Medical kickbacks

Scott Haig at Time Magazine reports the mood was more foul at the American Academy of Orthopaedics convention in San Francisco earlier this month, mostly because the Department of Justice has turned the spotlight on the cozy relationship (some people say “kickbacks”) between doctors and the orthopedic device industry.

No more free dinners, or flashlights or pens. And this year there was a new rule that every research presentation had to be preceded with a full disclosure of all monetary deals the speaker had with any company.

That requirement, says Haig, didn’t stop much:

Every single fully trained doctor I heard speak was getting paid by a company; many of the bigger-name doctors were getting paid by three or four. How much money was still the subject of gossip — the exact amount is not required to be broadcast in these podium confessionals. The DOJ has, however, ordered companies to list the doctors in their employ, as well as the amounts paid them, on their websites. Judging by those figures, it adds up to plenty. And it got our attention at AAOS. Some doctors thought it immoral; others lamented the doubt it cast on the integrity of research. But I think most just wanted in.

One wonders today whether this culture has gotten so ingrained into the medical profession that it’s no longer able to see what the problem with it might be.

The New York Times reported today that a 2006 study on lung cancer that suggested 80 percent of lung cancer could be prevented through widespread use of CT scans, was funded by the tobacco industry through a front group called the Foundation for Lung Cancer.

Dr. Jeffrey M. Drazen, editor in chief of the medical journal, said he was surprised. “In the seven years that I’ve been here, we have never knowingly published anything supported by” a cigarette maker, Dr. Drazen said.

The conclusion of the study was questioned almost immediately. Yet it took the Times going through the tax records from the group to ask what Drazen’s editors should’ve asked the researcher two years ago: Who paid you?

In Minnesota, the issue came up this month during testimony on a bill that would ban the the sale of prescriber-specific prescription information for commercial purposes.

On the blog of the National Physicians Alliance, Chris McCoy, who testified, wrote that the hearing earlier this month quickly shifted.

At several intervals, several of the state Senators expressed their personal experiences. I never expected to have many of my arguments presented by a legislator, but one described working in a psychiatry office that has weekly lunches sponsored by drug companies.

McCoy criticized supporters of the practice who say they need “detailing” (as it’s called) to keep up with the latest medical information. ” There are plenty of unbiased, evidenced-based sources of information about new drugs,” says McCoy.

Minnesota is one of the few states that has banned large gifts from drug companies to doctors.

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