We expect our doctors to "first do no harm" and to provide treatment based on what's in our best interest. However, this tenet of the Hippocratic Oath may be compromised when doctors are on the payrolls of pharmaceutical companies. The practice of paying speaking fees to physicians' raises ethical concerns about whether this is actually a quid pro quo arrangement, where doctors receive payola for prescribing the medications made by the companies that contract with them.
This concern is nothing new: Several studies have indicated that when doctors receive even small gifts from a pharmaceutical company or medical device manufacturer, it increases the likelihood that the doctor will prescribe that company's products. With speaking fees, there are thousands of dollars involved, and many experts believe that it strongly influences how doctors behave.
"We know that if a doctor is getting paid by a pharmaceutical company, he or she will be more favorable to the medications that company produces," Dr. Sidney Wolfe of Public Citizen told the Orlando Sentinel. "It would be impossible for payments not to influence judgment."
Keeping Patients Informed
In order to help patients find information about potential conflicts of interest that their doctors may have, the federal government will require all medical device and drug companies to disclose how much they have paid to doctors for consulting fees, research and gifts. These companies will need to make all of this information public by 2013.
In the meantime, patients can find out this information from a database created by the journalism organization ProPublica. The database, called Dollars for Docs, includes the payments made to doctors by 12 companies that volunteered their records for public scrutiny. In addition, patients are encouraged to look into their doctors' histories to find out any negative information on their track record. State medical boards have information on any criminal convictions that a doctor has received, as well as disciplinary action that was taken against the physician. It is important for patients to keep well informed of who is treating them, what type of treatment they are getting and why in order to stay safe.