Streams

ProPublica's Dollars for Docs

Monday, September 19, 2011

Charlie Ornstein and Tracy Weber, lead reporters of ProPublica’s Dollars for Docs project, relaunched this month, talk about their investigation into how much pharmaceutical companies are spending to train and ultimately influence doctors about their products. They discuss how much is being paid, why there are payments at all, the issues these payments raise, and how many doctors in New York City are getting money.

Guests:

Charles Ornstein and Tracy Weber

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Comments [16]

ImPatient from NY, NY

Drug reps are not clinically trained medical professionals, they are sales people who work on commission. They are provided company cars and expense accounts for meals, often at haute restaurants. Now, wouldn't you push your product at whatever cost to maintain that lifestyle? Rossella, I'm grateful for your husband's work and wish he was part of the majority.

Sep. 22 2011 11:13 AM
Sick of It All from NYC

I had a primary care physician for two years. I never met the woman. In my half dozen visits to her office, there were never fewer than 3 pharm sales reps---with their little airport carry-all carts in tow---in the waiting room. I'm sure THEY got to visit with the doctor.

The only person I met with---besides the receptionist---was the P.A., who once actually handed over samples of Prozac when I mentioned I was dealing with situational depression!

No, there's no conflict if interest. No problems at all with the health care system. They're all fine, fine professionals. No reason to be cynical or suspicious. Move along, nothing to see here.

What a sickening joke.

Sep. 20 2011 12:12 AM
JD from Manhattan

If the Doctor is being paid or compensated by the pharmaceutical industry, how is that affecting the prescribing practices? Your investigative reporter went on to say this information was not available.

So there was no definitive empirical evidence supporting assumptions and accusations of an unethical or " unholy" alliance between Physicians and the pharmaceutical industry. I applaud WNYC bring this topic to the attention of it's listeners. However, the presentation ultimately failed due the lack of evidence and the reliance on assumption and innuendo.

This program more then once gave the impression that a Physician is influenced by the pharmaceutical representative over what is in the patients best interest.

That's a powerful statement and should be substantiated and was not. In doing so WNYC failed the topic, the listeners and committed a disservice to the medical community as a whole.

The Physicians' first oath is to do no harm. Perhaps the media should consider the same ethic.

Sep. 19 2011 04:51 PM
Rossella from manhattan

I don’t know how ProPublica picked the doctors interviewed for their investigation, but I have a totally different story to tell. My husband is a doctor delivering medical services to community facilities that work with homeless or ex-homeless patients suffering from very serious medical problems. Years ago, he started speaking for a pharmaceutical company and then went on to speak for many others as new medications became available. He speaks only for drugs that he believes will really benefit the patients. Had he just done his job as a community doctor, he would have needed to charge his patients high fees to make a decent salary. He chose to speak for pharma and cut fees for his patients instead. He saw a chance to make decent money, to support his family, and at the same time pursue his dream of helping a population that had many problems getting good medical care. He used his ties to pharma to convince them to sponsor scholarships and awards that benefitted his patients and gave them a chance to live a much better life. Pharma paid because they saw the benefit of sponsoring programs that would improve their image in the community. Over the year he spoke to thousands of doctors, basing his speeches on the slides provided by the pharmaceutical companies but also on his personal experiences. He educated them on the pro and con of using certain drugs, on when to be careful and what symptoms to watch out for etc. He took questions from countless of colleagues challenging what he was saying, because the doctors who attend these events do not go there to passively listen to what the pharmaceutical company are dishing out, like you seem to imply, but rather are there to listen, criticize, and discuss!
So yes, I’m sure there were cases of doctors who spoke for pharma that had no scruples or qualifications or worst yet had severe disciplinary actions taken against them…and there was a time when pharma was too generous with the gifts or acted in dubious ways….but let’s put things in prospective. I’m sure all the bad cases you can come up with still only represent a small percentage. How many are the true experts in their fields that really spoke for pharma because they believed doctors needed to know about these new drugs and how to best use them? And no, my husband doesn’t prescribe drugs to his patients based on what the pharmaceutical companies pay him! He prescribes according to what’s best for them, and generics if they are available! You said you were not allowed to attend any of the speaking events, I wish you could have done so, because you would realize that there is no big monster or scandal hiding there. And if doctors use their lunch or dinner time to get an education..is it really that big of a deal? And by the way… how are these practices different from those of any other for profit company in the USA?

Sep. 19 2011 04:46 PM
Michael From Manhattan from Manhattan

Regarding Mike Pescas followup comment on the amount of money spent on "doctors being bought by food" or "spent on educational meals: " Thats a lot of money, especially if the way to a Doctors' prescription pad is through his stomach." The implication is clear, a Physician can be bribed or influenced. This is clearly a possibility.

Perhaps the host could better serve his audience to allow the guest to present their investigative reporting rather then express his own opinions. Some journalistic objectivity even on a talk show should is not an unrealistic expectation. Mr. Pesca, " the winner of the Edward R. Murrow award for best radio feature," should know his role is to host the show, not be the show. Such off-the-cuff remarks can overshadow the information the investigative reporters are trying to present.

Allow the listener to make up his or her own mind based on the information presented.
Is the host speaking on behalf of WNYC with regards to his opinions?

Sep. 19 2011 04:00 PM
Michael Shakarjian from New Brunswick

"...some companies have been forced to disclose witch doctors as the benificiaries..." Witch doctors?! I'm calling my shaman right away!

Sep. 19 2011 03:54 PM
luke from hoboken

ProPubblica is patting themselves on the back for a database that doesn't really mean much.
They say they do not pass judgement, but they do! They imply that if a doctor takes money from pharma, he/she is corrupt. They themselves use the word "bought" at a certain point..really??? chachkis or a dinner can swing the prescribing habits of a doctor? a pen in the shape of a syringe??Furthermore, they do not differentiate from the speakers, who are hired and paid by the pharmaceutical companies and those attending the speakers' programs which just might be there to get information on a particular product. They put them all together under dollars for docs. And the slides might even be prepared by pharma but I'm sure they can not contain information and data that are not supported by studies approved by the FDA or that are misleading! and of course, once the drug gets off label they stop paying for speaking events...they are not making any money out of it, why should they be the ones supplying information without a return? and by then every doctor should know everything there is to know about that drug! There are much bigger problems in this country ...

Sep. 19 2011 03:11 PM
Rose from new jersey

I think this is a useless controversy.. DO YOU TRUST YOUR DOCTOR OR NOT?all pharmaceutical companies advertise to doctors.. so a doctors sees many reps, all pushing their own products..it is the doctor responsibility to choose the best treatment for his/her patient!!..why do doctor go to pharma for education? because pharma takes them to dinner and educates them while they eat!! doctors don't have much down time.. are extremely busy and it is certainly better to get updates over a dinner paid for by pharma than don't get it at all (which would probably be the case in many instances) ...I seriously doubt that a doctor can be convinced to use a product that would not be the best for his/her patient because he's been attending $50 dinners or has received a few samples!..again in my opinion it boils down to..DO YOU TRUST YOUR DOCTOR OR NOT? IF YOU HAVE DOUBTS ASK QUESTIONS! IF YOU DON'T RECEIVE THE RIGHT ANSWERS.. CHANGE DOCTORS!!! it has nothing to do with how much money they have received from pharma!..personally I want my doctor to be as well informed about the latest medical products and news as he can be.. and if the pharmaceutical companies are willing to pay for his dinner so he can listen to their reps and speakers I really don't think it's a big crime...I trust him to be able to judge what's best for me...it's a capitalistic society after all...while should pharma not be able to advertise their product like any other company?.. In my line of business we get dined and receive perks all the time...does it mean I would choose a product over another depending on that? no I research...I choose the product depending on which one is the best for me and my company...don't you?

Sep. 19 2011 02:07 PM
Peter Panic from Just above you

We will never be able to keep up our leadership as the most expensive health care in the world unless we condone and encourage doctors to be in the thrall of pharma.

I was very disappointed to see my own primary care physician only taking one free lunch a year (what can you eat for $18?). No wonder the poor guy has to work so hard.

Sep. 19 2011 01:27 PM
Eduardo from Phila from Phila

Interesting show...

1 -- many journal articles are ghost-written by writers hired on the pharm companies behalf

2 -- no longer able to jet doctors to Bermuda or Las Vegas, companies now bring them to high-value cities like NYC, New Orleans, and San Francisco

Sep. 19 2011 12:51 PM
John A.

My doctor gives me ~$1K. of my drugs as free samples that he gets. Cost to me in additional visits to the doctor? About the same.

Sep. 19 2011 12:43 PM
bk from Nj

Lis- ask your doctor how much time he or she has to read dozens of medical journals to get the results of the most recent clinical trials.
I am a drug rep and we do our best to provide the doctors with the most recent relevant data related to our products and disease states. I wouldn't mind seeing these speaker dinners going away (I don't see much return on these) but doctors need to be able to get the rundown in a short timeframe during his day.
Lastly, these speaker programs present te exact clinical data that the FDA requires and approved in every Package Insert that comes with each prescription.

Sep. 19 2011 12:39 PM
Dorothy from Manhattan

Insurance doesn't cover name brand drugs when there's a (usually lower priced) generic available. I do not intend to diminish the importance and validity of ProPublica's investigation.

Sep. 19 2011 12:37 PM
thatgirl from manhattan

the doctor that called in can boil this down to "information transfer", but rare to never would a doctor review the slate of available pharmaceutical options with a patient (including OTC), and weigh the pros and cons of each, and help guide real choice--and nowhere in the world but here do we have, normally, a choice of several different molecules. they whip out a script pad, tell you what they want you to have filled, and move on to the next customer.

Sep. 19 2011 12:36 PM
thatgirl from manhattan

thank you, propublica, for your ability to cut through the influence of this too-powerful industry in a way that even NPR can't, because of the undue influence of their corporate financial sponsors!

Sep. 19 2011 12:30 PM
lis from nyc

why are doctors going to drug reps for medical education? do they stop reading actual scientific studies at graduation?

Sep. 19 2011 12:27 PM

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