much less than the $3,400 national average Pfizer paid for a speaker during the same time period.
The article then notes how a retired Madison doctor received $42,000 during the six month reporting period. If a physician is not seeing patients, where is there any potential for bias in treatment or prescribing?
Despite this lapse, the article goes on to claim that “promotional speaking for drug companies can lead to biased information being delivered to other doctors who are expected to write more prescriptions for expensive brand-name drugs after hearing the talks.” As we have written numerous times, this claim is overstated, the FDA regulates promotional speaking, it is completely on label and the talks mandate physican interaction and discussion. With the adoption of Risk Evaluation and Mitigation Strageties (REMs) the FDA is mandating physician to physican education.
While Pfizer and other companies now have public lists of payments that create greater transparency for the public, this will not largely change how patients view their doctors. In fact, it is more likely that patients who learn their physicians have experience and training with a certain drug or device will be more likely to ask questions and get better options and information from their physicians who are better up to date with new treatments and innovations.
Some think that because company payments to doctors for services encompass a wide varity of physicians, there is a greater potential for conflicts of interest, and thus a greater need to investigate financial relationships between doctors and the drug and medical device industry. With average payments to physicians nationally of $3,400, how can anyone call this a “huge industry?”
Although the national payment disclosure legislation does not take effect until 2013, the Sentinel noted that 15,000 doctors showed up on the lists of Pfizer and four other companies who have begun disclosing (Merck, GlaxoSmithKline, Cephalon, and Eli Lilly). While critics maintain that the lists “of drug company payments to doctors does not put an end to the misleading, costly and potentially harmful information that can come when doctors are used to promote expensive drugs,” their claims are once again wrong.
The reality is these lists ensure that doctors have nothing to hide, and the overwhelming majority does not because these financial relationships represent the legal and ethical collaboration between doctors and industry that help create better patient outcomes and newer treatments for physicians to be trained in.
Articles like this one focus entirely on the risk and very little on the benefit that physican to physician interation, learing about new products can have on improving patient health.
Regardless of the clear benefits industry funded programs have provided to physicians and patients, critics claim that industry lists “may not be complete” based on their distrust for certain companies, rather than specific evidence. While several “drug companies have been investigated by the federal government for illegal promotion of their medications, leading to fines and other payments totaling billions of dollars,” these are the exceptions, not the practice.
This kind of biased and negative reporting of legal and ethical payments made to physicians from industry for innovative work that helps train and prepare physicians to help patients should be ignored and discouraged.
These websites created by industry, regardless of their origin, are designed so that patients can look up their doctors, not so that media can try and fill their pockets for selling papers and getting more revenue from advertising.
Additionally, the Sentinel barely had enough facts about certain speakers to make any substantial claims about what doctors were paid for, and even used retired physicians to make exaggerated claims about such payments.
Instead of investigating doctors who receive $3,000 on average, why not look at how much public officials spend wining and dining with lobbyists and potential sponsors or donors. Better yet, why not investigate how much renowned journalist, politicians and celebrities are paid for making appearances and compare it to the $3,000 physicians receive. The obvious difference being that doctors speak to save lives and help train, while the latter usually do neither.
In the end, many paid speakers who work for industry are advocates for the prevention and treatment of a particular disease or condition they specialize in. The Sentinel, which fails to recognize this also, ignores the fact that many paid speakers have extensive experience with the medicine or device they speak about well in advance of speaking. Accordingly, their influence or bias is minimal if any because they use their clinical experience to advocate for a products use, not the small payment they receive. As a result of this passion, physicians who work with industry value their experience because they help other physicians and patients learn the newest techniques to create better health outcomes, and their work, like everything in life, should be fairly rewarded.
To discredit these payments once they are published publicly will only discourage doctors from working with industry, something patients and America cannot afford.