ProPublica investigates pharma payments to doctors

ProPublica’s massive investigation into the hefty fees pharmaceutical companies have paid doctors with dubious track records stamps an exclamation point on what has been a banner year for high-profile assaults on pharma-paid physician/marketers.

Books like Daniel Carlat’s Unhinged and Carl Elliot’s White Coat, Black Hat, and the promotional tours that came with them, led the charge and raised awareness of an issue that reporters Charles Ornstein (you may know him as AHCJ’s president), Tracy Weber and Dan Nguyen have driven home with tens of thousands of carefully researched data points and one flagship story.

The ProPublica database is built upon the voluntary disclosures of seven drug manufacturers (Eli Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck & Co. and Pfizer) which represent about 36 percent of the market. Reform law requires the other manufacturers to make similar disclosures by 2013. The package uncovered a bucket of horror stories — that mug shot of high-earner Dr. Donald Ray Taylor next to the paragraph describing why he was disciplined is the very definition of “disturbing” — yet also distinguished itself by giving doctors who rep pharma the opportunity to explain both their work and their motivation.

In its examination of pharma payments, the investigation goes beyond a simple database match with disciplinary records. Some physician/marketers had clearly earned their stripes and displayed impressive resumes and relevant research records, the reporters found, but others had disciplinary records, lacked any board certification or publications or appeared to have been manufactured by the drug-makers themselves.

“It’s sort of like American Idol,” said sociologist Susan Chimonas, who studies doctor-pharma relationships at the Institute on Medicine as a Profession in New York City.

“Nobody will have necessarily heard of you before — but after you’ve been around the country speaking 100 times a year, people will begin to know your name and think, ‘This guy is important.’ It creates an opinion leader who wasn’t necessarily an expert before.”

If you can’t get enough of the investigation, see the work by ProPublica’s partners at The Boston Globe, Consumer Reports, the Chicago Tribune, Nightly Business Report and NPR.

Finally, don’t miss the comments on the article, headlined by a lengthy response from the leading pharmaceutical industry group.

4 thoughts on “ProPublica investigates pharma payments to doctors

  1. Avatar photoPaul Raeburn

    I wrote a contrarian view of this investigation at the Knight Science Journalism Tracker:

    I’m arguing that this is an important and valuable project, as Andrew says. But it’s much, much too much. I counted a dozen anecdotes in the ProPublica story, many more than I needed to get the idea. I’m sorry to criticize such a worthwhile job, but I just couldn’t get through it all.

  2. Avatar photoElaine Schattner, M.D.

    This is a really important story.

    Andrews’ right in mentioning the ego-boosting effects of the pharma-gigs, which make some doctors feel important and valued, even if they’re not particularly good clinicians or exceptional researchers.

  3. Avatar photoAndrew Van Dam Post author

    Having read the full piece, as well as many collaborative and derivative efforts, I would say that Paul Raeburn’s on to something when he talks about anecdote quantity. He was just looking in the wrong place.

    It’s not until you step beyond the flagship story and examine the database that you find the story’s real power, in the form of more than 17,000 anecdotes. Each of them can be effortlessly localized to a state, town, or even individual patient.

    Here are two companion pieces from ProPublica which show the impressive national impact this pile of tiny anecdotes has had:

  4. Pingback: N.Y. reporter finds local doctors in ProPublica database : Covering Health

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