Media Project Exposes Pharma Payments to Docs

Some of the nation's largest media outlets are teaming up for a series of stories detailing drug company "secret" payments to physicians to promote their products.

Today, ProPublica, along with NPR, Consumer Reports, PBS, the Boston Globe, and the Chicago Tribune all rolled out stories as part of their "Dollars for Docs" project, exposing the millions of dollars received by physicians nationwide who work with pharma. ProPublica has even rolled out a Web site listing which pharma companies pay the most, which physicians received the most since 2009, and what states have the highest compensated docs.

[For the curious: Eli Lilly; Nevada internist Firhaad Ismail; and California.]

ProPublica, which bills itself as an "independent, non-profit newsroom" specializing in investigative journalism "in the public interest," lead the effort in taking public pharma disclosures of payments - totaling $257.8 million to nearly 17,700 providers - and putting them in a single database where patients can even search for their own physician.

Among the findings by ProPublica and its partners are that some of the doctors on the pharma payroll have been accused of professional misconduct, were disciplined by state boards, or even lacked credentials as researchers or specialists. Some physicians even lost their licenses, but were paid to discuss pharma products, according to the news outlet.

ProPublica makes the following statement on its "Dollars for Docs" Web site: "Receiving payments isn't necessarily wrong, but it does raise ethical issues." Agreed.

And Consumer Reports' entry into the project is a survey indicating that of 1,250 adults, more than three-fourths say they would be "very" or "somewhat" concerned about getting the best treatment and/or advice from a doctor accepting pharma cash. Add to that the 70% in the survey who feel doctors should disclose this relationship to patients.

Now in 2013, this all becomes a little clearer, thanks to the Affordable Care Act. That's the deadline for all pharma companies to publicly disclose payments to docs - the seven companies highlighted in the media project either did so voluntarily or by a legal judgment requiring them to go public.

"We saw no reason for readers to wait three years for information that is already beginning to become available to anyone who could penetrate and scrape data from pharma’s labyrinthine websites," Stephen Engelberg, ProPublica's editor, notes in his editorial accompanying the project. Again, I agree. Kudos on compiling this data.

I've expressed my thoughts on potential conflict of interest when it comes to the pharma-physician relationship before, and I stand by those statements today. And I think that the ProPublica-led media project is good in that it could expose some issues that pharma may or may not know about - disciplined doctors representing their products.

But what I hope this doesn't turn into is a witch hunt, where physicians are instantly judged by the dollar amount after their names on the ProPublica Web site. Some doctors freely disclose this information to patients on their own Web page or at their office, others speak about pharma products but don't push them on patients, and still others do this as a legitimate way to supplement their income.

The perceived "conflict of interest" question is a valid one, but let's not paint all physicians with the same brush when it comes to disclosure. Let's take this as they take patients - on a case-by-case basis and carefully examine the facts.