Many Doctors Still Don’t Disclose Consulting Fees

An article in the October 7, 2009 issue of the Atlanta Journal Constitution (AJC) reports on a study showing that doctors are still not disclosing the amount of money, perks and gifts they receive from medical device and pharmaceutical companies. The AJC article was reporting on a “special article” appearing in the October 8, 2009 issue of the New England Journal of Medicine (NEJM).

The NEJM study looked at payments made to doctors from five manufacturers of total hip and knee prostheses in 2007. Each of the recipients in this study was an author of a presentation or served as a committee member or board member at the 2008 annual meeting of the American Academy of Orthopedic Surgeons. Each doctor was asked to fill out a conflict of interest disclosure statement. The results of those statements were compared to actual payments.

The results showed that of 344 payments made to doctors, only 245 of them were reported in the conflict of interest disclosure statement. When a follow-up questionnaire was sent to the doctors to determine why some payments were not reported, less than 40% responded to the questions. Of the responses that were received the most common reason for non-disclosure was that the doctor felt that the payments made were not directly related to the subject for which they spoke on the program.

In the AJC article, lead researcher Dr. Mininder Kocher, an associate professor of orthopedic surgery at Brigham and Women’s Hospital in Boston stated, “In a high-tech field like orthopedics, surgeon relationships with industry are common. The disadvantage is the suppression of negative results and restriction of investigators,” he said. “There is also a risk to the doctor-patient relationship of trust.”

In the article Dr. Kocher suggests that there should be a mandate for all manufacturers to disclose who they give money to and how much. He notes that doctors do not do a good job in voluntary reporting. “Right now, the norm is self-disclosure,” Dr. Kocher said. “There are problems with self-disclosure. Sometimes physicians intentionally do not self-disclose, other times it’s confusing.”

Also in the AJC article were comments made by Diana Zuckerman. She is the president of the National Research Center for Women & Families. Zuckerman noted, “This is really quite sad. It’s amazing, after all these years and all the publicity, people are still not being honest.” Zuckerman rebukes the idea that the reporting is somehow confusing by adding, “Anybody capable of going to medical school or getting a doctorate are perfectly capable of understanding what these conflict-of-interest guidelines are”.

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