Monday, April 12, 2010

Conflict of Interest and the Cost of Medical Care

Every now and then there are media reports about the big bucks that drug and medical equipment companies spend on physicians for “conferences,” “seminars,” “research” and other cover events for the payment of money or the gifting of travel.

We’ve all been in an examination room and seen that pretty much everything in it is labeled with the name of a provider. We’ve seen the good-looking young men and women “just checking in” with the receptionist to see if Doctor (why is there no “the” in front of the noun in the medical field?) so and so “had a moment.” When told no, or it would be a while, they smiled and left some pens, pads and a box of cookies.

A few years back, I had some peripheral contact with a company whose entire business plan was catering lunches for drug and equipment companies’ “learning lunches” at doctors’ offices.

I’m pretty sure that a physician wouldn’t prescribe a drug or treatment that would harm me because of a free pad, pen, lunch or even a seminar fee and all expenses at an expensive resort; but, might he or she prescribe a drug that just might not be the absolute best, or might be a tad more expensive because of the bribes?

In the same light, might I be “ordered” an MRI at a facility that the physician just happened to be a part owner of?

The answer to both questions is, I think, yes.

Have you ever been in a doctor’s office and been told “you’re due for an xyz test or procedure” and upon inquiry learned that you are “due” because the insurance company will pay for said test or procedure every so often even though it isn’t a medical necessity for you at that particular time?

I wonder if this kind of stuff will change under Obamacare? Probably not. How much do the companies spend on the bribes? How much more than a truly competitive fee for the MRI are you paying? How many medically unnecessary tests and procedures are ordered because someone convinced insurance companies they should pay for them? My thought is that it adds up.


fermicat said...

Judging from the uproar that the new evidence-based guidelines for breast cancer screening caused not long ago, I would guess that the public will demand to have whatever tests they have grown to think are necessary, whether it makes sense for that individual or not.

By the way, under strict new ethics rules at my employer, no one is allowed to take anything free from a vendor. No pencils, pens, mouse pads, toys, free samples, or meals. Not even a mint. We are also not allowed to give vendor samples to our patients.

Posol'stvo the Medved said...

I did some work a while back for a company who's sole purpose was to help pharma companies measure the effectiveness of this type of swag giveaway marketing on how frequently their products were prescribed.

Yeah, Dave. You're kind of on the money here.

But, to balance that out, I also do work for an organization who delivers continuing medical education that is free from influence from the pharma companies. At least, I hope it balances out, kharma-wise.