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Doctors on the Dole

According to Pro Publica, the drug companies are doling out millions of dollars to pay doctors to shill their products to other doctors. Apparently, the companies can’t be bothered to check into the credentials of their salesfolks, as Pro Publica found a number of doctors who were either not particularly qualified, or who were distinctly not qualified.

The Ohio medical board concluded that pain physician William D. Leak had performed “unnecessary” nerve tests on 20 patients and subjected some to “an excessive number of invasive procedures,” including injections of agents that destroy nerve tissue.

Yet the finding, posted on the board’s public website, didn’t prevent Eli Lilly and Co. from using him as a promotional speaker and adviser. The company has paid him $85,450 since 2009.

In 2001, the U.S. Food and Drug Administration ordered Pennsylvania doctor James I. McMillen to stop “false or misleading” promotions of the painkiller Celebrex, saying he minimized risks and touted it for unapproved uses.

Still, three other leading drug makers paid the rheumatologist $224,163 over 18 months to deliver talks to other physicians about their drugs.

And in Georgia, a state appeals court in 2004 upheld a hospital’s decision to kick Dr. Donald Ray Taylor off its staff. The anesthesiologist had admitted giving young female patients rectal and vaginal exams without documenting why. He’d also been accused of exposing women’s breasts during medical procedures. When confronted by a hospital official, Taylor said, “Maybe I am a pervert, I honestly don’t know,” according to the appellate court ruling.

Last year, Taylor was Cephalon’s third-highest-paid speaker out of more than 900. He received $142,050 in 2009 and another $52,400 through June.

Leak, McMillen and Taylor are part of the pharmaceutical industry’s white-coat sales force, doctors paid to promote brand-name drugs to their peers — and if they’re convincing enough, get more physicians to prescribe them.

The article makes clear that there’s actually some social good flowing from some of the talks given by some of the doctors that are being enriched by the drug companies. But that’s only because our system is so screwed up that doctors don’t have an unbiased continuing educational system that both operates outside of the present system and reaches the folks in those hard to get places. Enter the drug companies. The payoffs are part investments in duping doctors into using selected drugs, and part direct payoffs to the speakers for overprescribing the drugs in question.

The Health Care act made a dent in this sort of thing, in the typically indirect fashion that present day compromised politicians prefer. Instead of just putting a stop to it, and putting an unbiased continuing education system in place, the government is requiring the drug companies to disclose the payments, strictures they will no doubt find a way around and which, at all events, probably won’t make much difference. The result, no doubt, is increased health care costs and poorer health care, but who cares when you’ve deluded yourself into believing you have the best health care system in the world.

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