Honesty and Transparency in Medicine

This week, Glaxo Smith Kline was fined three BILLION dollars for health care related fraud in falsely marketing several of their drugs.  Criminal charges would have been more effective, since the company had already put over 8 billion dollars away (in a rainy day legal fund) for just such an eventuality, (and they can always just pass any fees along to consumers in price hikes..)

The company had been falsely advertising the uses of several of their medications in direct-marketing campaigns to consumers as well as materials (bribes and gifts) to health care professionals.

This harkens back to the days of patent medicines and cocaine laced cough syrups were advertised as ‘cure all’ but it’s actually not the most disturbing part of the story.

This is.

Glaxo Smith Kline (GSK) was also caught paying celebrity physicians to endorse these medications for off-label or unapproved uses – including noted personality, Dr. Drew.  Now, this is nothing new, as we’ve stated.  In fact, several of Oprah’s personal gurus have been caught with their hands in the cookie jar, so to speak – but it is part of a disturbing larger trend of betraying public trust for personal gain.

Unfortunately, in this post-modern world of “Greed is good” and almost daily reports of corporate misdeeds – the fact that a huge company such as GSK would do this – is to most people, unsurprising.  A shrug, and a yawn – change the channel to ESPN.

Odious, I know that corporate responsibility has become such a joke, but even more disturbing is the lack of personal and professional responsiblity on the part of the health care providers that helped endorse these products.  

I don’t just mean Dr. Drew, and his equally contemptible counterpart, Dr. Phil – I include every single one of us – in our white lab jackets.  If we are in a position of public / patient trust – then we must take that very, very seriously and know that our integrity, our reputation and our ethics ARE NOT FOR SALE.

I write about medical tourism every day because my absolute conviction that someone needs to provide transparency , honesty, and objective information in this unregulated industry – but at the same time, I strive to ensure that my readers know EXACTLY where I am coming from.. All of these celebrity endorsers, and even our own family doctors need to so the same.

There was a recent bill passed that requires physicians to do exactly that; and the doctors I know back in the USA have been lamenting about disclosing the number of free lunches, and speakers fees that they receive every year because they think ‘it makes me look bad.’  If it makes you look bad – then maybe you should reconsider doing it.

Sometimes it really isn’t greed – its convenience.  Often drug companies provide dinners with speakers who have conducted research or written academic articles on hypertension, or cancer, or other various topics of interest.  [the new restrictions mean that drug companies aren’t supposed to just have speakers say – “hey, prescribe drug X to all your patients.” ]

So – you’ve worked 12 hours taking care of patients all day, and you are tired, but you read a bit about the study in the New England Journal of Medicine – and now you want to know more.. Having a bite to eat at the same time just makes sense, right?  But it’s about transparency.

So – if you really want to hear a presentation about a recent study in cardiology, go to the ‘dinner’ but pay your own way. 

This is why, in recent years – researchers and presenters have to disclose – whether or not they received money, gifts or other services to do their research study, or give the presentation..

In a larger sense – it means that celebrity endorsers and even people like me, (who are writing for a presumably larger audience who doesn’t always know these rules) that we have duties and obligations to the public: we have a duty to be transparent.

It’s not just that we shouldn’t take money to tout a product, or a service.  It’s also that we need to be willing to disclose our financial information, if needed, to demonstrate that.

It’s something I am fully willing to do – and have done, several times.  Embarrassing, yes – to admit to people:

a. I don’t make much – because I don’t receive, and have never received money from medical tourism companies, doctors, etc.. (and my book sales are less than stellar).

b. sometimes my parents have actually helped me – because as embarrassing as it may be as a thirty-something adult – I would rather take money from parents then sell my integrity.  Their money comes with less strings – they give it because they believe in what I am doing.  (Now before you get the idea that I am some sort of “trust-fund baby” – let’s clarify that right now).. if you saw my pathetic financial statements it wouldn’t be an issue, but transparency, right..

you’d see that I make the majority of my living as a nurse, working in short term positions.

my husband, a computer technican, contributes through his own short term work.  (Sometimes he repairs our neighbors’ computers too for a fee).

you’d also see that writing does not pay – or it pays a pathetic amount.. All the articles, books, etc. combined equal less than one paycheck as a nurse. (and Yes – it is humiliating to admit that I’m no best-seller, but readers deserve no less than the truth.)

(You’d also see a pile of student loan debts, that I am slowly, and steadily attempting to pay off, but that’s another issue.)

No huge sums.  No big payouts.  And no sneaky, sideways, or under the table dealings.

Now, Dr. Drew, Dr. Oz and every other ‘expert’ touting themselves on television to the public, under the guise of their medical credentials, or white coat and stethoscope needs to do the same.

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