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Greed and Corruption On Our Medical School Faculties.

UD provides a link to an article on this topic in her recent post with the above title.

From the original source:

Weston Library hosts distinguished author of 'On the Take'

Every profession has its ethical problems, and, as Dr. Jerome P. Kassirer makes clear, the medical profession is no exception.

In his talk at the Weston Library on Jan. 14, sponsored by the Friends of the Weston Public Library, he focused on the problem of improper connections between the pharmaceutical industry and doctors, and of doctors who put profits ahead of the welfare of patients.

"My subject," he said at the outset, "is the conflict of interest in the contemporary practice of medicine." He began by telling the group of almost 80 people in the room that drug company representatives make frequent visits to doctors’ offices, bearing a grab bag of free samples and an artful sales pitch. He went on to point out that many doctors receive favors, such as lavish dinners or expense-paid trips, from drug companies as inducements to prescribe their products freely. Many doctors work cooperatively with the manufacturers of drugs and medical devices, he stated, to market and promote these products. The marketing effort might include lectures by doctors to their peers or articles submitted to medical journals, both usually presenting the products in the best possible light.

"Many doctors," he continued, "claim not to be influenced by the blandishments of the pharmaceutical companies."

To illustrate his skepticism about this, he cited a little experiment of sorts in an "upscale Italian restaurant in northern New Jersey, showing that all it takes to influence people is candy." Waitresses distributed free candy to patrons in varying amounts, and sure enough, those who received the most candy left the biggest tips!

Candy is dandy, and as for the rest of that old saying, Dr. Kassirer might change it to, but cash is even sweeter. He asserted that "there are legions of stories about doctors receiving large amounts of money." The quid pro quo might vary from simply pushing certain drugs or diagnostic tests for their own patients to the practice of "ghost writing," in which "a professor of medicine is paid to put his name to a study," passing himself off as the author and thus ensuring the credibility of the study.

Dr. Kassirer also spoke of doctors who receive payments and other benefits from pharmaceutical companies while serving on committees charged with drawing up objective evaluations and/or recommendations for the use of new drugs and procedures. He gave as an example a committee that issued guidelines in 2004 for using the cholesterol-lowering drugs known as statins. The joint committee, representing the American Heart Association, the American College of Cardiology and the National Institutes of Health, had nine members; seven of them were closely connected to the manufacturers of statins. "Why," Dr. Kassirer asked rhetorically, "aren’t committees like this composed of doctors who have nothing to gain from the committee’s recommendations?"

Dr. Kassirer cleaves to the old-fashioned view that "the primary goal of the physician is not to enrich himself, but to take care of the sick." While he acknowledged that plenty of doctors still subscribe to that view, he lamented "the epidemic of doctors who don’t."

Increasingly, the media have been reporting, he noted, on medical research practices that subordinate safety to profit-making potential and on doctors who are questionably involved in the promotion of pharmaceutical business. He cited recent articles in The New York Times and The Wall Street Journal.

All this "conflict of interest" contributes, in his view, to the rising cost of health care and, more importantly, it "leaves patients open to the dangers of inadequately tested drugs." He urges patients "not to be passive, to inform themselves about their ailments, and to question doctors on proposed treatments."

Dr. Kassirer is in a position to know whereof he speaks. He has been for many years a professor at the Tufts School of Medicine, and was editor-in-chief of the New England Journal of Medicine from 1991 to 1999. He is the author of "On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health" and other books and articles on this topic.

At the end of the talk, Dr. Kassirer responded to numerous questions and comments from the audience. In one response, he alluded to laws in Vermont and Minnesota requiring drug companies to disclose payments made to doctors in those states, and he said that a number of irregularities have come to light as a result. He added that a similar bill has been introduced in the U.S. Senate by Sen. Charles Grassley, R-Iowa, and Sen. Herbert Kohl, D-Wisconsin. It’s called the Physician Payments Sunshine Act (S. 2029), and its sponsors envision it as at least a partial remedy for the ethical lapses in contemporary medicine that Dr. Kassirer decried in his talk.

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