The Best Bits Of ProPublica’s Pharma Payroll Investigation - Matthew Herper - The Medicine Show - Forbes

ProPublica, the non-profit journalism organization, released an amazing project last week looking at exactly which doctors are taking money to give speeches for drug companies, how much those doctors get, and what ethical issues result.

Unfortunately, ProPublica wrote its main article on the project like a feature for some bygone newspaper, which meant most of the really, really good stuff wound up at the bottom. But this is the internet age, and nobody reads to the bottom. So I’m shamelessly grabbing those good bits — including one idea I really think is important — and reprinting them. First, the juicy, unimportant stuff.

In 2009, Michigan regulators accused one rheumatologist of forging a colleague’s name to get prescriptions for Viagra and Cialis. Last year, the doctor was paid $17,721 as a speaker for Pfizer, Viagra’s maker.

A California doctor who was paid $950 this year to speak for AstraZeneca was placed on five years’ probation by regulators in 2009 after having a breakdown, threatening suicide and spending time in a psychiatric hospital after police used a Taser on him. He said he’d been self-treating with samples of AstraZeneca’s anti-psychotic drug Seroquel, medical board records show.

via Docs on Pharma Payroll Have Blemished Records, Limited Credentials – ProPublica.

The beginning of the ProPublica story was pretty good reading, too, featuring  an “anesthesiologist [who] had admitted giving young female patients rectal and vaginal exams without documenting why,” but I still think the Taser should have been up higher.

And then there is this idea, about which I’ve been worried for a while. Now that conflict of interest rules at universities often prevent many real top experts from taking drug company speaking fees, and because many of those experts have given up the money because they are afraid it will hurt their reputation, the people giving these speeches are not always really the best and the brightest.

ProPublica puts it this way: “Some top speakers are experts mainly because the companies have deemed them such.” For example, the top paid speaker in its database.

Las Vegas endocrinologist Firhaad Ismail, for example, is the top earner in the database, making $303,558, yet only his schooling and mostly 20-year-old research articles could be found. An online brochure [15] for a presentation he gave earlier this month listed him as chief of endocrinology at a local hospital, but an official there said he hasn’t held that title since 2008.

And several leading pain experts said they’d never heard of Santa Monica pain doctor Gerald Sacks, who was paid $249,822 since 2009.

via Docs on Pharma Payroll Have Blemished Records, Limited Credentials – ProPublica.

Think about that: the top earner in the database has almost no qualifications that reporters can find. That’s pretty shocking.

Most of the discussion about paid speaking either marks it as a blight on medicine or defends it as a necessary evil. It may be that we need drug and device companies to fund education about new products. But I think everyone should be able to agree that this system is not working very well. If we’re not going to trash it, how do we fix it?

via blogs.forbes.com

Posted via email from Jack's posterous