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What the doctor ordered

Patients should know if their doctors get paid by drug firms.

September 08, 2011|By Tracy Weber and Charles Ornstein


He's the expert. But how do you know his expertise is untainted? The makers of the drug, the replacement hip or the stent may have paid your doctor to deliver promotional talks extolling the virtues of the product. Or they could be paying him, or her, to consult on marketing plans. It doesn't necessarily follow, of course, that this kind of moonlighting influences the treatment you receive. And many doctors don't accept these kinds of payments. But if yours does, wouldn't you like to know that?

As it stands, doctors don't have to tell you if they're working with the makers of the products they're prescribing you. They don't have to tell you whether they own stock in those companies or do research on their behalf.

There's no place for you — the patient — to find out whether your doctor is prescribing more drugs or medical devices made by companies with whom he has a relationship.



Many physicians say the close ties between drug and device firms and doctors lead to new and more effective medications, life-saving innovations and a better-educated profession. Although this is certainly true, the relationships also can cause physicians to — consciously or not — downplay side effects and poor research outcomes, studies show.


Only recently have some tools become available to help patients learn about their doctors' financial ties before they are in the exam room.

Several companies, pressured by Congress or required by legal settlements, have started to reveal the names of the doctors they've paid to deliver promotional talks or serve as consultants.

By 2013, every drug and device company operating in the United States will have to do the same, under the healthcare reform law passed last year. They'll also have to say if they've paid doctors for consulting, research, even a dinner.

We've looked at the data from 12 companies, which make up 40% of U.S. drug sales, and found some surprises among pharma's favored speakers and consultants.

Many of the doctors who received the most money hadn't published much in the way of research, and many didn't have associations with academic medical centers. Some had no credentials beyond a medical license. And some had been sanctioned for misconduct by their home state medical boards.

Among the top-paid speakers from that sampling was Santa Monica pain physician Gerald Sacks. Since 2009, he has earned at least $522,113 giving promotional talks and consulting for four companies, according to the data.

Sacks, an anesthesiologist, isn't a leader in prominent pain medicine societies, and several top pain physicians told us they hadn't heard of him. He doesn't work in an academic medical center such as UCLA or USC. He hasn't published much research. We tried to talk to him about what he was paid for, but he didn't return numerous messages.




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