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?

[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.

[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]

[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.

[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-

[midland666]

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

[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.

[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]

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.

[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.

[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.