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Do pharmaceutical payments compromise physician integrity? Part II

Earlier this week, we began a discussion about doctors who receive payments (cash and otherwise) from pharmaceutical companies and medical device manufacturers. These for-profit companies are not buying lunch for physicians and paying them to speak on behalf of their products simply because they want to reward doctors for the important work they do. Instead, these companies understand that such tactics work. It takes money to make money, and pharmaceutical companies definitely make money.

ProPublica reports that about 606,000 physicians received payments from pharmaceutical and medical device companies last year (as did dentists, optometrists, chiropractors and other medical professionals). Obviously, a physician who has frequent contact with pharmaceutical reps and receives a lot of payments is less likely to be trustworthy than the doctor who has maybe accepted a free lunch once or twice. But where do we draw the line between objective/ethical and biased/unethical? It is precisely this question that prompts some physicians to avoid drug company payments and perks altogether.

If your doctor has had a significant amount of contact with drug reps and has received a significant amount of money, you may be wondering:

  • Did your doctor prescribe new and still-patented drugs because they work better than older generics or because they were promoted?
  • Did your doctor examine objective research on the effectiveness of a drug or did he get his information directly from the drug company?
  • Was the drug prescribed to you actually necessary?
  • Is a newly prescribed drug safe?
  • Has the physician considered alternative drugs, or did he just happen to think of a drug recommended by a pharmaceutical sales representative?

Some doctors who receive payments from these companies claim that they only promote drugs or devices that they believe in. Therefore (they argue), there is no harm in accepting a payment for a drug they would have recommended anyway. But because they have taken the payments, how can any of us be sure that they are telling the truth? Credibility is something far more valuable than whatever a drug company is willing to pay.

We may not know whether doctors who accept payments have compromised judgment or are unethical. We also don't know if they are more likely than other docs to make serious errors that lead to medical malpractice lawsuits. But we should at least know whether they receive payments from these companies. From there, patients can make up their own minds.

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

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