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Do pharmaceutical payments compromise physician integrity? Part I

Medicine is a science. And like all sciences, one of its most important aspects is objectivity. If a doctor prescribes a certain course of treatment or a certain medication, it should be because it has proven to be effective, it is reasonably safe and it will meet the patient's medical needs. In most cases, these are the only factors a doctor needs to consider.

As patients, we have to trust that are doctors are objective. But can we trust them if they regularly receive payments and other perks from pharmaceutical companies? Many doctors say that they can remain objective, but how can we be sure. Moreover, how can the doctors themselves be sure?

A joint investigation by ProPublica and National Public Radio found that in 2014, approximately 606,000 doctors received some form of payment from pharmaceutical or medical device companies. Sometimes, the payments were money for consulting and promotional speaking. Other times, the payments were lunch for the entire clinic paid for and delivered by the pharmaceutical sales representative in the area; the representative with suspiciously close ties to physicians and their staffs.

Investigators with ProPublica have created what's called the "Dollars for Doctors Database." It allows people to see if their physician has received any payments from either a pharmaceutical company or medical device company. There are even rankings of the doctors who have received the most money and who have received payments on the greatest number of days. There were 768 doctors in 2014 who received payments on more than half the days of the year.

Are doctors who take such payments able to remain objective? Would such doctors be more likely to prescribe drugs or treatments that could lead to preventable harm and/or a medical malpractice lawsuit? Unfortunately, there is no good way to answer these questions, and that's precisely the problem. Please check back later this week as we continue our discussion.

Source: ProPublica, "A Pharma Payment A Day Keeps Docs’ Finances Okay," Charles Ornstein and Ryann Grochowski Jones, July 1, 2015

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