A Public Register for Physician-Drug Company Interactions
Joseph S. Alpert, MD wrote a recent editorial in the American Journal of Medicine. In it, he suggests a (partial) solution to the pharmaceutical industry's inordinate influence on physician prescribing habits. He suggests a national, public database that logs all "transactions" between doctors and the drug companies.
Sample entries would be:
"Dr. Q whose office address is 34 Main Street, Maintown. , USA received travel expenses valued a $670.00 to attend the annual national meeting of Medical Society W from Major Pharmaceuticals, Inc. of Township G, New jersey."
or
"Professor U of H Medical School is a major partner in the new start-up company, B Pharmaceuticals of Maintown, USA> The value of Professor U's stock is estimated to be $500,000."
(personally, I'd have liked to receive the latter.)
The idea is that patients could check out potential conflicts of interest their doctors might have and thereby be able to more more "informed" decisions.
I don't particularly care for this idea. Besides being difficult, time consuming and expensive to manage administratively, to me, it will do more to foster confusion and mistrust in patients with very little upside. Of what real use will this information be to the patient (other than providing a rather prurient insider look into the inner dealings of their doctor)? I don't think that it will result in more informed decision-making on the part of the patient.
To me, the relationship between doctors and the drug companies is what needs to be dealt with. Merely bringing it to light is not a solution but merely a start.
Dr. Alpert suggests that the relationship between doctors and the drug companies is inevitable:
"In our capitalist society, marketing of any product to any group of potential users is legitimate and acceptable."
This seems fatalistic. Certainly things can be done which will get more to the root problem such as better physician education and limiting the reach of advertising. As Dr Alpert suggests, we do practice medicine in the framework of free market. That doesn't mean however that the general public has no overriding interest. It often does and protections can legitimately be superimposed over a free market.
I often feel that patient's have too much information rather than not enough. Information overload is a very real phenomena. When we decide to provide greater transparency and openness to patients, we have to decide whether that increased information will be truly useful or whether it simply adds to the cosmic "noise".
Sample entries would be:
"Dr. Q whose office address is 34 Main Street, Maintown. , USA received travel expenses valued a $670.00 to attend the annual national meeting of Medical Society W from Major Pharmaceuticals, Inc. of Township G, New jersey."
or
"Professor U of H Medical School is a major partner in the new start-up company, B Pharmaceuticals of Maintown, USA> The value of Professor U's stock is estimated to be $500,000."
(personally, I'd have liked to receive the latter.)
The idea is that patients could check out potential conflicts of interest their doctors might have and thereby be able to more more "informed" decisions.
I don't particularly care for this idea. Besides being difficult, time consuming and expensive to manage administratively, to me, it will do more to foster confusion and mistrust in patients with very little upside. Of what real use will this information be to the patient (other than providing a rather prurient insider look into the inner dealings of their doctor)? I don't think that it will result in more informed decision-making on the part of the patient.
To me, the relationship between doctors and the drug companies is what needs to be dealt with. Merely bringing it to light is not a solution but merely a start.
Dr. Alpert suggests that the relationship between doctors and the drug companies is inevitable:
"In our capitalist society, marketing of any product to any group of potential users is legitimate and acceptable."
This seems fatalistic. Certainly things can be done which will get more to the root problem such as better physician education and limiting the reach of advertising. As Dr Alpert suggests, we do practice medicine in the framework of free market. That doesn't mean however that the general public has no overriding interest. It often does and protections can legitimately be superimposed over a free market.
I often feel that patient's have too much information rather than not enough. Information overload is a very real phenomena. When we decide to provide greater transparency and openness to patients, we have to decide whether that increased information will be truly useful or whether it simply adds to the cosmic "noise".
posted by The Medicine Man at 12:44 PM
1 Comments:
You make some interesting points.
I do take issue, however, with your statement that
patient's have too much information rather than not enough.I see just the opposite. As a proponent of consumer driven health care, I urge my clients to do as much research as possible, not to try 2nd-guessing the provider, but to be able to make an informed decision regarding their own healthcare.
Recently, the Medical Director of Humana (the insurance carrier) spoke to a group of us about exactly that. He advocates that insureds (i.e. patients) use the web to learn about their conditions. Of course, there's bad info out there as well as good, but it's a start.
Not to "flog my blog," but I recently posted on a related topic: pending legislation that would require providers to inform patients of the costs of given procedures, in advance.
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