Over the last several years, many of us have raised issues concerning the propriety and appropriateness of doctors receiving funding from medical device companies. For my part, I consider such payments as harmful, violating the trust between doctors and patients. In some cases, they clearly influence the clinical behavior of doctors. In other cases, they simply raise doubts about doctors' loyalty to patients' interests at a time when we should be enhancing that partnership, rather than eroding it. When I make these points--in general or in specific--many US doctors respond by saying, in essence, "Well, everyone does it."
In contrast, people from other countries are appalled when they read of these kinds of payments. They are viewed as unseemly, at a minimum, and often as corrupting of the relationship between doctors and patients.
But how likely are thing going to change in the US?
There are a plethora of US medical associations, each representing a specialty in the field, e.g., urology, obstetrics and gynecology. They perform useful and helpful functions, from board certification to publication of professional journals to continuing medical education.
However, many of those associations themselves solicit and enjoy the sponsorship of those same companies that provide funds to individual doctors. So how can we ever expect that they would adopt meaningful prohibitions on these matters for their members?
Until and unless the specialty associations start to take decisive action on these issues--for themselves and their members--the press and other observers of the health care system will write about examples that raise doubts about whether the public trust is being fulfilled. Doctors may very well say, "That's not fair!"
Sorry, but it seems to me that "everyone does it" isn't a good enough answer any more.
In contrast, people from other countries are appalled when they read of these kinds of payments. They are viewed as unseemly, at a minimum, and often as corrupting of the relationship between doctors and patients.
But how likely are thing going to change in the US?
There are a plethora of US medical associations, each representing a specialty in the field, e.g., urology, obstetrics and gynecology. They perform useful and helpful functions, from board certification to publication of professional journals to continuing medical education.
However, many of those associations themselves solicit and enjoy the sponsorship of those same companies that provide funds to individual doctors. So how can we ever expect that they would adopt meaningful prohibitions on these matters for their members?
Until and unless the specialty associations start to take decisive action on these issues--for themselves and their members--the press and other observers of the health care system will write about examples that raise doubts about whether the public trust is being fulfilled. Doctors may very well say, "That's not fair!"
Sorry, but it seems to me that "everyone does it" isn't a good enough answer any more.
In 2007, I wrote about payments made by device manufacturers to the American Academy of Orthopedic Surgeons
ReplyDeletehttp://hcrenewal.blogspot.com/2007/11/aaos-patient-discussion-guide-regarding.html
It looks like little has changed
Spot on. There is so much money here and few membership organizations can turn down what seems at first to be practically free money. (That should be the red flag.) Years later they realize after being hooked on this "free" money that they have sold their soul to the devil (hyperbole I realize, or is it).
ReplyDeleteI am in medical device sales, more on the nursing side of products so not nearly as much money at stake. I see it when it comes to attending their conferences, meetings and how the big guys(mfrs) throw around their sponsorship dollars and always seem to maintain their market share even after new players enter the market with equivalent product and pricing.
I agree, and many patient groups take money from drug and device companies as well.
ReplyDeleteThey are too busy gouging docs for MOC to care to do anything. As long as the gravy train comes in, they don't care.
ReplyDeleteBtw, there is a new cert. group. Have you seen it?
I think the health care industry has so far escaped scrutiny from the FTC due to the entire field being 'given a pass' on such matters. For some strange reason the public, including regulators, seems to feel that medicine has its patients' best interests in mind and therefore all of this hype of new procedures, devices and drugs is information, not advertising. At some point this will become brazen enough that attitudes will change.
ReplyDeleteIt is a shame that the medical societies are essentially trade associations, collecting dues and enabling their members' efforts to make money while exerting little effort to monitor their behavior, beyond recertification, or instill any sense of professional ethics.
This seems to be worse in the surgical societies.
Eventually doctors will get just what we will deserve - to be treated just like any other money-making industry which tries to mislead the public. Only that's a loss for patients, too.
The National Physicians Alliance is the only physician group I know of that doesn't accept money from the pharmaceutical or medical device industries. Are you aware of their Unbranded Doctor work to combat conflict of interest?
ReplyDeleteNope, please tell more.
ReplyDelete