Could Doctors' Drug Industry Ties Affect Your Care?

He added: "[Physician-industry relationships] bring shame to the profession. They damage the trust between the public and the profession. They raise the cost of care. They threaten patients' health when the wrong drug … is given."

Dr. Peter Schulman, associate professor of medicine at the University of Connecticut Health Center, agreed. "The less those physicians are tied to the pharmaceutical [and device] industry, the better," he said. "Doctors will make better, unbiased decisions regarding therapy for their patients."

But others argue that not all interactions with the pharmaceutical industry are bad. Because physicians often have little time to keep up with new information, some say relationships are necessary for the advancement of medicine and are actually helpful to patients.

Scott Lassman, a senior assistant general council for PhrMA, said that discouraging interactions between physicians and the pharmaceutical industry, "would not be in the best interest of patients."

"We do think the pharmaceutical representatives are able to provide very valuable information about drug products," he said. "We don't think that ought to be physicians' only source of information, but sales representatives can give very valuable information."

Some doctors agree. "It is inevitable that physicians have relationships with people in the pharmaceutical industry," said Dr. Rachelle Smith Doody, chair of Alzheimer's disease research at the Baylor College of Medicine in Texas.

"We would not expect the people who develop our city infrastructure to do so without knowing something about the vendors who support their efforts, or without using the vendor as a source of some information regarding its own products," she said. "Medicine requires some degree of interchange between companies and doctors."

Dr. Keith Isaacson, associate professor of obstetrics and gynecology at Harvard Medical School, added, "There are no longer 'departmental funds' to support research, travel to academic conferences, fellowship training opportunities, et cetera."

He added: "As a result, clinicians have learned to work together with industry. Clinicians have a lot to offer industry such as a good grasp of clinical needs and ideas for new medications and devices. In return, industry offers clinicians funding for research, fellowships and travel."

And, in some physicians' opinions, accepting payment for consulting services or enrollment of patients into clinical trials does not necessary result in bias.

"Payment does not automatically mean bias," said Dr. Charles Blanke, professor of medicine at the Oregon Health and Science University, "but full disclosure of the relationship between company and physician is mandatory. "

Dr. Susan Fisher-Hoch, professor of epidemiology at the University of Texas Health Science Center at Houston, agreed.

"The industry and the profession should be working together to promote health. However, the issue of conflict of interests needs to be clarified, limits set, and statements clearly made publicly."

Disclosure as Absolution

But is disclosure alone enough?

"I don't have a problem with consulting as long as money isn't involved and there is full disclosure," said Dr. Marshall Strome, chairman of the Cleveland Clinic Head and Neck Institute.

However, Hadler said, "Disclosure is not a cleansing event, an admission of guilt or an apology. It is some sort of rite of passage."

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