Pharmaceutical companies paid out more than $250 million to some 17,000 doctors and nurses across the country in 2009 and 2010, according to a new database compiled and published by ProPublica, a non-profit investigative journalism group.
The data from seven drug makers -- who manufacture about 35 percent of the medications sold in America -- showed that nearly 400 of those doctors received payments of $100,000 or more to promote drugs, serve as medical consultants and speak at conferences.
Separately, ProPublica found records in 18 states that showed 250 of the doctors had been accused of professional misconduct, disciplined by state medical boards or didn't have the credentials to be considered specialists or researchers. The list includes some doctors ProPublica found were accused of sexual misconduct and other criminal behavior.
Does this mean doctors are on the take, prescribing medicines or treatments they might not otherwise recommend? Are doctors corrupted by the money? Not necessarily, said researchers -- but it's complicated.
Susan Chimonas, associate research scholar at Columbia University's Center on Medicine as a Profession, said the database casts light in a shadowy area.
"There are really extensive relationships between doctors and pharmaceutical companies that have been secret from the public," she said. "Now, we're getting a sense of how many there are and the incredible amounts of money that are involved."
It's not illegal for health care providers to be paid by pharmaceutical companies for certain things. Professional societies consider it unethical if a financial relationship isn't disclosed in certain situations. But experts say it should always be disclosed in order to maintain a relationship of trust with patients.
Despite that, some experts say that if a doctor has taken money from a drug company, it doesn't necessarily mean the doctor's ability to serve patients was compromised.
"If there's a relationship at all, it's an inverse relationship," said Dr. Rick May, vice president for clinical consulting at HealthGrades, a health care rating organization. "If you're a drug company, you're at risk if you form relationships with bad physicians since they're representing you."
"Doctors tend to be scrupulously honest, have professional ethics and little tolerance for bad colleagues," said May.
"Only a small percentage of physicians get in trouble," said Arthur Levin, the director of the Center for Medical Consumers, a non-profit consumer advocacy group in New York. "But I expect that there are a lot of doctors out there that have problems, but have kept out of discipline system. That could be based on agreements to stop doing something, to leave the field entirely, etc."
May and Levin advised people to check with state medical boards or watchdog groups in their states to see if a doctor has any sanctions, but May cautions against jumping to conclusions about medical malpractice litigation.
"Some physicians will have judgments against them, but they may be frivolous lawsuits and the insurance company advised the doctors to settle to eliminate the need to defend the suits," said May.