Monday, May 07, 2007

doctors & the appearance of impropriety


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In my profession, lawyers are constantly speaking of avoiding the appearance of impropriety, particularly among the judiciary. The idea is that whether you are in fact doing something unethical, it harms the integrity of the justice system if you engage in actions that appear to be improper. I wonder if the medical profession needs to start having a similar kind of conversation.

Doctors’ Ties to Drug Makers Are Put on Close View
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Patient advocacy groups and many doctors themselves have long complained that drug companies exert undue influence on doctors, but the extent of such payments has been hard to quantify.

The Minnesota records begin in 1997. From then through 2005, drug makers paid more than 5,500 doctors, nurses and other health care workers in the state at least $57 million. Another $40 million went to clinics, research centers and other organizations. More than 20 percent of the state’s licensed physicians received money. The median payment per consultant was $1,000; more than 100 people received more than $100,000.

Doctors receive money typically in return for delivering lectures about drugs to other doctors. Some of the doctors receiving the most money sit on committees that prepare guidelines instructing doctors nationwide about when to use medicines.
I certainly cannot say whether these payments influence doctors to tweak recommendations to favor the companies who pay them. But it creates the impression this may be happening, and it does not sit well with me.

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