April 14, 2011

Every day doctors see many patients and expect to be paid for their services, as it should be. Many are paid by their patients’ health insurance coverages and by their patients’ co-pays (which seem to increase every year). But are our doctors receiving compensation for their professional services from other sources? And how may the receipt of compensation from our sources affect the treatment recommendations they provide?

For many years, many primary care physicians (internists and family practice specialists) as well as other physician specialists received things of value ranging from pens, mugs, and free lunches for office staff to exotic vacations described as professional development seminars held at luxury resorts, from pharmaceutical companies and medical device manufacturers. While many of these perks have been eliminated, doctors may still receive pay for research, speaking engagements, onsulting services, advising, and they may own stock in companies involved in their medical field. These possible conflicts of interest raise potential ethical and other issues that impact the decision-making processes of the doctors involved.

By way of example, “clinical practice guidelines” are developed and established for many medical specialties in order to provide doctors and others with authoritative guidance on the comparable pros and cons of various medical treatment options. The clinical practice guidelines are developed by panels of experts usually within the particular medical field who discuss and debate the proposed contents of the  guidelines. Once the clinical practice guidelines are established, they are followed by the vast majority of the medical specialists within that field of medicine. Therefore, conflicts of interest among the experts on the clinical practice guidelines panels must be minimized if not eliminated so that objective, non biased guidelines can be implemented.

 A recent study found substantial financial relationships to the medical industry among experts who make the clinical recommendations that shape medical care. More than 50% of the people who served on the cardiovascular guideline-writing panels between 2004 and 2008 had financial conflicts. Eleven of the 17 guideline panels had a majority of their members disclosing conflicts of interest. In one case, almost 90% of the people serving on a 2007 guideline panel on intracerebral hemorrharge reported conflicts on interest. In another case, nearly 80% of the people serving on panels covering device-based therapy of cardiac rhythm abnormalities and care of unstable angina had financial relationships with the medical industry.

Even with the disclosure of these conflicts of interest by the people serving on the various guideline panels, how can the results of the panels be considered trustworthy and credible?

When your medical specialist recommends a particular medication or medical device for your treatment, you may want to inquire whether your doctor has any conflict of interest that may be clouding the treatment recommendation such as your doctor receiving any compensation from the pharmaceutical company or medical device manufacturer for consulting, advising, or for speaking engagements.

When medical malpractice causes you injuries or damages, you may need a medical malpractice attorney to help you with your claim. Our website can connect you with medical malpractice lawyers in your area to answer your questions. We can also be reached toll free at 800-295-3959.