Monday’s WSJ (online now) features an exceptionally important and courageous op-ed by Harvard professor (and frequent co-author of mine, although not in this case) Tom Stossel, discussing a rule within recently enacted healthcare legislation with the Orwellian title, “The Physician Payment Sunshine Act,” focused on physician/industry relationships.
Taking its name from the assertion that “sunshine is the best disinfectant,” the Act apparently aims to help disinfect physicians who might be contaminated by industry contact, an interaction the Act seems to assume is intrinsically corrupting — in stark contrast, one suspects, to the many other activities in which physicians engage, and the many other factors in their environment that might influence their behavior, as Stossel and I previously discussed here and here; see here and here as well.
To restore physicians to their baseline state of virginal professional purity, the Act mandates a stultifying series of reporting requirements, impacting amounts as little as $10. While such reports may be a Pharmascold’s wet dream, they are a logistical nightmare for the physicians involved, and serve to create an enormous compliance bureaucracy for everyone.
My recent experience at an innovation symposium at Duke University, as well as my frequent informal conversations with academic physicians at other leading institutes, suggest the increasing bureaucratic hurdles confronting university physicians seeking to strengthen the essential translational relationship between academia and industry are a particularly unfortunate problem, and are having the presumably intended effect of stifling these interactions. Young physicians worry that the burdensome requirements are overwhelming, while senior leaders seek desperately to avoid the inevitable media takedowns predictably led by the NYT, public radio, and the rest of the usual suspects. (Not infrequently, these stories seem to originate with material selectively provided to a sympathetic journalist by a plantiff attorney — but of course, nothing cozy or sketchy here….)
I’m all for transparency – as are all the university physicians with whom I speak, to a person. But I’m also for common sense, and beyond that, for an environment that seeks to balance appropriate and genuinely useful compliance regulation with an understanding and belief that university/industry interactions are vitally important for the translation of knowledge. Researchers and clinicians seeking to strengthen these relationships deserve to be celebrated, not demonized.
Kudos to Stossel for speaking out, and shame on the sanctiomonious pharmascolds who perpetuate the myths that his intelligent commentary articulately eviscerates.
David Shaywitz is co-founder of the Harvard PASTEUR program, a research initiative at Harvard Medical School. His a strategist at a biopharmaceutical company in South San Francisco. You can follow him at his personal website. This post originally appeared onForbes.
Filed Under: Physicians, THCB
Tagged: Ethics, Pharma, Physician Payment Sunshine Act, startups Jan 27, 2012
Again advocacy for transparency without a plan. The only meaningful plan is to make public all medical expenditures or generated costs by physician. This the cost per physician per year per patient for all public medical charges, Medicare and Medicaid. Published perhaps quarterly on the internet broken down by specialty or type of service such as home health or medical equipment and sorted by zip code. Surely we have the computer power and knowledge to be able to do this and for even more analysis code by things like diagnostic testing or even prescribing data. Let the investigative reporters at the data and they will sort out if grants and financial relationships are related to volume of usage for any of these areas which we get glimpses of in rare expose articles from time to time.
Dear Drs Shaywitz and Stossel,
Thank you so much for your courageous (“an exceptionally important and courageous op-ed by Harvard professor”) engagement for the powerless and marginalized docs connected to the equally oppressed and helpless pharmaceutical and medical equipment industry. Cochones with a capital C.
The “transparency” initiatives in ACA were a cop-out. Both equipment manufacturers and drug companies continue to find ways to pay off the major users/prescribers of their products.
It is hard to argue against physician collaboration with manufacturers in creating or perfecting new intellectual property, but when a device manufacturer has hundreds of “consultants”, which by mere co-incidence includes their top users, or when a pharma company spends tens of millions paying leading physicians to influence the prescribing behavior of their colleagues, there is an unmistakable and pungent odor.
Let’s pay docs for royalties on the patents they own, and be done with it. . .
Better to have forbidden industry payments to physicians and academic departments outright, except for certain highly circumscribed conditions, than to burden every practitioner with expensive and burdensome reporting requirements.