Corporate Influence On Physicians Must Be Checked

To the editors:



Katherine Gray reported on a recent feature of medical journalism (“Journal Has Docs Disclose Conflict,” news, Aug, 11)—in an effort to maintain scientific credibility for their publications, editors have increasingly insisted on disclosure of the funding sources and individual intellectual contributions of medical authors.

From such disclosures it quickly becomes apparent that much “research” is simply a feature of a broad continuum of pharmaceutical and medical device promotion. The research is designed and processed by industry; the FDA accepts the selective data; the audience of prescribing physicians is primed with a beautiful array of advertisements and educational promotion; the “thought leaders” among physicians are paid to lecture and influence; academics further work mightily to expand a disease concept to include greater application of product; emoluments are funneled to favored physicians to perform pseudo-research “seeding studies” to introduce prescription momentum into communities, and finally, platoons of sales agents (90,000 currently) arrive with catered lunches in physicians’ offices, carrying loads of starter samples.

There’s nothing surprising here. That’s the way it works, and it produces marvelous disarray in the ethics, delivery, and pricing of certain health services. The physician and his employer are simply the point-of-sale brokers for drugs and devices and very readily cede their fiduciary responsibility to the marketplace. It is all the more remarkable that several institution-wide reforms have been made to block the promotional juggernaut: namely, the efforts by the University of Pennsylvania, University of Michigan, and several others. It’s too bad the initiative doesn’t come from our government.





JAMES H. LAMPMAN ’68

Bismark, N.D.

August 16, 2006



The writer is a physician.