Doctors and medical sales representatives in a hospital
In a sweeping investigation of doctors paid by leading pharmaceutical companies to promote their drugs, the nonprofit ProPublica has found that hundreds have been accused of professional misconduct, lacked credentials or have been disciplined by state boards. Some lost their jobs or their license to practice. Yet many were paid up to several hundred thousand dollars to educate other physicians. (More on Time.com: In Illinois, Sex-Offending Doctors Continue Practicing With No Oversight).
It’s not news that doctors and other specialists are hired by pharmaceutical companies to teach their peers about the uses and benefits of various drugs — for one thing, they tend to be better trusted than the average drug sales rep, and a single successful drug can bring in hundreds of millions of dollars for its maker. Doctor-consultants speak at conferences, give lectures in hospitals or confer with their peers over industry-funded dinners. Many take their role as teacher very seriously, interviews by ProPublica reporters reveal, and often their service is a boon: in rural communities, where primary-care physicians are expected to give specialized care but haven’t got the time to keep up with the latest research, educational tours by industry-paid specialists can be key to good care.
Many of these educators, however, have questionable histories. ProPublica senior reporter Charles Ornstein and his investigative team compiled data from seven drug companies — Merck & Co., GlaxoSmithKline, Johnson & Johnson, AstraZeneca, Lilly, Cephalon and Pfizer — which disclosed on their websites doctor-payment information from 2009 and 2010. ProPublica then did a background check of the credentials and licensing records of the highest-paid physicians — which is something, the organization observes, the drug companies don’t make a habit of doing. (More on Time.com: The Hispanic Mortality Paradox: Why Do Latinos Outlive Other Americans?).
Since 2009, a total of $257.8 million has been paid out to 17,700 individuals by the seven companies. (It should be noted that more than 70 drug companies have not disclosed doctor-payment data, so these figures are likely underreported.) Among them, Ornstein and his colleagues found that 384 — most were doctors, but some pharmacists, nurse-practitioners and the like were included — earned more than $100,000; 43 doctors earned more than $200,000, including two who pocketed more than $300,000. Also:
A review of physician licensing records in the 15 most-populous states and three others found sanctions against more than 250 speakers, including some of the highest paid. Their misconduct included inappropriately prescribing drugs, providing poor care or having sex with patients. Some of the doctors had even lost their licenses.
More than 40 have received FDA warnings for research misconduct, lost hospital privileges or been convicted of crimes. And at least 20 more have had two or more malpractice judgments or settlements. This accounting is by no means complete; many state regulators don’t post these actions on their web sites.
In interviews and written statements, five of the seven companies acknowledged that they don’t routinely check state board websites for discipline against doctors. Instead, they rely on self-reporting and checks of federal databases. Only Johnson & Johnson and Cephalon said they review the state sites.
On NPR, Ornstein described a few of the disciplinary cases his team found; among them, he said:
The Ohio Medical Board, for example, voted a couple years back to revoke the license of William David Leak who they accused of performing unnecessary nerve tests on 20 patients and subjecting some to an excessive number of invasive procedures. Dr. Leak is appealing the penalty and his license is still active, but since 2009 he has received $85,000 from Eli Lilly and Co.
Another one is a hospital disciplinary case out of Georgia — the state appeals court in Georgia in 2004 upheld a hospital’s decision to kick Dr. Donald Ray Taylor off its staff. He’s an anesthesiologist, and he admitted to giving young female patients rectal and vaginal exams without documenting why. He had also been accused of exposing women’s breasts during medical procedures, and when he was confronted by a hospital official, he said, “Maybe I am a pervert; I honestly don’t know.”
By 2013, the health-care reform law will require all drug companies to report doctor-payment information to the federal government, which will make the data public. The real question is what impact these payouts have on the delivery of care to the American public — are doctors pushing expensive brand-name drugs instead of generics? Are they prescribing drugs inappropriately? If it’s any indication, the federal whistleblower lawsuits against several companies, which resulted in much of the payment data being released, claim that they paid doctor-consultants highly as a reward for prescribing their drugs. (More on Time.com: Top 10 Product Recalls)
For now, the ProPublica team has created a searchable and interactive database of the 17,700 individuals who have accepted consulting fees from the seven pharmaceutical companies. This is useful information for patients to know, especially if they are being prescribed medication. “If you see your doctor as receiving money from a company that makes your drug, it’s good to ask if there are alternatives that are less expensive. If there are alternatives that have fewer side effects, ” Ornstein said on NPR. “And to just exercise a degree of caution — not necessarily to distrust your doctor at all, but to ask questions to make sure that this is the drug that’s best for you.”
The ProPublica investigation fairly overflows with insight and some astounding accounts of misconduct among the rolls of physicians paid by the pharmaceutical industry. We would encourage you to read the full story here.
[Via NPR]
5 Keys to Health Reform’s Success or Failure
Why Medical Malpractice Suits Have Little to Do with Doctor Performance