Dec 202010


(1)  PBS, DOLLARS FOR DOCS, December 20, 2010


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(You may want to click on the above link which takes you to a video.  Or, read the transcript below.)

Dollars for Docs
Medical School Professors Violate Rules By Accepting Paid Speaking Roles

Monday, December 20, 2010

More Dollars for Docs

GHARIB: Many medical schools and teaching hospitals have new policies to put your interests first. Those rules ban faculty members from serving as paid speakers for drug products. A new investigation by the independent newsroom Propublica found those policies look good on paper, but don`t always work in practice. Tonight Darren Gersh continues our “Dollars for Doctors” coverage, with an ongoing examination of the monetary ties between drug companies and your doctor.

DARREN GERSH, NIGHTLY BUSINESS REPORT CORRESPONDENT: They are some of the most prestigious medical schools in the country: Stanford University, the University of Pennsylvania, the University of Pittsburgh, the University of Colorado Denver. But reporters for the independent newsroom Propublica found dozens of faculty members at these schools were accepting payments to speak on behalf of drug companies, an apparent violation of university policies banning the practice. The names were found by searching a new database developed by Propublica, which tracks payments to doctors from some of the nation`s largest drug companies.

CHARLES ORNSTEIN, SR. REPORTER, PROPUBLICA: At Stanford we identified more than a dozen doctors who were giving drug industry talks and Stanford`s policy is very clear on banning that sort of thing.

GERSH: Propublica`s Charles Ornstein says the violations at Stanford are surprising, given that the university has taken the lead in restricting drug company sales reps on its campus and put in place a ban on speakers` programs last year.

ORNSTEIN: We`re not talking about $1,000 or $2,000. One of the doctors who was the vice chair of the medicine department and he brought in more than $50,000 speaking on behalf of Eli Lilly. Then there were two doctors who each took in more than $100,000 in their speeches.

GERSH: In an email to faculty, Stanford Dean Philip Pizzo called the conduct unacceptable.

PHILIP PIZZO, DEAN, STANFORD UNIVERSITY SCHOOL OF MEDICINE: We simply do not believe, do not advocate for or affirm in any way that physicians, particularly on our faculty, should be involved in marketing for industry.

GERSH: Pizzo says there`s no question some faculty violated Stanford policy and he says the university is evaluating what the consequences should be.

PIZZO: Across the board, everyone who has seen their names on the list has been very, very remorseful and very apologetic, didn`t realize that they were violating the policy and very quick to say that they were going to be ceasing and desisting this going forward. That`s important. That`s how change occurs.

GERSH: The Association of American Medical Colleges advises its members to ban drug- company sponsored talks. But its President Dr. Darrell Kirch, says the group doesn`t have the power to monitor enforcement of those policies.

DR. DARRELL KIRCH, CEO, ASSN. OF AMERICAN MEDICAL COLLEGES: Have we attained the degree of adherence that we want? Not yet. But we`re moving much more quickly than I and others thought we might be able to given the complexity of the national health care system.

GERSH: For some medical schools, the key issue is not how much drug companies pay faculty to speak, but how much control the professor has over his or her presentation. In response to Federal lawsuits charging illegal marketing, drug companies have gotten much stricter, requiring speakers to stick to carefully crafted company-provided slides. But critics told Propublica in the academic world, that`s like using someone else`s work.

ORNSTEIN: And here you are teaching students not to take other peoples` work, but yet at the same time, you`re using somebody else`s slides to make a presentation and they see sort of an inherent disconnect in that.

GERSH: Medical schools argue they are striking a balance — banning drug company marketing while encouraging industry to bring discoveries that begin here to the patients who need them here.

PIZZO: We want those kinds of connections to occur. We can`t, as a university, bring things to the public good in terms of products. We can develop ideas that others can work on to develop further. What we don`t want to do is use our name and our reputation to serve as the marketing for industry.

GERSH: But critics of drug company marketing practices say if medical schools want to protect their reputation, they will have to rely less on the honor system if they want to make sure some faculty member names don`t end up on a database like this.

ORNSTEIN: And this is sort of the quintessential surprise is when you discover somebody on a list that you didn`t know about.

GERSH: Tomorrow we`ll learn why medical students are grading their own schools and changing the relationship between doctors and industry in the process. Darren Gersh, NIGHTLY BUSINESS REPORT, Washington.

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Stanford Doctors Face Down Scandal

2010 December 23   1:23 pm

tags: conflict of interest, eli lilly, phil pizzo, pizzo, smithklinebeechum, stanford medical school

by Otis Reid

Stanford Medical School is currently excising itself of conflict of interest issues.

The Stanford Medical School is currently confronting two scandals related to its doctors facing conflicts of interest related to their work for pharmaceutical companies. One scandal is from earlier in December. Two psychiatrists, including one at Stanford university, have been accused of letting a company affiliated with pharmaceutical giant SmithKlineBeechum (now known as GlaxoSmithKline, following its merger with Glaxo Wellcome) effectively ghostwrite the book Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care. Although Stanford Medical School did not adopt a policy against ghostwriting until 2006, well after the 1999 publishing of the text, it still leaves a bad taste in the mouths of people who see the pharmaceutical industry as having too much influence over doctors.

The allegation came to light thanks to the Project on Government Oversight, a non-profit that investigates corruption and conflict-of-interest claims. Alan Schatzberger, the Stanford professor mentioned in the complaint, has not commented on the allegations, but the medical school itself has responded, with a spokesman saying that Schatzberger “strongly den[ies] that the manuscript was ghostwritten.” As Stanford lacked a policy against this practice at the time of the book and as Schatzberger has left the university, it seems as though little more will come of this accusation.

What about the other accusation?

The second accusation might be a bit more problematic: twelve Stanford physicians have been accused of violating Stanford’s 2009 ban on accepting money from drug companies for speaking engagements. The sums paid to the speakers tend to vastly outweigh the relatively modest consulting fees that many doctors receive. Stanford child psychiatrist Kiki Chang received $5,936 for consulting for Eli Lilly. Emeritus child psychiatrist Hans Steiner received an outsize $109,000 from the same company for a talk about its drug Strattera. Stanford Medical School dean Phil Pizzo says that the school is currently investigating these allegations, which were discovered by a different crusading non-profit, ProPublica. Some of the doctors seem to have honestly misunderstood the rules – Dr. Steiner, for example, was apparently under the impression that the rules did not cover emeritus professors. However, others clearly did not suffer such confusion. Pizzo noted:

Some individuals…had understandable reasons for confusion. Others, though, offered explanations why their activities continued that are difficult if not impossible to reconcile with our policy, and here we have concerns…This is unacceptable, certainly for anyone with a Stanford title.

It will be interesting to see what punishments, if any, are meted out by the school for non-compliant faculty, or if the current honor system of reporting is replaced with a more precise system. 12 doctors is a tiny number compared to the 1,500 Stanford-affiliated physicians, but keeping everyone honest should still be a goal of the institution.

COMMENTS (posted on the blog):

Alan Schatzberg:   As the man behind the scandals that led to Stanford revising the ethics policy in 2006 and in 2009, I can tell you exactly what Stanford will do. Nothing.

The administration will close ranks, deny culpability, and wait for this to go away.

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