The relationship between the medical profession and industry has drawn the attention of academia and the lay press for decades. There is literature that demonstrates the influence marketing can have on physician decision making. Many residency programs now provide structured education on professionalism, including discussions of this interface. Physicians frequently interact with representatives of pharmaceutical companies, device makers and medical supply companies and are challenged to make ethical choices that focus on the care of patients and educational opportunities.
There is increased scrutiny of this relationship and prosecution of those involved in inappropriate relationships. The American Medical Association, the American College of Physicians, the California Medical Association and many subspecialty organizations have set up guidelines for interactions with industry. Many academic institutions have benefited from relationships with industry with both financial support and scientific interchange. Industry helps support important basic science and clinical research.
The increased scrutiny has led to legislation that requires public disclosure of these interactions. This is often referred to as the “Sunshine Law.” If you scan the website noted in the article published in the paper recently (The Tribune, April 29), you will note the inclusion of prominent academic institutions and researchers. The purpose of the law is to make the relationships public to prevent inappropriate interactions. The fact that one’s name appears on the list does not mean that there is an inappropriate relationship. It merely documents the relationship.
The development of new drugs and medical devices requires physician involvement at various levels. The FDA requires two randomized studies of the drug’s efficacy prior to approving it for use. Such studies are labor intensive and require physicians to function as primary investigators. These physicians are appropriately compensated for their time and efforts. Many of the physicians listed on the website are funded to do clinical and basic science research.
Medical education is an important aspect of quality care. Unfortunately, government funding of graduate medical education is diminishing. Industry support for medical education is important to inform physicians regarding new therapies, changes in therapy and drug safety. There is clearly a difference between nonbiased support of the educational process and marketing. Hospitals and academic institutions have very restrictive guidelines for approval of educational seminars that are funded by industry.
The San Luis Obispo County Medical Association (SLOCMA) understands the community concern over this subject. We feel the majority of physicians interact with industry in an appropriate and ethical fashion. Transparency in the relationship is a powerful tool but should not be misinterpreted to discourage appropriate interactions of physicians with industry. The listing of names and amounts of compensation may inappropriately lead patients to conclude that the physicians listed are tainted. It is the nature of the relationship that is important, not the mere presence of the relationship.
As the voice of organized medicine in our County, the SLOCMA is disappointed by the incomplete reporting on this subject. We hope that in the future, prior to reporting on what can be construed as a controversial subject, that a more complete job of research is performed prior to publication. More in-depth research would have provided a more objective article, one that did not implicitly taint the names of some very fine and ethical medical colleagues.
The SLOCMA board of directors: Dr. Ahmad Amir; Dr. Rene Bravo; Dr. Douglas Cannon; Dr. Tom Hale; Dr. Vance Rodgers; Dr. Joe Schwartz; Dr. Fred Vernacchia.