Wednesday, January 25, 2006

Medical professionalism and Big Pharma

An article in today’s JAMA received heavy coverage in the media and around the blogosphere. (Via DB’s Medical Rants). The authors, concerned that the pharmaceutical industry corrupts medical ethics, want stringent regulations. My first read was the New York Times coverage which hypes the issue in the opening paragraph: “The free gifts, drugs and classes that pharmaceutical and medical device makers routinely give doctors undermine good medical care, hurt patients and should be banned, a group of influential doctors say in The Journal of the American Medical Association.” (Italics mine). So--- pens, note pads, drug samples and sponsored CME activities hurt patients! The JAMA authors, to their credit, said no such thing. And, as I have blogged previously, there’s not a shred of evidence to support that assertion.

I agree with some of the points in the JAMA article. However the authors are inconsistent on their position concerning conflict of interest. Out of concern for conflict of interest they argue for elimination of small gifts yet acknowledge the token nature of such gifts under existing regulations.

They assert: “Arguably, the most challenging and extensive of these conflicts emanate from relationships between physicians and pharmaceutical companies and medical device manufacturers.
” Yet, as Health Care Renewal pointed out today, our profession is faced with many conflicts of interest other than those created by the pharmaceutical industry. Perhaps the most pervasive, at least in primary care, is the perverse financial incentive to spend less time with individual patients due to an ill conceived compensation system, as recently pointed out by DB.

Finally, I think their restrictions on CME support are ill advised. I’m afraid if they have their way we can say good bye to Medscape, emedicine, and CME as we now know it.

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