I’ve been following this at ProPublica:
As medical schools wrestle with how to keep drug companies from corrupting their faculties, Stanford University is often lauded for its tough stance. The school was one of the first to stop sales representatives from roaming its halls in 2006. It cut off the flow of free lunches and trinkets emblazoned with drug names. And last year, in a blow to its physicians’ wallets, Stanford banned them from giving paid promotional talks for pharmaceutical companies. One thing it didn’t do was make sure its faculty followed that rule. A ProPublica investigation found that more than a dozen of the school’s doctors were paid speakers in apparent violation of its policy—two of them earning six figures since last year.
Faculty at a half-dozen other institutions—including division chiefs—also lectured for drug firms in the last two years, ProPublica found, despite restrictions on such behavior. The University of Pennsylvania, the University of Pittsburgh and the University of Colorado Denver, among others, have launched reviews.
The investigation resulted in this:
The University of Colorado Denver and its affiliated teaching hospitals have launched an overhaul of conflict of interest policies after a ProPublica database revealed extensive ties between its faculty and pharmaceutical companies. At a meeting of the faculty senate last week, Dr. Richard Krugman, vice chancellor for health affairs, said he hoped members would soon consider a policy to clearly ban faculty from delivering talks for drug companies. Without such a clear rule, he said, the school faces a loss of public trust, damage to its reputation and the specter of it physicians parroting industry-designed materials.
You can look up your doctor here, but the data isn’t complete:
Drug companies have long kept secret details of the payments they make to doctors for promoting their drugs. But seven companies have begun posting names and compensation on the Web, some as the result of legal settlements. ProPublica compiled these disclosures, totaling $295 million, into a single database that allows patients to search for their doctor. Receiving payments isn’t necessarily wrong, but it does raise ethical issues.
Violet
Hey, look! One of my doctors is on the list. Doesn’t surprise me, actually. He’s a good doctor for me, though. I had to visit a lot of doctors before I found him and he takes my complaints seriously and treats me so that I feel well. There’s no way I’d switch.
dr. luba
When I was a resident, drug reps would sometimes bring us lunch at the clinic. We were too busy to actually stop and go to the cafeteria for lunch, so it was nice, but we were also to busy to listen to their spiel. We were at an inner city hospital, and this was the 80s, so we didn’t get much more than lunch and an occasional pen or mug.
Out in private practice, I would allow those reps to visit who would bring me lots of samples–birth control pills were expensive, and not covered by most of my patients’ insurance. I kept a lot of my patients in pills this way.
I know of several docs who got lots of expensive gifts and vacations paid for by drug companies. I always thought that was wrong, and didn’t participate myself. I would occasionally wrangle a few textbooks from the reps, which went to deserving places. I probably didn’t get much more than that because I rarely went all out for the new, fancy more expensive drugs that the companies were pushing.
At the hospital where I now work, formula reps used to bring lunch to our labor unit. I would get them to give me free pregnancy wheels (which I take to my friends’ hospital in India, for the docs and nurses there).
Our policy has changed though, and drug reps are not allowed to bring us anything any more. This is a good thing, generally, and I support it in principal–but I miss the wheels.
Stillwater
Can I blame part of this on Obama? That it’s another way Obama has let me down?
Violet
@dr. luba:
My very favorite drug rep freebie was in the possession of a psychiatrist I knew. It was a big alarm clock that had in big letters across its face, “Have a Zoloft morning!” I cracked up every time I saw it.
Kay
@Stillwater:
ProPublica are brutal, to everyone. They target Obama REGULARLY.
It’s an interesting idea, investigative journalism :)
meh
@Kay:
They are truly becoming the last bastion of true hard-hitting investigative journalism. I know a lot of people in the industry that look at them a bit love struck…they are the shit.
kay
@meh:
Their TARP tally has been fantastic. It’s curious to me that no one is reporting that banks are paying the money back. The feds could break even (on banks), or even make money.
There was SO MUCH outrage, I would think they would want to tell people banks are paying the money back. It doesn’t fit the narrative, so it’s ignored.
PeakVT
Eli Lilly is the big payer in Vermont, and the top recipients are psychiatrists. Not surprising, since finding the right drug for a psychiatric patient is often a trial and error process.
jeffreyw
Random kitteh pic.
eemom
@kay:
heh. I thought the same thing this morning while listening to an interview of Ben Bernanke about “audit the fed.” He pointed out, rather forlornly, that the govt is being paid back with interest — exactly like he knew no one was listening. : (
kay
@eemom:
hah! I think both Parties would just as well never mention TARP again, so maybe that’s it.
I’m glad I’m not the only one wondering. He’s forlorn as a rule. I watched a 60 minutes on him when he was appointed. His whole thing was that he was the son of a small business owner and a REGULAR PERSON!
I felt a little sorry for him.
maya
While on the subject of doctors, this Sunday is Ronald Reagan Day here in Ca commemorating the 100th year of his birth. School children will be singing his praises with a special song, [a la SP’s Battle Hymn, I suppose] celebrating the famous 1983 battle of Gran-nay-da where RR singlehandedly saved the world’s supply of off-shore medical degrees. Could this be a surprise part of the halftime entertainment at the Super Bowl?
eemom
@kay:
indeed, one can’t help feeling sorry for him, sent in there to clean up Greenspan’s mess — and getting nothing but shit thrown at him from all sides, after fucking Greenspan got treated like a god all those years.
And I think it’s yet another in the long list of Stoopids by the bumbling gang of clowns that is our Democratic party that instead of getting all defensive about TARP, they don’t simply point out that the $$ is being repaid WITH INTEREST.
elm
@kay: It’s good that banks are paying back the TARP money and interest owed but that’s not the only important factor.
The original bailout proposal put forward by Treasury Secretary & former Goldman Sachs CEO Henry Paulson granted him significant authority without any meaningful oversight.
The revised program (revised after Congress and many individuals raised objections) was less-bad. It still smelled like a loan to a gambler who has gone broke. The banks made another gamble (with public money this time) and won. Now they’re paying back the amount of the loan + interest owed, but there was a real chance that they’d just lose it all as well.
Ireland’s bank bailout is an example of the latter. Investors and bondholders essentially took the bailout money out of the country leaving Ireland with a failed banking industry + a crippling debt. It was also a much larger bailout (per-capita), which didn’t help matters.
Villago Delenda Est
Ethics are for chumps. Winners don’t care about ethics.
kay
@elm:
Well, sure, but as the lender, I still like to know they’ve paid it back.
I don’t think it’s a vast conspiracy to hide the pay-back, to be clear. I think we have a 7 day attention span.
numbskull
@kay: It’s not clear that this is being paid back in the way we think of it. Someone I read on the intertoobs this morning said it’s more like the government discovering that counterfeiters had printed $900 billion dollars and used it to buy stocks. The government then let them print another $100 billion, which they then gave to the government.
However, the original $900 billion is still some sort of actual wealth that was simply removed from our economy.
Additionally, the “with interest” part is working out to a bout $20 billion total, a very low return on the investment by us into them. We could have largely handled this by regulatory fiat, and hell, if we wanted to actually SPEND the TARP funds anyway, we could’ve built a whole bunch of stuff like bridges, dams, roads, shelters, high speed rail, etc.
Opportunity cost.
Mnemosyne
@kay:
I think that’s being overly generous.
gordon schumway
@maya: Also nutmeg.
kay
@numbskull:
ProPublica never had the total at higher than 548 billion. It was my understanding that 700 billion was allocated, but they borrowed 548, and that’s for banks, AIG, GM and Fannie and Freddie.
I just followed the numbers, so your point is well-taken about opportunity cost, whether we should have, etc.
I just think it’s amazing that we lent out 548 billion dollars, we were really, really MAD, and then “no one” (meaning average news consumer) followed up to find out if anyone was paying it back.
It’s all but forgotten.
elm
@kay: Absolutely agreed. I’m glad that ProPublica is following up on that and publishing that information. It’s shameful that political arguments only rarely refer back to facts or evidence and that the public attention span is terribly short.
patrick II
It is not just drug companies but medical device companies that bribe doctors. I had a doctor recommend a type of hip operation that I later found that according to the FDA I was an inappropriate candidate for. It turns out the device company paid the doctor $2 million that year for using their device. I had sciatic nerve damage and walk with an AFO on my left foot, not to mention neuralgia in my left leg.
It is not just that they work for these companies, it is that they don’t tell you. If I walk into a Ford dealership, I know the salesman is working for Ford and take what he says in that context. When I walk into a doctor’s office I have in the past thought he was working for me. That turned out not to be true — the device company paid him a lot more than I did, so it seems he was working for them.