Tuesday, February 10, 2009


Disclosing Gifts to Docs

The WSJ Health blog has an interesting commentary on the difference between some of the plans for disclosure of gifts to docs put forward by companies and the plan advocated by Chuck Grassley.


Some of the commenters point out that none of this would impact patients; they would not change docs or question a particular prescription.

I wonder if that is true. I'm not talking about the small sums, but if you knew your doc was receiving very significant moolah from this or that company, would it impact the way you viewed that practice and impact your experience and even choices as a patient?


  1. Where is the harm in forbidding any gift giving to doctors or advertising in their office? Why put a pricetag on payola? How much is too much? I should not have to question why my doctor prescribes what he does or what his profit margin is on the drugs he pushes.

  2. Docs who oversee clinical trials--and put serious time into it--are entitled to compensation. The Grassley bill would only make it known what companies are paying docs--I assume (someone correct me) both how much and for what.

    I believe there are relatively few docs who are genuinely, and seriously, "on the take." But transparency on whatever their relationships is the goal here. Assuming the info is fully released, there will be important things to know about _some_ industry-doc relationships.

  3. Hey Justice,

    The gifts are there because the industry "counts" on them having some affect. So, the gifts need to go. Additionally the gifts increase the cost of getting the drugs to market i.e the patients.

    In health care there should be no incentives.

    However, if a doctor is involved in a Phase I, II or III clinical trial, the institution needs to be compensated for the time effort and energy. However, people would debate this in the grander scheme of things. Why? Well within a "for profit" health care as we have here in the US, large health care centers can attract top Doc because of the clinical trials, and patients go there because of the clinical trials. So industry is seen as quite helpful in promoting large centers. There really isn't enough space here to fully go over this topic.

    There is no simple fix to this problem.

    However, we need to come up with ways to restore trust.

    So, yeah, I would want to know how much my Doctor gets from which company. It will figure in my decision making and, if I think it is really important, I will probe the issue directly with my Doctor.

    We cannot trivialize our illnesses, nor the treatments we take to correct them to the point where we forget that we have a partnership role in restoring our own health.

    At the end of the day, while many people working in health care are in the business for altruistic reasons, there is still money on the table. When money is on the table, the dynamics change, whether we like to admit it or not..


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