A recent Pro Publica report finds that doctors at for-profit and southern hospitals are more likely to take money from pharmaceutical companies and medical device companies. What does that mean about the hospitals at which these doctors work? And, why should you care?
In prior Just Care posts based on earlier Pro Publica research, we’ve explained that some doctors take tens or even hundreds of thousands of dollars in money and gifts from pharmaceutical and medical device companies. You can learn about your doctors’ relationship with these industries here. We’ve also explained that doctors who accept gifts from industry, even free lunches, are more likely to prescribe the products to which the gifts were linked.
The question we should care about is whether the doctors who accept industry gifts and use these products are acting in the best interest of their patients. Or, are they conflicted, prescribing drugs and using products on their patients that are more expensive and deliver less value?
Overall, two out of three doctors take money and gifts from the drug and device companies. In some states, an even higher proportion of doctors take money from these companies. In New Jersey, Pro Publica found that eight out of ten doctors took money and gifts from these companies. And, in Louisiana, Mississippi, Florida, South Carolina and Alabama, more than three out of four doctors accepted drug and device company money and gifts.
The rate of acceptance appears to turn in part on whether states have had policies in place requiring public disclosure of gifts, policies that predate federal disclosure requirements. In some hospitals, three of ten doctors or fewer accept fees and perks from the drug and device industries. Vermont has the lowest rate, at fewer than one in five doctors. In Minnesota, three of ten doctors accept fees. And in Maine and Massachusetts, fewer than half do.
Not surprisingly, hospitals that have rules banning drug and device company reps from meeting with doctors in their hospitals to promote a drug or device have the lowest rates of gift acceptances by doctors. Kaiser Permanente has such a ban. Since 2014, Kaiser staff may not accept anything of value from industry. “Our intent was to disrupt the strategy of using what industry calls ‘food, friendship and flattery’ to develop relationships with prescribers and influence the choice of drugs, the choice of devices, implants, things like that,” said Dr. Sharon Levine, an executive vice president of the Permanente Federation.
Pro Publica also found some instances in which a small proportion of hospital doctors took money or gifts but that those doctors accepted large gifts.
There is no consensus as to when it is appropriate for doctors to take money or gifts and, if it is, how much is too much. And, we don’t understand the degree to which these gifts are driving up health care costs or hurting patients. Based on the amount of money the pharmaceutical and medical device companies invest in building and maintaining these relationships, we can be sure it’s helping their bottom lines.
Here’s more from Just Care: