Category Archives: Conflicts of interest

Use caution with new data on doctor payments from drug, device companies

Charles Ornstein

About Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member and past president of the Association of Health Care Journalists' board of directors and a member of its Right to Know Committee.

Photo by **Mary** via Flickr

Photo by **Mary** via Flickr

This article originally appeared on ProPublica’s website.

The government’s new website on drug and device company ties to doctors will be incomplete and may be misleading – for now.

The government’s release today of a trove of data detailing drug and device companies’ payments to doctors has been widely hailed as a milestone for transparency. But it is also something else: a very limited window into the billions in industry spending. Before you dive in and search for a specific doctor, here are five caveats to keep in mind: Continue reading

Covering hospital ratings? Here’s one aspect consumers need you to report #ahcj14

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Photo: Pia ChristensenA Health Journalism 2014 panel about hospital rankings included (left to right) Evan Marks of Healthgrades, Marshall Allen of ProPublica and John Santa, M.D., of Consumer Reports.

If you were at Health Journalism 2014, you might have heard that things got interesting on Saturday when journalists questioned panelists who represented hospital ranking services about their business practices.

Tony Leys

Tony Leys, a reporter for the Des Moines Register, was in the audience for “Hospital grading: Reporting on quality report cards” and asked Evan Marks, the executive vice president of informatics and strategy for Healthgrades, how much hospitals pay his organization to be allowed to advertise their ratings. Marks refused to answer the question.

After the panel, Leys pursued the question and got some details that all reporters should be aware of when they consider writing about hospital rankings, including some concrete data on how much hospitals are paying in “licensing fees” to ratings services. You might use his technique to find out how much some of your local hospitals are paying.

Read this tip sheet to find out more.

Researchers ‘owe’ the public information about financial ties #ahcj14

Blythe Bernhard

About Blythe Bernhard

Blythe Bernhard reports on health and medicine for the St. Louis Post-Dispatch and serves on AHCJ's Right to Know and Contest committees. She attended Health Journalism 2014 as an AHCJ-Missouri Health Journalism fellow, a program supported by the Missouri Foundation for Health.

When writing about medical studies, reporters should always ask researchers about any financial relationships with drug companies or device manufacturers. That was one of the main lessons from a panel on conflicts of interest on Saturday at Health Journalism 2014.

Starting in September, sunshine provisions in the Affordable Care Act will require drug companies to disclose most payments to doctors. Some companies have already started to publicize their financial relationships with doctors. But most medical journal articles do not give accurate information on researchers’ potential conflicts of interest, said panelist Susan Chimonas of the Institute of Medicine as a Profession at Columbia University.

“You shouldn’t be uncomfortable asking these questions,” Chimonas said. “They owe you this information. They owe everyone this information.” Continue reading

Prescribing data and the side effects of assumptions #ahcj14

Jaclyn Cosgrove

About Jaclyn Cosgrove

Jaclyn Cosgrove is a medical and health reporter at The Oklahoman. She is attending Health Journalism 2014 on an AHCJ Rural Health Journalism fellowship, which is supported by The Leona M. and Harry B. Helmsley Charitable Trust.

Reporters curious about the financial relationship between physicians and pharmaceutical companies can use publicly available data as a starting point – although that comes with some caveats, journalists and industry leaders say.

During the workshop “Covering prescription drug data,” Charles Ornstein, ProPublica senior reporter, pointed out resources that ProPublica has created that reporters can use to write stories about doctors in their communities. Continue reading

Reporter looks at why, how clinic banned drug reps and their samples

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Markian Hawryluk

Markian Hawryluk

Six years ago, a clinic in Oregon made the decision to ban representatives from the pharmaceutical companies. The doctors and staff say goodbye to free samples of expensive drugs, lavish lunches, pens, notebooks, mugs, toys for children and other “benefits.”

Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin, picked up on a recent journal article about the transformation and used that as his inspiration to write about how the clinic made its decision and how it changed the way doctors there practice medicine, as well as how the move impacted the community.

As data is collected under the Physician Payments Sunshine Act, a part of the Affordable Care Act that will require pharmaceutical companies to disclose the money and gifts given to physicians, reporters may start noting similar changes in their area.

Read more about how Hawryluk reported the story and what he learned about the influence drug reps and samples have on prescribing.

Independent reviews find less benefit, more harm than first reported for bone protein product

Brenda Goodman

About Brenda Goodman

Brenda Goodman (@GoodmanBrenda), an Atlanta-based freelancer, is AHCJ’s topic leader on medical studies, curating related material at healthjournalism.org. She welcomes questions and suggestions on medical study resources and tip sheets at brenda@healthjournalism.org.

Efforts to correct biased and dangerous medical studies are making more headlines.

Shortly after I posted about a new idea to correct missing and misreported research, I got an email from AHCJ member John Fauber, an investigative reporter at the Milwaukee Journal Sentinel.

His latest story for the Journal Sentinel and MedPage Today involves an extensive undertaking coordinated by Yale University to correct the record on a product made by Medtronic called Infuse. The project is called YODA, for Yale Open Data Access. (Read more..)

Infuse — officially a device — consists of a metal cage fitted around a sponge that is soaked in a genetically engineered protein. The protein is supposed to promote bone growth and healing. It works, but perhaps too well. Side effects linked to its use include bone overgrowth that can trap and irritate nerve roots causing chronic pain. It has also been tied to a complication called retrograde ejaculation, which leads to sterility in men.  Patients who receive infuse also experienced more problems with wound healing and more cancer.

All in all, pretty devastating outcomes for patients who were hoping to feel better after their back surgeries. Continue reading

When disease charities partner with drug companies, where does that leave patients (and reporters)?

Brenda Goodman

About Brenda Goodman

Brenda Goodman (@GoodmanBrenda), an Atlanta-based freelancer, is AHCJ’s topic leader on medical studies, curating related material at healthjournalism.org. She welcomes questions and suggestions on medical study resources and tip sheets at brenda@healthjournalism.org.

A few weeks ago, I reached out to a disease charity for comment on a story I was working on. Disease charities are nonprofits like the American Heart Association, the Cystic Fibrosis Foundation, etc., that raise money to support the research, care and awareness of people who live with a given condition.

The story was about a rare but very dangerous side effect that was tied to new drug. The side effect is considered so serious that other drugs that cause it have been yanked off the market because of the risk.

I expected the scientific officer I spoke with to react to this news, which was published in a top-tier medical journal, with alarm and concern for patients who were taking the medication, which is poised to become a blockbuster. Instead, though, he was largely dismissive of the reports. He extolled the potential benefits of the newly approved medication for patients.

As reporters, we all have those moments when our spider senses tingle. You may not be able to put your finger on exactly why, but something just doesn’t feel right. Continue reading

Pharmaceutical industry influence starts with the doctor’s prescribing pen #ahcj13

Tracey Drury

About Tracey Drury

Tracey Drury is a reporter at Buffalo Business First. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Can a doctor’s prescription be bought for a tuna sandwich?

Whether it’s a tuna sandwich, steak dinner or a four-figure payment, there’s always the possibility of influence. And that’s how conflicts of interest begin in the medical field.

That was the message this morning from reporters Peter Whoriskey of The Washington Post and John Fauber of the Milwaukee Journal Sentinel during their panel on reporting on medical and financial conflicts of interest during AHCJ’s Health Journalism 2013 in Boston.

“Their job is to sell as much product as they can and maximize profits,” Fauber said of the pharmaceutical companies. “One of the ways they do that is by creating financial relationships with various stakeholders, which can be doctors, medical societies or medical schools. While this may be good for the bottom line of the drug companies, it may not work out for the patients.”

Fauber advised journalists to be on the watch for several things: promotional speaking gigs by physicians; participation in continuing medical education (CME) events; financial relationships between medical journal editors and drug companies; and royalties that come back to hospitals and physicians.

“It struck me very quickly that all the cynicism the media brings to politicians or companies, anybody, is held in abeyance for doctors and anybody that wants to heal you,” Fauber said. Continue reading

Using data to track doctors’ referrals, relationships #ahcj13

Jason Hidalgo

About Jason Hidalgo

Jason Hidalgo is a business reporter at the Reno (Nev.) Gazette-Journal and a 2013-14 AHCJ Regional Health Journalism Fellow.

Fred Trotter

Photo by Pia ChristensenFred Trotter.

Going online is usually a great way to waste time or — for adventurous social media users — get in trouble.

For resourceful journalists, however, the Internet is a treasure trove of information that can be invaluable for reporting. These include providing access to open-source tools such as DocGraphs, which can provide crucial data that may not easily be available anywhere else.

A crowdfunded project from open source developer Not Only Dev, DocGraphs aims to shed light on the relationships between various medical providers, and make that information more accessible to the public. Examples include which doctors and medical centers a specific doctor refers patients to or which laboratories a physician group tends to use. Continue reading

Panel will discuss newly released 990 data on hospitals #ahcj13

Karl Stark

About Karl Stark

Karl Stark, the assistant managing editor for health and science at The Philadelphia Inquirer, serves as president of the AHCJ board of directors.

AHCJ has just released a new trove of information from GuideStar on the finances of nonprofit U.S. hospitals. This information – from tax years 2009 and 2010 – contains carefully selected highlights from the hospital’s IRS 990 forms, which nonprofits must file to maintain their mostly tax-free status.

Reporters can use this AHCJ spreadsheet to get:

  • detailed salary info on top executives
  • the institution’s charity care and community benefit numbers
  • a hospital’s lobbying expenses
  • and the business relationships of board members, among other things.

This data will be discussed at the Health Journalism 2013 session, “Diving into documents: Using 990s and more to cover hospital finances,” on Sunday at 10:40 am. Howard Rivenson, senior lecturer on health management, Harvard School of Public Health, will join me to help demystify hospital finances.

The newest material from 2010 is here and here are last year’s data.