Thanks once again to friends on Twitter yesterday, I received an article that included a search engine, allowing one to enter the name, town, or city of Doctors in MN who had received funds from the Pharmaceutical Companies, usually for giving a speech or serving as a KTL (Key Thought Leader) at an Industry-Sponsored Convention. Some seem to be “on retainer” to a BigPharma and are available to consult, give feedback, share research, etc. The major question is “Is there anything unethical about this?” assuming the speaker discloses funds were provided by a given Company? As an M.D. in private practice, I have some very strong convictions that it is indeed unethical. Not to be self-righteous, but through my years in Medical School, Specialty Training, and Clinical Practice; my opinions have changed dramatically. Initially, I assumed they “where part of the territory”..you met with them, accepted their free medication samples for people in need, welcomed the free doughnuts, lunches, pens, Post-its, Mugs, Novelty items, etc. Frequent Invitations to participate in a Webinar with other MDs, and be paid an “honorarium” for the hour – often over lunch. By the late 1990s, I gave in and accepted an official ‘Thought Leaders’ convention from Eli Lilly…..1st class air to Orlando, 4 star hotel, incredible meals, great speakers from Major Universities with impressive PowerPoint Presentations. Then professional coaches that would train us how to improve our delivery, if we were to speak….sending the videos home with us for review. Everything was provided. No need to research for a lecture to deliver. Online, the Lilly Lecture Bureau would provide FDA approved Powerpoint slides for the future presentations, once “training” was completed. A decade ago, a typical honorarium for devoting one’s weekend to the lectures and training was $1500.00. No known strings attached. On the return flight that Sunday a.m., I felt at first well informed, enthused, and enlightened ! But then I began to question the intent of the “BigPharma Host” for the first time. The company had succeeded in tapping into my grandiosity in so many ways. Once I returned home, I began questioning the information I had been given in earnest.
1) Why was the online lecture bureau a “closed system” for presentations? Why did the local drug reps have expensive, up to date laptops with closed networks so that they could not surf the web, only the Company approved information?
2) Why was I repeatedly reminded that I could only talk about “FDA-approved” information (which somehow excluded me talking about so many concerns about Prozac & Zyprexa that raised major adverse side effect concerns?
3) How could the company possibly afford to pay so much money for so many doctors to be given “The Gift ” of a TL (Though Leader)? Many at the seminar were from other countries & working hard to master speaking English.
4) As an aside, my Honorarium Check arrived, but I was uncomfortable knowing what to do with the $1500.00 I later was told – off the record- that the “Key Thought Leader” who enlightened us received $15,000.00 dollars for his lectures that weekend – but he was from Harvard!
5) I learned from a soon to be whistle blower drug rep – a very successful one- that they were paid bonuses for every script I wrote for their products. Furthermore, I was shown my very own “data mined” profile of my scripts written over the past many years (and this was is 1999)..no patient names, but how did they receive that information?
My level of discomfort was great enough, I declined any further invitations for conferences, Webinars, – but still accepted free drug samples for indigent patients…and refused offers for lunch, golf, pheasant hunting, fishing trips, etc. As of Oct 1st, 2010 – with a move to a new office location – have not received any samples nor reps and it just feels like the right thing to do for me. As for my fellow psychiatrists in the State, many must have a completely different opinion. Many state they can accept the “honoraria” and that they are objective enough to not allow it to affect their prescribing choices.http://extra.twincities.com/CAR/doctors/default.asp
http://extra.twincities.com/CAR/doctors/default.asp
Check our your Doctor or Town anywhere in Minnesota, if interested in seeing if they receive BigPharma Monies. I was surprised by money received by Docs in Hibbing, Bemidji, and even Grand Rapids. In Minneapolis, there is a John Simon – psychiatrist – who does quite well, also a Dr Adson in Edina- whom I do not know, but is said to practice Psychiatry. Dr Tomac in Duluth seems to be paid quite well !
Dollars for Docs rocks!
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