The drug companies never cease to amaze me. When they can’t find reputable doctors to tout their products, they hire doctors who have been disciplined by the Texas Medical Board. This behavior was documented in a recent article in the Dallas Morning News. You should read the entire article, but here are excerpts:
The 33-year-old woman suffered from bulimia, anorexia and drug addiction. Her psychiatrist, Dr. Wayne C. Jones of Richardson, prescribed stimulants, antidepressants, anti-psychotics and a drug used to treat a thyroid condition.
After the woman died of an overdose, a suicide, the Texas Medical Board found in 2000 that Jones “failed to thoroughly document his rationale for administration of dangerous drugs.”
Jones has had other troubles with the medical board since then: A pending complaint accuses him of “negligence in providing medical services … poor medical judgment, poor decision-making and non-therapeutic prescribing.”
But that hasn’t stopped drug companies from seeking – and paying for – his expertise. For example, Glaxo-SmithKline recently reported paying Jones $27,000 as a speaker. Pfizer paid him $1,126.
Jones is not alone. An investigation by the journalism website ProPublica, in conjunction with The Dallas Morning News, found that 46 physicians in Texas who have been disciplined by the state medical board have received more than $800,000 from pharmaceutical firms since 2009.
The doctors are not prohibited by the medical board from accepting these payments. Individual amounts from drug companies – usually fees for consulting or speaking engagements before other physicians – ranged from a few hundred dollars to tens of thousands per physician. The violations cited by the medical board went from the relatively minor to sexual contact with patients and repeated “non-therapeutic” prescribing of drugs.
Dhiren Patel, a Dallas psychiatrist, was found by the medical board to have grabbed and kissed a female patient outside the office and to have made graphic sexual remarks to her. According to figures from ProPublica, Patel has been paid $96,229 by one drug company since 2009.
Patel denied the patient’s allegations and defended the pharmaceutical fees. “It’s not my position to judge other physicians,” he said. “I know many around this area who have done far worse and are paid by pharmaceuticals to speak.”
In all, ProPublica found that drug companies have made more than $19.5 million in payments to more than 1,100 Texas physicians since 2009 for promotion or consultation. Nationwide, ProPublica discovered more than 30,000 payments totaling nearly $282 million.
Those numbers are far from comprehensive. Only seven of the more than 70 drug companies operating in the U.S. have disclosed such payments, either voluntarily or through legal settlements. Rules in the new federal health care legislation require companies to disclose such payments, but not until 2013.
Whether the drug companies made a bad decision hiring disciplined doctors depends on the situation, said Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston. It would depend on each case and how the doctor reacted toward the findings, he said.
But to ask whether pharmaceutical companies should hire disciplined doctors may be missing the point, Brody said. He questioned why any doctor should be compensated by drug companies to tout their drugs.
“We are just kind of in denial about this,” he said. “And this has perpetuated – this willingness of doctors to take this stuff that if they were lawyers, and if they were journalists, red lights would’ve been going off a long time ago. Bells would be ringing. People would be shrieking about unethical behavior. And somehow in medicine, this came to be tolerated.”
Medical ethicist Brody said that if a drug works, companies shouldn’t have to pay doctors for promotion.
“Why should the pharmaceutical industry be paying money to any group of doctors to shill for them, which is basically what’s going on here?” he said. “Why shouldn’t the public distrust any doctor who is in this kind of thing?”
