Should Doctors Be Barred From Accepting Perks?

Q. I’ve been reading in the news about gifts and payments to physicians from drug companies and medical-device makers—free samples, trips to conferences, speaking and consulting fees, research grants and so on. Why aren’t these prohibited?

A. A growing number of medical professionals and government regulators think these kinds of financial relationships pose potential conflicts of interest that could disadvantage patients by influencing physicians in what they prescribe. I agree.

The federal government and some states ban cash payments to doctors for referrals and the prescribing of particular drugs and devices. Some university medical systems ban or limit gifts and fees to their affiliated doctors. But many gray areas aren’t covered.

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Codes of medical ethics continue to tighten the standards of acceptable conduct, but compliance is typically voluntary. At present, physicians are still allowed to be investors in labs to which they refer patients, or part owners of so-called group purchasing organizations (GPOs) and physician-owned distributorships (PODs) of medical products that the doctors use in their practices.

Ethical hard-liners in the profession, in groups such as the National Physicians Alliance and No Free Lunch, are organizing health care professionals who refuse all personal support from drug and device companies.

But disclosure, rather than prohibition, seems to be the trend. The U.S. government has begun requiring manufacturers of drugs and medical devices to disclose virtually all gifts, fees and research grants they pay to doctors and teaching hospitals. Similarly, manufacturers and GPOs will have to report the ownership interests of physicians and their family members in these businesses.

Under the new law, the Physician Payments Sunshine Act, the information will be available in a searchable online database. A public-interest journalism group, ProPublica, already maintains its own online database, Dollars for Doctors.

Some activists predict (and hope) that broader disclosure will be embarrassing to recipient physicians and cause them, on their own, to start refusing gifts and fees from the health industry.

Have a money-and-ethics question you’d like answered in this column? Write to editor in chief Knight Kiplinger at ethics@kiplinger.com.