Under legal pressure in recent years, several of America’s big pharmaceutical companies started publicly reporting the cash payments they make to medical researchers who deliver presentations to other doctors — a good thing. Better yet are federal mandates that will require all drugmakers do that and more starting next year.
But the half steps toward transparency require nothing more than a neutral declaration by a drugmaker that it pays thousands of dollars annually to a Portland or Bend doctor who may use the company’s visual aids and findings in “educating” medical providers.
It shouldn’t work that way. As ethicist and physician Susan Tolle of Oregon Health & Science University puts it: “I think it’s marketing, not education.” So, too, did the more than 100 OHSU students who earlier this year signed a petition saying the school should prohibit faculty from joining the speakers’ bureaus of pharmaceutical companies.
Now OHSU weighs a rule that would do just that, ending even the appearance of conflicts of interest. The proposed rule has cleared the dean of OHSU’s School of Medicine, The Oregonian’s Nick Budnick reports. But it still needs sign-off by the schools of dentistry, nursing and pharmacy before adoption as a university-wide standard.
OHSU and its president, Joe Robertson, should make this standard a reality soon. And OHSU, as the state’s premiere medical research and treatment center, should seize this opportunity to lead by example. A wide embrace of such transparency, particularly in Oregon, would build trust as our health care providers and treatment centers struggle to find thriftier approaches to managing chronic disease and emphasizing prevention.
A medical conflict of interest, real or suspected, runs across several levels. Any Oregonian undergoing medical treatment must have the confidence his or her doctor is possessed of independent judgment and free from a drugmaker’s influence.
But doctors are also entitled to know they’re not being sold a bill of goods by an otherwise well-regarded colleague who “teaches” by using slides and data furnished by a sponsoring drugmaker. And medical students must have every assurance their training and careers will go untainted by bias or any influence that could warp an honest search for truth and treatment efficacy.
In posting to its website a legible and useful state-by-state accounting of doctors who are paid by drugmakers, the newsgathering organization ProPublica found that pharmaceutical companies employed widely different metrics in reporting their payments. That complicates things, at least in the short term.
But an ethics rule is uncomplicated. It simply bars researchers from accepting a drugmaker’s money to lecture, lead a discussion or demonstrate a procedure to our medical professionals. Those activities are within the realm of education, not marketing, and must be safeguarded.