Are Perks Compromising MD Ethics?

Conflict Of Interest Issues Raised By Drug Company Freebies Given To Doctors

(CBS)  This report was created in special collaboration with BusinessWeek.

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For five years, Mathy Downing has struggled for an explanation.

Why would her daughter Candace - a happy 12-year-old - hang herself from the bedpost, leaving no notes and no clue?

"We had no warning," Downing said. "Absolutely no warning."

The Downings blame Candace's suicide on the antidepressant drug Zoloft.

They wondered why the doctor gave such a powerful drug when Candace's only complaint was anxiety in school. Then recently, in their lawsuit against the doctor, they think they found an answer, CBS News correspondent Wyatt Andrews reports.

"I said, 'wait a second … what?'" said Candace's father, Andy Downing.

Wait a second, because Candace's doctor, Matheme Selassie, had been paid around $12,000 making speeches touting Zoloft, with some of the payments coming from Pfizer, the drug's manufacturer.

The Downings believe the money influenced the prescription.

"Did the doctor tell you he was taking Pfizer money?" Andrews asked Mathy Downing.

"Absolutely not," she said. "How dare he! How dare he take money for a medication that killed our daughter."

Today the chances are good your doctor accepts benefits from drug companies - and not just the free samples and the pens you see in most doctors' offices.

Estimates say drug-company payments to doctors go as high as $57 billion a year, according to a University of Quebec study, covering consulting fees, speaking fees on drugs, and medical seminars on the benefits of drugs.

That means the industry spends far more money marketing to doctors than it spends on advertising.

"If they are being paid, it ought to be reported," said Sen. Charles Grassley, R-Iowa.

Grassley is also looking at the money drug companies pay doctors for academic research. He is investigating some 20 top medical schools - including Harvard, Stanford and the University of Cincinnati, for under-reporting the income top researchers are getting from the drug industry.

Grassley wants to learn if the money is influencing research.

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Read BusinessWeek's "Doctors Under The Influence"
Also: "Drugmakers and College Labs: Too Cozy?"

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At Harvard, for example, Dr. Joseph Biederman, whose research has led to huge increases in bipolar diagnoses in children - and the prescriptions to treat those children - is being asked why he allegedly failed to report $1.6 million in fees from drug companies.

What kind of flag does that raise for Grassley?

"Well, it raises a flag to me that they might have something to hide," he said. "It raises a flag that the university doesn't care."

Biederman tells CBS News some of that industry money was "not personal income," and that his life's work is devoted solely "to rigorous and objective study."

Fixing this problem is complicated because some relationships between doctors and drug companies are legitimate, and necessary to achieve breakthrough therapies. Sen. Grassley says the answer is more public information.

Grassley and other senators have proposed a law requiring drug companies to report any payments to doctors of more than $500. That reporting will be available publically on a government Web site.

"There has to be full transparency," Mathy Downing said. "Parents, families have the right to all the information."

As for the suicide of Candace Downing, Selassie says in a deposition he was paid to speak about adult use of Zoloft. He declined further comment.

Pfizer, in a statement says its paid consulting work with doctors helps the company learn "how to reduce adverse reactions ... and improve effectiveness."

But the big question for the Downings is still about the money.

How much of the industry's money is buying legitimate consultations, and how much of it could be buying the wrong prescription?

[j2921610e]

And to add insult to malpractice, have you not sat in a Doctor''s waiting room, 45 minutes past your appointment time, and observed a well dressed, wide smiling, young person walk right up to the receptionist and then right in to the Doctor? The brief case full of samples and the jokes with the receptionist about the expensive luncheon last week give him away as the drug salesman.

[naucoming4u]

"Pre-hypertension"

"Pre-diabetic"

Before the big pharma companies realized they could buy off our doctors like they do with our politicians...

...there used to be a more defined line to determine if you had diabetes or high blood pressure and heart disease.

Yes, advancements in science have found new ailments and treatments for those ailments. But where can trust be found when there are companies who depend on diseases, (mental or physical), to keep their profits flowing?!

[naucoming4u]

Disease(s) and war are far more profitable than...

...health and peace!

[denn034]

All this emphasis upon perks and none on the fact that most doctors are activist liberals that see no problem with abusing their profession by using it to advance their liberal agendas. The fact that most doctors and the medical establishment generally are mostly liberals is an imbalanced environment that couldn''t be considered neutral in any way.

[tongo31]

I think that ALL politicians should also have to report any and all gifts, donations or payments of $500 or more on a public website to insure complete transparency of their actions. Also, any earmarks that a politicians submits into pending bills should also be made public to insure complete transparency.

[luvbug1104]

this really scares me because last year on feb 14, 2007 my son who was five years old was placed on two diffrent kinds of medication for bi-polor he became very distanced from us acting out then three months later he tryed killing himself twice thank GOD my husband and i got to him intime and neither time he was able to doit but thanks to this stupid dr with all his phds and *** i rushed my five year old baby to the er where they told me he had to stay this was at 11pm on june 29th 2007 by 7 am june 30 2007 my son at the age of five years old was being place in a sherriff cruser in the back where no child his age should ever be place taken to the county jail put in a holding cell then placed in a sherriff van and drove two hours away to a mental hospital for two weeks he spent fourth of july 07 there his father and i followed the van from the jail to the mental hospital where we waited 6 hours just to find out what was going on with our baby we as not aloud to see him the first day we had to wait to the following sunday to see him then we was only allowed to see our baby once aweek we was told while he was in the hospital he did not have bi polor and if he does hes way to young if he does have bi polor you cant tell to teen years i could have lost my son do to this stupid dr there really needs to be somethin done with the drs and taken money and everything there doing before more young children die

[denverjohnw]

Great story. There is a lot more to it. I hope you follow this up with more indepth reporting on how drug companies are pushing their pills. Yes, sometimes they are live savers, but too often today they are just band-aids on bullet holes.

I suggest you talk with Dr. Elio Frattaroli, author of a very imporant book, Healing the Soul in the Age of the Brain. www.eliofrattaroli.com

[zerosum2009]

"Overdosed America"
By John Abramson

The drug companies post fictionalized conclusions in medical journals directly after actually proving statistically in the same articles(!)that specific drugs not only do not work--but directly kill people.

To put it bluntly, its also very common for the drug companies to deliberately hire pretty girls to go around and directly influence whether a doctor prescribes a drug.

The whole industry needs to be drastically changed, yesterday--it needs to be nationalized--and this is no joke.

[sistatee-2009]

No school can operate today without its "nurse" pushing the drug cart, room to room dispensing nose candy to all the little 5-yr old psychopaths. Johnny can''t read because he''s morphed out of his skull.

[fstop100]

The drug companies only care about money. If we all died tomorrow and it didn''t affect their profits they could care less.

[garbosmed]

About time! Let''s start with Paul Offit and Children''s Hospital in Philadelphia, why don''t we, and go on from there. How much money have they received from Pharma and vaccine makers? I think patients have every right to know if their doctor''s bank account or office overhead is padded by payments from Pharma or other medical suppliers. And I think that must necessarily include any stock transactions.

[randallk44]

Well, this is another subject I''m glad to see FINALLY covered. Some of the things I tried to bring to my local CBS news attention only to be ignored. They (doctors) get catered in fancy lunches on a regular basis on top of the other things. I know, used to manage my doctor''s computer network. Also had the gall to ask me to give him an inflated quote on a used computer so he could get a bigger tax write off.

So here is another thing tried to bring to many news stations attention. The anti-depressants cause suicidal thoughts in adults as well, not just children! I weened myself of them years ago and not a single suicidal thought has run through my head.

Our nation is broken folks, in its leadership, our bureaucracies, many of our businesses (big & small). As much as the news has been talking about gas, food, etc going up, the disabled have gotten NO cost of living increase. Our heroes returning from war are barely mentioned but if a school wins the national champianship, I''m told on the local news I should be ashamed if I''m not down there for the parade. YEP! We really have our priorities straight, don''t we???

[cyberus-2009]

As long as it is occurring in every government building (in the form of lobbyist money) it will never stop elsewhere.
Why? Because the people that pay for the rules to be made their way won''t allow it. Oh you may see a rule or two put in place ... with loopholes you can fly a 747 through to make sure they were pointless to begin with.
In other words .. until our elected officials are forbidden to feed at the *perks* trough they will see no need to stop others from doing it ... when they can not play the game you will be sure that they will put a stop to others doing it.

[beehive21-2009]

Everyone one is on the take,including,you.

[stick1770]

yep let''s once again point fingers and blame. Let''s medicate ourselves and kids when we have feelings that we are uncomfortable with. How about dealing with the emotions and getting the girl through the issue of attending school. Nope, the parents run to the doctor and look for a quick fix in drugs.

Same with the 20/20 where they were showing parents druging their 2yr old "bi-polar" children. It''s called parenting and it''s something this country is lacking anymore. It''s got to be someone elses fault that the kids are acting up. Drug them. Ah..there now we don''t have to worry about dealing with the children they are nice and calm and burned out on drugs at 3. Good job people. You don''t drug kids, you help them figure out how to deal with the problems they face. Or they turn out to be liberals that look to the government for all the solutions to their fears and problems. Heaven forbid that we actually take responsibility .

[whournameiz]

CBS is starting to become the dumbest news channel. You go and find the most tragic case and then go targetting doctors to make your point. Unfortunately for your story. doctors are not as dumb as your reporting. Don''t you think they teach medical students and doctors about drug companies. Doctors need the reps and vversa. Otherwise doctors would never know about the new medications. 1/2 a sandwich is not gonna make someone prescribe anything more than something else. Is America not done yet beating up on their doctors?

[fharlass]

I wrote an article about this problem many years ago and it was recjected by the major journals. Advertising money, I was told was an issue. This is the reason why I do not attend the major meetings anymore. The drug companies, the MD/DO and the colleges (e.g. ACOG, AAFP, FACS etc.)have strong financial dealings. ALL the major meetings of the colleges are support by the drug companies. Pens, t-shirts, golfballs, food, junkets, etc etc. are pfaid for by the drug companies. Any physicians that says otherwise is being dishonest.
-an MD

[randynason]

Contrary to what some of these posts seem to indicate, the issue isn''t one of being too liberal or overly conservative. It''s an issue of either having moral character, or not. Humanity is not something that can be purchased. It''s developed at a young age and nurtured throughout life. Some people sell it, for a price.

[randallk44]

Well said RandyNason!

I can''t even describe what its like trying to sort it out, for a person like me, with mental illness. Its very frustrating to work as hard as I am able with both mental and a physical disability, to try to be good and honest and left feeling it means very little.

[okie1717]

whournameiz is out of touch. Doctors constantly take gifts, vacations, expensive dinners and, yes, even cash to push drugs. Your 1/2 a sandwich comment is shows your stupidity. I''ve seen the dog and pony show first hand. Check this list of Pharmaceutical companies. It''s highly ompetitve. www.pharmacy.org/company.html I''m guessing already know this. You sound like a rep. This is wide spread and it''s getting worse. New medications aren''t neccessarily better medications. Docs perscribe expensive antibiotics that, in some cases, aren''t any better than the cheaper one''s like Cipro. Another example is Omeprazole, which is the active ingredient in Prilosec. The generic, over the counter Omeprazole is 20mg and cost $7.99 for 14 tabs. The percription Omeprazole is the same drug but only 40mg. It costs $249.00 for 30 tabs! I asked the Pharmacist if I could just take 2 over-the-count 20mg tabs and she said "Absolutely". That''s $32 per month versus $249 per month. These doctors have been taught but, we have all been taught about pitfalls and what not to do when we get older. The problem is, money and greed. There are certainly people who need these medications but, there are many more that do not. I had anxiety when I was in my early 20''s and my doctor perscribed "Lithium". After a 5 minute conversation with him. No physical, no observation, nothing. I''m not Bi-polar and I have never been. It''s a huge problem and it needs to be corrected.

[apprxam]

So far, patients, Big Pharma, For-profit hospitals, insurance companies, medical equipment manufactuers, goverment, lawyers and government, have all been blamed for the poor condition and high expense of healthcare in the United States. When are we going to place of these problems on doctors?

[veolla]

I''m not at all surprised at what is going on in the world today with humankind, for this was fortold in the scriptures.
Know this that critical times hard to deal with will be here. Luke 21:11,12 New world Translation.

Also in 2 Timothy 3:1-5, Men would be lovers of money, lovers of pleasures rather than lovers of God,haughty, and ect. if you look up these scriptures and read for yourself and then you will see why the scriptures are being fulfilled just as it said.

Men in these days have no moral''s, everything goes and it is leading many off to destruction.

False teaching''s, false christ are here and it tell''s us not to follow these.
Indeed the last days are here and those who oppose Jehovah God will be destroyed.

[billoviatt]

I am a nutritional medicine consultant now with 46 years as a scientist/chemist in the antioxidant field. Every day I wrestle with these facts:
1. Legally prescribed and taken Rx drugs are now the fourth leading cause of death in the US - 180,000/year. Behind heart disease, cancer and stroke.
2. The average lifespan of people in the US is now 45th in the world - Japan is 1st.
3. The average healthcare cost per person in the US is now almost $7000/year. Second in the world is Switzerland at around $4300.
Is Big Pharma more concerned with the well-being of their sales and stockholders over their customer consumers? Worthy of serious examination!!

[sparks224]

Are Perks Compromising MD Ethics?

Is thst a stupid question?

[moglislok]

The specific report is biased, because it does not describe the full story of the tragedy regarding the young girl. The photos of the child show a happy teenager, however, if that%u2019s the case why HER parents needed a psychiatric evaluation and accepted the recommended treatment for their child? Where is their responsibility in their conduct and communication with their daughter?

The loss of a child is the most formidable tragedy a parent has to endure; blaming medicine, doctors, or the limited knowledge humans have to deal with disease is just another way to deal with the guilt and frustration that result from a tragedy of this magnitude.

Although I do not agree with the way the system works between pharmaceutical companies and physicians portraying a young girl as a victim of the medication and the doctor who prescribed it CBS is sending the wrong message that the thousands of doctors are collaborating with drug companies to harm their patients for money.

No news here, it is how the game is played, only people a sleep at the switch were not aware of this news. The profit base system of "drugs and surgery" is in full swing ans Big Pharma hides behind the very questionable FDA.

[alphaa10-2009]

The unholy alliance of the medical industrial complex will kill many more Americans before we recognize physicians are fallible human beings, just as subject to temptation as the rest of us.

They can and do make reprehensible decisions based on personal gain, overriding patient interests.

Beyond such persoal failings, however, we must eliminate a system of inbred conflict of interest. Doctors are legally prey to every blandishment lobbyists throw at congressmen-- and more. Too many doctors know only what salesmen tell them about a pharmaceutical-- and many doctors claim they cannot stay abreast of research to evaluate drug maker claims.

While congress at least has begun to recognize its faults, there is little regulation beyond state medical boards. The respective state legislatures are often lapdogs to the state medical associations, which routinely demand, "Leave us alone-- we can police ourselves."

But have they?

[oneworldusa]

I knew a guy who years ago, maybe in 2000, 2001 who worked for a pharm company and was paid $100k to wine and dine doctors, on an expense account, of course.

This kind of nonsense simply adds to the cost of our medication needs. I simply just don''t take anything at all unless its truly needed.

Demand generics and get them at your local store offering a $4 copay. It''s the only way to send the message we won''t be held hostage by unaffordable medications.

Pharm ads should be outlawed again.

[bluestardad]

HEY MEDICAL PROFESSION!

CURE SOMETHING

ANYTHING!

QUIT MAKING MONEY OFF TREATING ILLNESS

PROVE TO THE AMERICAN PEOPLE YOU ARE WORTH THE BILLIONS OF DOLLARS SPENT ON YOU EACH YEAR!

AMERICA DESERVES MORE!

AMERICA STAND UP OR SHUT UP!

[tootall10142]

I take sevral drugs for arthrirtis,lupus and gerd,if you go to three diffrent doctors you will most likely get three diffrent opinions.How do you get the correct answers ? Well first realize if you arent smart enough to understand get some one you know has the savy to explain it youthen lookit up on the net its there if look hard enough.my insurance co. wants me to switch to generics i tell them , hey if you put a suit on snake its still a snake if you dont want to pay premium then talk to your congressman when they change the stupid profit scheme ill change to generic. They knew the cost when they got in the insurance business and i have no sympathy for you.but yo can find sympathy in the dictionary between sh---t and syphliss.

[tootall10142]

I CANT EMPHASIZE ENOUGH ON HOW IMPORTANT IT IS TO KNOW KNOW KNOW WHAT IT IS YOUR ARE PUTTING DOWN YOUR AND YOUR KIDS THROAT,THE DOPERS ON THE STREET SEARCH OUT THE CLEANEST DOPE THEY CAN FIND WHY SHOUDNT YOU DO THE SAME WHEN YOUR DRUGS ARE COMING FROM THE PHARMACY.

[sandy19731]

If you don''t want to deal with big pharm, lose weight, exercise, wear your seat belt, quit speeding, be careful and get violent people out of your life (also relieving stress) and quit running to your doctor for every ache and pain.

[tootall10142]

DONT BUY CIGNA INS. THEY DONT PAY WITHOUY COURT ORDER

[rational_1]

I am a nutritional medicine consultant now with 46 years as a scientist/chemist in the antioxidant field. Every day I wrestle with these facts:
1. Legally prescribed and taken Rx drugs are now the fourth leading cause of death in the US - 180,000/year. Behind heart disease, cancer and stroke.

Where are you getting your information? Here is a publication listing death statistics in the U.S. for 2005.
http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf
Drug-induced mortality was blamed for 33,500 deaths, far less than accidents (177K), diabetes (75K), Alzheimers (71K), pneumonia & influenza (63K) . Note also that the 33,500 figure is all drug-related deaths, which includes overdose deaths from people taking illegal drugs. Your statement about prescribed drugs being the 4th leading cause of death doesn''t seem to be supported by the facts.

2. The average lifespan of people in the US is now 45th in the world - Japan is 1st.
3. The average healthcare cost per person in the US is now almost $7000/year. Second in the world is Switzerland at around $4300.
Posted by billoviatt at 12:32 AM : Jun 27, 2008

Valid points - but also worthy of serious examination are differences in diet and exercise between Americans and those living in other countries. Lifestyle choices play a major role in public health and costs of health care. Blaming it all on Big Pharma is pretty simplistic.

[docpeter-2009]

Posted by billoviatt at 12:32 AM : Jun 27, 2008: "Is Big Pharma more concerned with the well-being of their sales and stockholders over their customer consumers? Worthy of serious examination!!"
____________________________________

It isn''t even necessary to ask tha question. The answer should be obvious. Ask the same question about the insurance industry, oil industry, banking industry. The answer should be an obvious YES to all of the above.

What also really disgusts me is all of the Pharma commercials on TV. I get bombarded nightly for Cialis, Lavitra, Viagra, Prilosec, etc. Ever listen to the commercials, hear the side effects? Why would people want to put the drugs into their system?

Now, how do we get these people out of congress and away from congressional leaders (and doctors for pharma) so that we can become a country of "By The People and For The People"?

The rape of America began many years ago and has perpetuated and festered for far too long.

It is often said the money talks and Bu11sh*t walks. Maybe it is time we wiped the slate clean and started over in Washington. Get rid of the $$ interest and get back to taking care of The People.

[drivelphobe]

sandy19731....

Absolutely correct. Don''t go to the doctor unless you''re bleeding or so ill you can''t move. Enough of the "regular" exam and annual physical routine. Everyone knows what a healthy regimen is but few have the sense to walk the walk. Your doctor isn''t your friend you should go see every time he says he wants to see you. Use your head. The doctors work for you and you pay the bills. Be reluctant to take any medications at all.

[rational_1]

Absolutely correct. Don''''t go to the doctor unless you''''re bleeding or so ill you can''''t move. Enough of the "regular" exam and annual physical routine. Everyone knows what a healthy regimen is but few have the sense to walk the walk.
Posted by drivelphobe at 09:32 AM : Jun 27, 2008

As someone who doesn''t regularly see a physician (despite my wife''s exhortations), I still see very good reasons for occasional health exams, even if I feel healthy. Do you have hypertension, high cholesterol or poorly controlled blood sugar, for example? How would you know you had any of these problems (and others) without occasional bloodwork? So, every few years I go in and get these tests done. It''s better to head off these problems as they are developing rather than dealing with the consequences (stroke, heart attack, diabetes) when they''re established.

[drivelphobe]

rational_1

I agree with your agenda. My point was to use medical care facilities when good sense dictates. I am convinced our healthcare costs are exorbitant due to misuse by both the uninformed populace and the money-grubbing medical industry. We all know individuals who constantly have some kind of medical care going on, and many times it''s benefitting the physician more than the patient.

It is wise to keep an eye on your health, but you are in charge.

[midland666]

this just in,
Cuba has Patented a "Cancer Vaccine"
Not a pill for Prolonging the illness and the payments, but a Vaccine.

[kenhamlett]

The story is thought provoking and should be a series. My response will be in two parts. it is worth the extra typing. The answer is that money is more important than choosing the best treatment. I have come across several doctors in California that were very interested in doing the best job they could for their patients but they were outnumbered by those that could care less. From there it only gets worse. The rules of engagement seem to limit being too specific so I won''t go into detail but I can say that medical care in SC may be the current cesspool of the medical profession so I will use that as the baseline for medical indifference. They only care about money, expedience, personal vanity and manipulation for their own advancement. I''ll say money again just to be sure you don''t miss it. On the whole I think their patients are the unhealthiest people I have encountered in this country. Most interesting the opposite is true with faith based healing there. The docs can''t even educate the people to help themselves. I''ll take prayer. It works better.
See part two-

[kenhamlett]

-Part two
Back to the main theme, the doctors and shrinks pushing drugs for so called mental anomalies are actually enemies of their patient/victims as far as I can see. It is anything goes to gain control. While I am picking on one state the same can one day be said of your community. This is a trend that is spreading. Ignorance and misplaced trust is a prime component but dollars and corruption are they main source of the problem. Most interesting I have noticed good nutrition has solved more problems than these drugs but it is unlikely anyone will admit to that. For most of you shop around for better information. For the rest of you run for your life when the doc shows up.

[billybob5898]

My story is simple. I had 2 massive heartattacks caused be end stent thrombosis. I clinicaly died with each one. Because of ny current condition my doctors say I cant work. My lawyer says that my lawsuit is going to be hard to try because even though the drug companies failed to disclose all of the study to the FDA and the FDA approved their product they can not be held liable. It has also been found out that doctors helping the FDA approval were also working for the drug companies. I would like to hear any coments to my posting. E-MAIL ME AT [e-mail]

[Marie Zarankevich]

Considering the state of medical technology, and our level of control of communicable disease, it is not surprising that the medical field is in flux. -- The true job of medical professionals is to work their way out of a job. -- The fewer sick patients, the less work, the less money available. -- The real need might be to generalize medical care among the population, and stop with all the specialization. -- Good databases, and key specialists can provide most of what''s needed now. -- People are finding that they know more about their condition than their doctor does. -- It might be time for a change, a shift in direction. -- Lay people can do research, too.