Juliana Keeping

Tue, Dec 28, 2010 : 8:12 a.m.

Dr. Zubieta, Thanks for responding. I sent an e-mail and also tried to reach you at your place of business on 12/23. I will keep these comments on hand as we follow up.

Jon-Kar Zubieta

Tue, Dec 28, 2010 : 3:08 a.m.

Dear Julianna: I was told about your story by a some friends who were bewildered by its content. A few points: (1) In the vast majority of cases, probably most of the ones you are reporting on, drugs companies pay physicians to present information about their clinical trials to clinicians. I guess that they also tend to favor academicians, simply because we are typically rather scrutinizing of the data that they present, myself among them, thank you very much. They occasionally also get into agreements to perform clinical trials, or to consult on their upcoming trials and those are regulated by the contract offices at U-M and their respective institutions. (2) If lectures on their products are involved, those are regulated by a federal agency, the FDA, which reviews content and are part of the agreement between the pharmaceutical industry and the FDA so the data is presented squarely and fairly. The presenters are then asked to stick with the facts and do not deviate from the content that is exactly approved by the FDA. By definition, those who agree to present the data have to agree to those basic rules and are under FDA rules and regulations. Evidently, nobody is going to take time away from their families if you do not get paid to do so. So, yes, you make money when you work. It typically happens that way in this country. (3) In your article, you are reporting earnings from 2009 and 2010, and for some of the drug companies (Lilly is one of them), there is a cap of $50K pre-tax per year that was established sometime around 2009 if I recall correctly. In my particular case, I happen to be a popular speaker and receive frequent requests from north and west areas of Michigan, where they receive minimal information regarding newer trials or indications. That takes substantial travel, time, and effort, and the expectation is that you will be compensated for it. Payment amounts are also FDA-regulated. (4) The money earned from non-UM activities is reported yearly to the University and regulated by existing consulting rules like any other consulting job, which by the way, are not examined by ProPublica or your report. In my particular case, there is no conflict of interest with patient care or research, in that I do not provide medical care, I am not involved in clinical trials with pharmaceutical companies, I am not involved in pharmacy committees, nor I receive research money from pharmaceutical companies. I am otherwise a full time researcher working on basic mechanisms of disease. "Moonlighting", as you put it, is performed off work hours. Any consulting agreements are reported in all manuscripts published or scientific presentations, even when there is no conflict of interest with the content of the article or the presentation. I hope that clarifies some of the issues you raise, and I would appreciate a little bit less sensationalism and more factual research from your side. Best, Jon-Kar Zubieta, MD, PhD

feerof retribution

Tue, Dec 28, 2010 : 12:01 a.m.

Fernando Martinez (#14 on the list) is actually the editor of a major medical journal for pulmonary medicine (american journal of respiratory and critical care medicine)- he decides which articles are accepted for publication, including those funded by drug companies that also pay him to give talks. But don't worry it's perfectly legal! He also sees patients and decides which medications to prescribe. I wonder which medications they are? Could they be the ones that the drug company pays him to talk about? Naahhhh.

say it plain

Mon, Dec 27, 2010 : 11:03 p.m.

wait, @matt cooper...do you know for sure then that these docs are merely getting monies from speakers bureaus? I don't understand your 'inside knowledge' lol? Conflict of interest and illegal are not synonymous, surely you must realize. And the point is, of course, that at some level *it doesn't matter* why the drug and medical device companies are paying these doctors extra. The conflict of interest comes from their using these relationships for various degrees of marketing. That comes even from merely sponsoring lectures from various expert speakers, though I agree that this would be the subtlest form of marketing by association, as it were. Hundreds of thousands of dollars per 'expert' physician can buy a lot of marketing of that and more nefarious sorts. I don't think I need to understand anything about motivations or specific personalities to see that. I think the medical ethicists who see this as a problem might agree on that point.

Matt Cooper

Mon, Dec 27, 2010 : 8:51 p.m.

@say it plain: Unless you personally know these doctors and their finances well enough to comment on their motivations, you really have no idea what you're talking about. Secondly, it might perhaps do you some good to enlighten yourself as to what actually constitutes a conflict of interest and what does not. For instance, a world renowned pulmonologist getting paid a fee for doing a speaking engagement in his area of expertise is not a conflict interest if he has no other financial interest involved. Since you don't know any of their personal finances, I would suggest you keep your "opinions" to yourself. There is nothing in any law that says these doctors are in any sort of conflict of interest, nor is there any ethical question involved. Dr.'s are entitles to get paid for their expertise, like it or not. In short, you know naught of what you speak.

Snarf Oscar Boondoggle

Mon, Dec 27, 2010 : 6:12 p.m.

who: buncha doctors.. what: received $$$$$$$$$$$$$!!!!!!!!.. when: recently.. where: ann arbor.. why: "nevermind"..

say it plain

Sun, Dec 26, 2010 : 9:21 p.m.

@matt cooper exhibits textbook example of what is referred to in this interesting NYTimes piece on the issue at hand here--doctors colluding with drug companies in ways that mutually enrich themselves, and hurt the rest of us. http://www.nytimes.com/2009/03/04/health/policy/04doctors.html It starts with:" WASHINGTON Federal health officials and prosecutors, frustrated that they have been unable to stop illegal kickbacks to doctors from drug and device companies, are investigating doctors who take money for using these products. For years, prosecutors rarely pursued doctors because they believed that juries would sympathize with respected clinicians" Just because you respect the clinician's 'expertise' in his or her field, that doesn't mean they are entitled to have these kinds of conflict-of-interest-based relationships with big Pharma and medical device companies. Sometimes the physicians in question--surgeons in particular--realize that they can pull off 'relationships' that are essentially equivalent to bribery. Pay me, they can say to companies, or else I'll use the equally good (or bad) product put out by your competitor. In the fast-and-loose world of psychiatric diagnosis and medicating, things are far far worse really. Nobody really understands how or why many of the medicines work and everybody really knows that exercise is as effective as antidepressants, for instance. Most clinicians also know that the side effects of some of the antipsychotics which are increasingly prescribed to address many many issues, not just real psychosis, are horrifically debilitating and the side effects of so many drugs are more serious and less well understood than anyone will readily admit. Thus, imo, any kind of relationship *at all* that could arguably effect the likelihood that medications be offered and prescribed should be forbidden. The NY Times article gives very clear examples of how drug companies realize this is the game they are playing--marketing is all--and how they now just set aside money for paying fines when their illegal practices are found out. Apparently prosecutors need to be willing to make 'examples' of some doctors with huge fines when they are caught in blatantly unethical situations vis a vis the drug companies to stop some of the more extreme practices. UM's own med school ethicists realize there is a big problem, and are at least pretending to begin to address it. In the meantime, the players who are (as I've heard it told in those circles) still putting their kids through college (and it adds to the whole obscenity that college-costs scene has become in this country what with the two-tier approach to all economic issues since Reagan really lol) with the drug company 'moonlighting' will take from those companies all that the traffic allows;-)

Matt Cooper

Sun, Dec 26, 2010 : 7:51 p.m.

I know zat least one of the docs on this list and I am appalled at the vitriol coming from some of you who obviously know nothing about the character of at least this one doc that I know personally, and probably know nothing of the others as well. The doc I am referring to (who I knonw personally and will not identify)is a world class expert on pulmonary medicine, a leader in his area of specialty and an expert professor and medical educator. He knows more about lung and pulmonary medicine than God (or so it seems sometimes, from having worked with him for a number of years). What I wonder is if any of you who choose to judge these docs have taken into account that perhaps they are paid for the knowledge, their expertise in their chosen fields of medicine. Perhaps they get paid for doing speaking engagements? Or do you honestly think they should educate other docs and pass on their knowledge, experience and expertise for free? Until you have at least some personal knowledge of these individuals character and their motivations, maybe you should hold your opinions in check until the final story is written.

Elizabeth

Sun, Dec 26, 2010 : 3:48 p.m.

I think that there would be fewer complains about AnnArbor.com if articles were published well from the start, rather than adding in information as users complain about biased reporting. This particular article is not an urgent matter of breaking news and could have waited to be published for a day or two while seeking comment from the individuals involved. While I appreciate the additions that were made to the article after the fact, those additions were not there when this article appeared on the homepage of AnnArbor.com, so I would venture to guess that most people that read it did not read the additions. Is that really fair to those doctors and researchers listed in the article? By using the term "moonlighting" you are implying that this is a negative thing. While I am not taking a stance on the issue, nor do I know any doctors or researchers involved, you may be causing unnecessary damage to the career and reputation of a respected member of our community because you failed to follow up on the issue until AFTER it was published.

timjbd

Sat, Dec 25, 2010 : 12:53 p.m.

I'm satisfied with my comment but not enough to want it posted 4 times. Would be great if there was a way to delete your own posts....

timjbd

Sat, Dec 25, 2010 : 12:49 p.m.

Heardoc, It would be nice if you put your name to your posts so potential patients could decide whether, in your treatment, you were more interested in making maximum profit off of them or actually helping them. I personally would prefer to NOT have an Ayn Randian freemarketeer treat me. But maybe I'm alone in that? This is so obviously a question of conflict of interest (as yet unexplained by the doctors in question) that your position would lead me to believe you might join the aforementioned Baltimore doctor in implanting unnecessary medical devices in patients simply because it was not specifically illegal and you were paid to recommend them by the device maker. The hippocratic oath is just more oppressive regulation to some, I spose?

Stan Hyne

Sat, Dec 25, 2010 : 10:51 a.m.

When I go to the tire store, we talk about what tires would be best for my use. A person who installs sliding glass doors might recommend a door that they have found to last without problems. Most persons have found some items that they think work best in whatever line of work they engage in. I would assume doctors are the same and prescribe drugs they think would work best. If they get paid by the drug companies so much the better. As far as advertising drugs or any other product the question is, if a dollar is spent will it generate more than one dollar in profits. It appears the greatest health break through has been in the sex endurance field. I like the thought that we should put the controls in the government because they are one of the most honest organizations I can think of.

David Briegel

Sat, Dec 25, 2010 : 7:47 a.m.

"leftist rants and jealousy". Ooohh, such an intellectual argument. Kind hard to discuss level playing fields, social justice, in an article about drug pushers, eh? Kind of hard to discuss the noble Haste, Delay and Tauzin and the way they held open the vote while the arm twisted congressmen passed that drug dealers law. Of course, it's only evil when Pelosi does it. The result was that Billy Tauzin got a 2 million a year bribe before they finally got rid of him. Of course, when Republicans do it it's because they are getting better govt!? The point of this Christmas morning "gift" is to show that Big Pharma is used to bribing to get their way! Heardoc and other apologists accept that as the American way of just "doing business". I'm still naive enough to believe America can do better than no-bid contracts, and bribery! But I don't believe in Santa.

applehazar

Fri, Dec 24, 2010 : 5:03 p.m.

this practice is illegal if the doctor does not pay income tax on all perks - including trips disgusied as training - maybe it hits too close to home - for the physicians that accept this type of payola - care to debate? i accept all comers. btw - payola is a crime - check the statute

Heardoc

Fri, Dec 24, 2010 : 2:45 p.m.

Just leftists rants and jealousy here.. any one that achieves success better do it so the far left will be happy..... such lack of real thought in this article.

julieswhimsies

Fri, Dec 24, 2010 : 2:42 p.m.

Hmmm...just noticed a doc I saw several times for migraines is on the list. Never went back to him, because he is an incompetent jerk. However, it appears he is a very well-compensated (by Big Pharma and the UofM) incompetent jerk.

oldgaffer

Fri, Dec 24, 2010 : 2:38 p.m.

Doctors who prescribe drugs in exchange for drug company kickbacks are engaged in unethical behavior as there is an economic incentive to prescribe drugs where drugs are not needed, or not the best treatment for a particular patient. Sometimes the best treatment is to do nothing as most illnesses are self-limiting. Drug companies say that their drugs are priced high in order to support pure research, but this is known to be false as studies show drug companies spend only 17% of their income on research. Most of the rest goes into huge salaries for their fat cat owners, and television advertising to create a demand where none exists. One of the worst things the Congress ever did was to allow the advertising of prescription drugs on television. Night after night big pharma bombards us with these commercials ad nauseam during prime time television. These greedy doctors are little more than aiders and abettors.

djsell

Fri, Dec 24, 2010 : 12:32 p.m.

..all of this is simply stated "marketing", the drug companies are marketing their products the best way they can,..the drs are a great marketing tool and each dr needs to make the decision on their own whether it is a conflict of interest with them selves, and if they are an employee of an institution, if there is a conflict there,.......that is an indiv situation for each dr accepting reimb from a drug company,...is the money they are receiving from the drug company for time spent researching traveling and speaking on the drug causing more damage in terms of health costs than the health benefits their pts may receive by enlightening other drs to use the drug to help pts........ everybody who has posted here, pro or con, most likely themselves, family or friends have used lipitor, nexium, plavix, celebrex, lyrica,...etc, etc........to make their lives healthier,...certainly it would be better if the costs were reduced for some of theses drugs, but we do not have a perfect system,....maybe the new health care reform will be the 1st step towards this, but again all of this is simply how marketing is done in a democratic and capitalistic country........whether you are buying drugs, cars, corn chips or electronics.........

Speechless

Fri, Dec 24, 2010 : 11:40 a.m.

Quoted from further above: "... Imagine you hire a lawyer. He is being paid by you, and being paid by the person or company you are suing. That would not only be unethical, it would be illegal. Imagine if your real estate agent was the agent representing the seller of a home and told you that you needed to make a larger offer than needed to secure the acceptance of the contract. They would lose their license, and you would have a lawsuit against them. BUT a doctor has no responsibility to disclose that the drug he just prescribed to you is manufactured by a company that is PAYING him...." Medicine in America, then, more closely reflects the pristine values — the full expresssion of cherished economic liberty — that is found only in the behavior of an open, free marketplace for services. Doctors and researchers who pocket cash from pharmaceutical companies are among the highest expressions of the economic engine that drives America forward. The more compensation they all receive, the sooner we'll be on our way to recovery! The practices of real estate and law, on the other hand — as you so correctly point out — have been stagnated and dimished by encroaching government regulation. I hope you will join me in beseeching our legislature to overturn their tyranny of rules which chain our lawyers and real estate sales people!

Juliana Keeping

Fri, Dec 24, 2010 : 11:27 a.m.

This story has been updated with comments from UMHS spokesperson Kara Gavin: She said Stevens is no longer at the medical school, and "...we have a robust system for reporting and managing interactions with industry by our doctors and medical scientists." We'll take a deeper look at that policy as we continue to follow up.

concernedinsaline

Fri, Dec 24, 2010 : 11 a.m.

Fellow citizens...we need to wake up. The insurance companies, drug companies, hospitals and Doctors are all in on this. They take advantage of all of us in the name of "the best health care system in the world". Unfortunately the statistics do not support this. The "death panels" are the insurance companies. The "poor", non-profit, hospitals have fund raisers every year (they solicit my business for donations) run by Doctor's wives. They continue to add on and build to their facilities. Insurance costs go up 15-20% a year when the rest of the economy stagnates to pay for the excesses and greed in the system. I could go on and on, but my blood pressure will rise. We need a single payer system, period, to end this nonsense.

A2Dave

Fri, Dec 24, 2010 : 10:51 a.m.

All of these "doctors" have clear conflicts of interest between their employers (the drug companies) and the interests of their patients interests. In medical care, there should be no contest between these interests. However, where the provider's personal financial interests conflict with the interests of the recipients of their services, there should be real concern regarding the ethics and trustworthiness of that provider.

Adam

Fri, Dec 24, 2010 : 10:33 a.m.

Juliana, great story. Thanks for all that you do to keep the world as honest as possible!

djsell

Fri, Dec 24, 2010 : 10:28 a.m.

briefly from the drs side...as a solo practitioner specialist for 20 yrs now in the A2 area and with an office in wayne mich as well, it should be duly noted that just like any other profession there are many diff levels of drs out there. i agree with mike, and i consider myself a "working stiff" just like the self employed auto repair store owner for over 30 yrs that i open extra late hrs for him so he can come in after his work to be treated, the kidney dialysis pt with open wound that we open up early for once a wk so she can get to dialysis, and the countless "apple pies" i have allowed for payments, 10$ a month installment plans, gratis pts, etc......i will admit as a resident in detroit and to this day i do accept pens, paper pads, calendars, samples from the drug reps and have attended many lectures at the chop house, vinology, etc and i can say that it is actually conceivable to think that i actually attend for the lecture portion and if there is bias in the lecture, let me decide as a health practitioner if the drug being represented is the best for my pt. i can also say i have never and will never be influenced by the "gifts", if its the correct drug in my opinion for my pt, thats what they get and i always tell the drug reps the same thing....also the samples i get are extremely beneficial for those pts who cannot afford them otherwise, (which is a whole other topic) and has benefitted the pts. also let it be known that a good portion of drs are "working stiffs" as we may make a large "gross" amount of money, but the "net" is a diff story after health educ loans (orig at 120K, still paying till i will be 68 yrs old) payroll, renting of 2 offices (we all know A2 rent prices!!), med supplies, office supplies, malpractice insur, bus insur, office supplies, cable, utilities, employee health benefits, cont med educ required seminars,etc, etc......so after a 12-14 hr day, 60-70 hr week- still (down from 80 hrs for 14 yrs), home emails, telephone calls, weekend hospital consults and surgeries, i believe i am entitled to catch a relaxing lecture on a topic of interest to better myself and my pts and if the small percentage of drs who receive emormous extra income feed me the info, so be it, but pls realize they are a small % and there is a much larger % of drs who work darn hard for their $ and deserve every penny they get, just like the auto repair man, cable guy, waitress, etc. so next time you go to your dr, pls remember we are all just individuals trying to make a living, some of us are honest and some not,....such is the human race.......

Truth_01

Fri, Dec 24, 2010 : 10:21 a.m.

This helps explain the run away cost of medical serices and products. I wonder if such things go on with college professors which would help explain the uncontrolled, run away cost of higher education in this country. We need to start asking our doctors and professors, how much are they getting paid and why. We do this with other profesionals, such as our plumbers and business executives.

glacialerratic

Fri, Dec 24, 2010 : 10:12 a.m.

These payments, which have become common practice, are a fundamental conflict of interest and violation of medical ethics. These practices have been criticized in professional journals. That some still don't understand this issue points to the need for better training in research ethics. ProPublic is to be commended for its outstanding investigative journalism. Medical students at Harvard at elsewhere are active in pointing out these conflicts. I hope this bodes well for the future.

5c0++ H4d13y

Fri, Dec 24, 2010 : 10:10 a.m.

^ How does single payer (aka government monopoly) solve that problem? It's worth noting that we don't know what these payments were for. It could have consulting. It could have been participation in an education event. It could have been expert witness testimony. People love to hate the drug companies until they want a cure for themselves or their loved ones. Then they hate the drug companies because the cures don't exist. Or they want the drug companies to sell them at cost which doesn't allow companies to make money to develop the next drug. So then the government should pay for all the development but then that REALY injects politics into healthcare. Which we like when politicians we agree with are in charge and hate when ones we don't agree with are in charge. Many americans are fickle whiny envious babies.

Ron Granger

Fri, Dec 24, 2010 : 10:08 a.m.

The majority of us in any other industry would be terminated for such moonlighting. And don't forget - you don't own your body. Anything a doctor cuts out is theirs. Many of them profit with the parts they cut out of you. Many General Practitioners are struggling to get by as they provide care to the masses. And then, there are the others... The greed is sickening.

clownfish

Fri, Dec 24, 2010 : 9:27 a.m.

Very leftist and class warfare type article..... awww! Anybody else notice how lately "class warfare" is to be avoided? Avoided by anybody seeking answers to why we have such massive, unbalanced wealth distribution in this country? Could it have anything to do with the FACT that the top 10% controls over 70%% of the wealth and they don't want anybody messing with one of the most corrosive sociological problems facing America? Why should I be outraged that the billionaires I used to work for laid off 600 people? Why should I care that many of those 600 can no longer pay for drugs that make their lives livable? Why should I care that docs that already have great jobs are raising the prices of those drugs by accepting payola from drug companies? Must be class warfare that is killing my former co-workers!! These poor doctors deserve tax cuts so they can hire another gardener (with no health insurance).

David Briegel

Fri, Dec 24, 2010 : 9:21 a.m.

Yes Heardoc, Shedding light on these sleazy tactics is class warfare. Which class do you think is winning? Just another war that America lost! When you have no logical argument, find a bogeyman!!

clownfish

Fri, Dec 24, 2010 : 9:15 a.m.

Doctors should be required to post all connections to drug companies in their office, and declare all connections to each patient for which they prescribe drugs from those companies. Malpractice insurance is a small portion of health care costs, it is yet another propaganda myth from talk radio/bloviators on the telly. Does anybody here know of a poor doctor? Poor, poor doctors! so underpaid!

johnnya2

Fri, Dec 24, 2010 : 9:02 a.m.

This is another reason for single payer universal health coverage. The fact that doctors/instructors are getting paid to promote their products is the same as a financial advisor pushing a specific investment that may or may not be profitable based on getting paid from both sides. Imagine you hire a lawyer. He is being paid by you, and being paid by the person or company you are suing. That would not only be unethical, it would be illegal. Imagine if your real estate agent was the agent representing the seller of a home and told you that you needed to make a larger offer than needed to secure the acceptance of the contract. They would lose their license, and you would have a lawsuit against them. BUT a doctor has no responsibility to disclose that the drug he just prescribed to you is manufactured by a company that is PAYING him. He can write things such as dispense as written on the scrip and not allow a generic alternative. This shows how screwed up the mentality in this country is. If you deal with a persons financial health you must disclose, but if it is their physical health you are supposed to trust the doctor. I have made efforts to ask a doctor what they will charge for something. I never get a number other than it is $50 for an office visit. Anything beyond that is never met with a straight answer. If a mechanic didn't give you an estimate before you got your car repaired, they would not have a valid contract, but a doctor can charge whatever the hell they want and it is considered valid.

Heardoc

Fri, Dec 24, 2010 : 8:54 a.m.

Very leftist and class warfare type article.....

healthy1

Fri, Dec 24, 2010 : 8:42 a.m.

This is just the tip of the iceberg folks. It goes much deeper. If you want the real scoop on the allopathic medical profession kickbacks and how to protect yourself, I suggest you attend the free 2.5 hour alternative health lecture featuring Naturopathic Doctor and author of "Dead Doctor's Don't Lie": Dr.Joel D. Wallach on Wednesday January 5th, 2011, 7:00 PM - 9:30 PM at the Interfaith Center for Spiritual Growth, Building 704 Airport Boulevard, Ann Arbor 48108. It is the lecture that your MD and Big Pharma prays you don't go to.

Soothslayer

Fri, Dec 24, 2010 : 8:34 a.m.

No surprise whatsoever. The medical industry is FOR PROFIT.

glimmertwin

Fri, Dec 24, 2010 : 7:12 a.m.

The entire process is flawed. I'm all for making a living, and being paid for your work and expertise. However, haven't we learned anything from past? What was the arthritis drug that ended up killing people a few years back? The drug companies pay for their own "drug studies"; pay the physicians to conduct the studies; use those "unbiased" studies to lobby for FDA approval. Talk about the fox watching the hen house.

trespass

Fri, Dec 24, 2010 : 6:59 a.m.

President Coleman recieves more than $240,000/yr for being on the Board of Johnson & Johnson (a drug company). During her tenure they have had 6 drug recalls, including one that is being inverstigated for criminal charges. Are her decisions on the Board and as UM President not biased by this large sum of money? She also lends the J&J Board the credibility and good name of the University of Michigan even when they misbehave. Why does the Board of Regents allow this conflict of interest to continue?

Evelyn Griffin

Fri, Dec 24, 2010 : 6:36 a.m.

Health care costs go up. Deductibles go up. The TV tells us what to tell our doctor to order. Our doctors are gatekeepers to referrals in many plans. The U of M hierachy gets HUGE raises. The front line workers in all industries are asked to give back, give back, take greater deductibles in health care and etc. But never mind, this is legal and these great doctors did nothing wrong. What is wrong with this picture? Evie G

arbordoc

Fri, Dec 24, 2010 : 5:56 a.m.

The UM Medical School is looking closer at conflicts of interest at a number of levels (research support, educational support and direct physician support), as was discussed earlier this year in a fairly balanced article in the NYTimes: http://www.nytimes.com/2010/06/24/business/24meded.html?_r=1&scp=1&sq=conflict%20of%20interest%20university%20of%20michigan&st=cse For disclosure, I am a physician at UMHS but do not represent the U in this posting. I do not receive direct (or indirect that I know of) support from pharmaceutical industry.

George Wieland

Fri, Dec 24, 2010 : 3:18 a.m.

Of course, greed can be good, leading to greater creativity and productivity. Greed is not good when there is a conflict of interest. I want my doctor to prescribe on the basis of objective evidence of what my medical condition requires. I don't want him or her to prescribe because of the money paid by a drug or appliance company. Large amounts of money can lead to bias. A rather blatant example is the Baltimore doctor who was recently found to have implanted stents in hundreds of patients who didn't need them. He was paid millions by Abbot Labs for being the biggest stent prescriber in the Baltimore area. See this brief article: http://www.nybreakingnews.com/news/Baltimore-Doctor-Faces-Legal-Trouble Medicare paid more than half of the money those stents cost, nearly four million dollars. Actually you and I paid because Medicare doesn't get the money growing on trees. Why does health care in the United States cost double what it costs in terms of percentage of GDP, compared to other developed nations, such as the ones in Europe? Why do Americans live shorter lives than the people in those countries? The Baltimore doctor provides the answer to both of those questions. If you don't need a stent and you get one, you have endangered your life. I've refused my cardiologist's suggestion of a stent for that reason. I used to use research articles in the medical journals to decide if I would follow a doctor's prescription of a drug, but now I am cautious. It is estimated that 80% of the authors of such articles are getting money from companies to do research and event to give talks about the drugs they are researching. The researchers know what side their bread is buttered on, don't you think. Another case of possible bias leading to poor medical care. Some of the medical journals are now requiring authors to list any financial conflicts of interest. For some answers why medical care costs double here in America and why we die sooner, I recommend a 2007 book by Shannon Brownlee, "Overtreated: Why too much medicine is making us sicker and poorer."

Speechless

Fri, Dec 24, 2010 : 1:03 a.m.

I greatly admire these industrious members of U-M's medical working class. If you've put in a long, long day at medical school — but you still got to do some moonlighting to help make ends meet — then a gig with big pharma will get you more spare coin than picking up an evening shift at Taco Bell. If the 'U' would increase their poverty salaries, they wouldn't have to do this.

David Briegel

Fri, Dec 24, 2010 : 12:56 a.m.

And, all you apologists for this otherwise criminal behavior should ask yourselves as Heardoc won't, Much Ado About Billions!? Mike, Why do Americans go to Canada for their drugs? Because Billy Tauzin didn't destroy the Canadian drug delivery system, just the American!! And Mike, the rationing in America is done by the "death panels" in every health insurance company board room!! Lady Audrey, How about LOBBYING? Sleazy is too kind a word! Julies, Sally and Kitty, 81Wolverine, Payola, Ya Think? The drug dealers and pushers give those Docs a lot of "candy"!! The "Greatest Health Care System In The World" is the biggest Lie/Myth that is being perpetrated on the Lemmings of America!!

dfossil

Fri, Dec 24, 2010 : 12:50 a.m.

I'm just wondering if these M.D.'s also got nice big salary increases from the University because they suffered so badly with a salary freeze last year?

David Briegel

Thu, Dec 23, 2010 : 10:49 p.m.

You ALL missed the point. Drug Dealers and Drug Pushing is an extremely lucrative business. I'll bet you can't even identify who Billy Tauzin was and what he did!! Why do you think the "people herbs" are illegal?? Get a clue!!

DonBee

Thu, Dec 23, 2010 : 10:14 p.m.

So long as they declare the income and pay their taxes, who should really care? Does it interfere with their day job? Does letting them do it keep them at the U of M, rather than moving to, say, Ohio State? Does it keep the pressure to raise their salaries down? Does it help them rise in stature so they can bring in more research money? If they have patient contact do they use the stuff they speak about, if so do they use it "off label"? These are the questions I would like to see the answers to.

Deborah

Thu, Dec 23, 2010 : 9:04 p.m.

it is good to id the most heinous tools of the pharmaceutical business. These guys forgot how to cure a long time ago.

Elizabeth

Thu, Dec 23, 2010 : 8:49 p.m.

Why did AnnArbor.com not seek comment from any of the doctors or companies listed as to what the payments were for? That seems like it would be relevant. Here is an article that does a better job explaining this issue: http://www.khou.com/news/investigative/I-Team-Does-pharmaceutical-companies-relationship-with-doctors-affect-patient-treatment-106800048.html

Salinemary

Thu, Dec 23, 2010 : 8:44 p.m.

It may not be illegal, but it certainly leaves a bad taste in my mouth.

AlphaAlpha

Thu, Dec 23, 2010 : 7:43 p.m.

Many suspect practices in the medical business are 'not illegal'. Why? 1. AMA & Co. authors most of the legislation affecting the medical business. 2. AMA & Co. has some of the best lobbyists in the business.

denise1inaa

Thu, Dec 23, 2010 : 7:10 p.m.

Google Donna Rice... wasn't she a salesperson to physicians for Parke-Davis/Warner-Lambert? It shows how far the pharmacuetical industry reaches into politics.

15crown00

Thu, Dec 23, 2010 : 7:03 p.m.

not illegal but not exactly right either.

denise1inaa

Thu, Dec 23, 2010 : 6:57 p.m.

Based on years of news reports and my own personal experience with Parke-Davis/Warner-Lambert/Pfizer (1978-2008) I would prefer to NOT do business with physicians who are advised/rewarded/PAID to prescribe drugs by the pharmaceutical companies.

trespass

Thu, Dec 23, 2010 : 6:54 p.m.

President Coleman decided that continuing education in the medical school could not accept sponsorship from drug companies because it might influence the speakers. However, she is perfectly happy to send out speakers from UM to teach other doctors. Does she think it is OK for UM doctors to give other doctors biased lectures?

Juliana Keeping

Thu, Dec 23, 2010 : 6:54 p.m.

I have updated the story with comments received via e-mail and phone from Thomas Roth. Roth is a researcher and does not prescribe drugs or provide patient care.

Z-man

Thu, Dec 23, 2010 : 5:55 p.m.

Given how little information contained in this weak, incomplete article, it's interesting how quickly everyone is jumping to conclusions or making accusations of greed or impropriety. The article has not indicated why doctors (most of which seem to be involved in teaching and/or research)are receiving money from drug companies other than as "speaking and consulting fees." Many of you seem to be also suggesting that the drug companies are wasting their money and just driving up everyone's cost of their product. Drug companies are profit-driven as they strive to serve their many stakeholders, which includes shareholders, patients, doctors, regulators, etc. So just why is it inappropriate for drug companies to hire doctors and medical researchers as consultants? Should drug companies instead develop their products in a vaccuum, or should they solicit input from the medical community? It's common practice in most industries for companies to interact with "lead users" of their products to get feedback.

trs80

Thu, Dec 23, 2010 : 5:50 p.m.

That's pocket change in comparison to the political side. Millions go to our political leaders. Welcome to the United States of Greed.

Cash

Thu, Dec 23, 2010 : 5:43 p.m.

Of course it changes my opinion! Who is paying him/her more...me or the drug company? Where is his/her loyalty? To the one who pays the most I'd assume. cant' wait to click off to the whole list. Thank you very much for publishing this article.

81wolverine

Thu, Dec 23, 2010 : 5:33 p.m.

These "fees" amount to payola as one person said - plain and simple. Just like the record companies used payments to influence disc-jockey's to play certain songs, Big Pharma is paying these doctors to write more prescriptions for their drugs or to influence medical students to do the same. If anyone has any confusion as to why pharmaceuticals are so expensive, this should help clear it up. The drug companies spend such a ridiculous amount of money on advertising, sales, "fees", travel junkets, etc, etc, etc, the prices have to be marked way up. This problem is at the crux of why our medical system in this country is so ineffective at making people healthy. It's a drug-based system of health today that only treats symptoms of diseases and conditions - not the causes. Until we change our philosophy away from a profit-based one to a healing-based one, this kind of corruption will continue.

kittybkahn

Thu, Dec 23, 2010 : 5:13 p.m.

How about this: Do away with pharmaceutical advertising. I bet that would lower the cost of prescription drugs. Other countries don't even allow such ads.

Sallyxyz

Thu, Dec 23, 2010 : 5:11 p.m.

I've never been to a doctor at UMH or anywhere else that ever said to me that he or she was receiving $$ from a drug company, and then said, "Oh by the way, that's the drug I'm writing this script for. It's best for your condition." Full disclosure? Ha. Think again. Big Pharma wines and dines the docs at UMH and other hospitals at fancy resorts in exotic locations under the guise of "training" where they spend all of 2 hours a day, maybe, in a lecture about how wonderful the latest drug at Pfizer or Merck is, and then spend the rest of the day on the beach or sightseeing, or eating at fancy restaurants, all expenses paid by the drug company. These costs are jacking up the price of drugs that all of us are paying for. The drug companies pass out free samples like candy to these docs right in their offices and feed them lavish lunches with high powered promos all the time right at the hospital. It's called marketing by the drug companies and bribes by anyone else. Drug reps are some of the most pushy, sleazy salespeople on earth. A reputable hospital would ban them from the premises. Doctors are the lifeblood of big pharma, and if you don't think that they are in bed together, you are very wrong.

julieswhimsies

Thu, Dec 23, 2010 : 5:06 p.m.

This is disgusting, nauseating, and reprehensible. Conflict of interest? Ya' THINK?!

5c0++ H4d13y

Thu, Dec 23, 2010 : 4:58 p.m.

@1bit When a company pays for research at UofM by UofM people the contract is with UofM and not the individual. So this cannot be research funding money.

Sallyxyz

Thu, Dec 23, 2010 : 4:53 p.m.

Greed, pure and simple. Doctors employed by organizations such as UM, St Joe's or any other hospital should be banned from accepting any kind of compensation from drug companies. It's a blatant conflict of interest and contributes to the billions of wasted dollars that drug companies spend on "marketing" instead of lowering their drug costs. The doctors who accept these bribes should be forced to return all the loot and a policy be instituted at UMH to ban all drug companies from paying doctors for anything. It's disgusting, to say the least. Keep pushing those drugs, docs, and keep writing those prescriptions for the drugs that are manufactured by the companies that pay you the most. Great medical care. The healthcare system is beyond broken. It's in a death spiral.

Erich Jensen

Thu, Dec 23, 2010 : 4:51 p.m.

There should be public disclosure, as indicated, and importantly the exact reasons for the payments. There can be some important reasons for receiving payments that doctors do receive payments fairly much like experts/consultants that are needed in court cases.

Steve Pierce

Thu, Dec 23, 2010 : 4:44 p.m.

One of the biggest moonlighters at U-M? Why that would be none other than President Mary Sue Coleman, who raked in far more in secondary income than any of these doctors. Wouldn't it be grand if we knew all public employees that were moonlighting and where and how much. Cheers! - Steve

Mary

Thu, Dec 23, 2010 : 4:42 p.m.

At least one study showed that giving medical students so much as a free drug company pen made them think more positively about the drug company; doctors who take money from drug companies may think their objectivity is not compromised, but it surely is.

5c0++ H4d13y

Thu, Dec 23, 2010 : 4:38 p.m.

I hope the UofM doctors disclosed the payments.

Mike

Thu, Dec 23, 2010 : 4:36 p.m.

Look, the same people who throw stones at the doctors want the government to "give" them free health care; i.e. they want people to pay higher taxes so they can get "free" health insurance. In my book that makes you just a greedy as the doctors who take the drug company payola. This is the same government that wants to cut reimbursements for medical care to the doctors. So, if you follow that logic then why shouldn't they make money any way they can? The doctors pay exorbitant malpractice insurance every year and the benevolent government won't curb payouts to the trial lawyers. Spend a couple of hundred thousand dollars to go to med school, work long hours, and pony up $100,000 for malpractice insurance every year and then complain. I'm not a doctor by the way but know a few of them. Teachers only make $35,000????? Try $70,000 with a masters degree plus the protection of tenure making it all but impossible to get rid of the bad ones. Plus once you add up their benefit package, paid vacation, pension plan, and health care (gold plated)they're making over $100,000 on the taxpayers dime. Too many jealous haters in this country anymore; if you make a good living they want to tax it away from you. I have relatives in Canada who get "free" health care and come here for anything important because everything is rationed over there and if you're too old you're out of luck. That's what is coming to America plus the amount of people who want to be doctors is declining Komrade. Bottom line is I don't think doctors should be getting those kinds of pay-offs but with the government dismantling the health care system they're going to need to take even more. Remember, you always get what you pay for, so if you pay nothing you should expect nothing in return. Merry Christmas to all. Can I say that on a public forum or am I promoting religion? Hope nobody from the ACLU or CAIR is reading this.

applehazar

Thu, Dec 23, 2010 : 4:28 p.m.

Juliana - GREAT REPORTING - keep up the good work - the more comments mean the more readers - AnnArbor.com rocks!!

stunhsif

Thu, Dec 23, 2010 : 4:09 p.m.

dispicable and disgusting, but not suprising. My father is a medical doctor and professor who teaches medical students and he is dismayed with so many of his students that want to be doctors for the money rather than the cause. Greed pure and simple, both for the doctors and the drug companies.

applehazar

Thu, Dec 23, 2010 : 3:56 p.m.

Lady Audrey - I totally agree- well said - I trust my primary doctor to treat me in MY best interest - if my primary care physician is receiving "kickback money" who can I trust? The federal government wants every American to enjoy health insurance - while I agree - we need to change the playing field. I applaud AnnArbor.com for reporting on this. Impartial news coverage is what we enjoy in the US and I want more!

Lady Audrey

Thu, Dec 23, 2010 : 3:31 p.m.

Heardoc, I think you may be missing the point. There are lots of unethical things that are not illegal. This is a public trust issue. Why do these doctors need to be paid by the pharmaceutical industry to share their knowledge about specific pharmaceuticals and their value to patients? Couldn't they do this in a less sleazy way?

applehazar

Thu, Dec 23, 2010 : 3:24 p.m.

Heardoc - are you kidding? comparing teachers who make $35K and have no interaction with vendors to doctors who make $400k+ and enjoy all drug vendor salespeople perks - ie accept lunches, trips - disguised as training lectures? Where do you think the costs go? This is NOT a waste of time - but newsworthy - rebuttal?

Jaime

Thu, Dec 23, 2010 : 3:21 p.m.

We all pay for this when we buy prescription drugs so it just adds to the cost of medical care for everyone. Another reason for a public option in the health care system.

Bob W

Thu, Dec 23, 2010 : 3:21 p.m.

With respect to the six listed, gee, their "moonlighting" income is $100,000+? How greedy can you get? It's a conflict of interest, pure and simple.

applehazar

Thu, Dec 23, 2010 : 3:17 p.m.

It is so hard to navigate the insurance game. First we have to ask what lab the doctor is sending the specimen to - because usually that is a hospital that "cooperates" with the doctor aka?? - but is out of network for us the subscriber - the person that is to pay the bill because it is "out of network". Now - the doctor is being paid by the drug company for perscribing brand name drugs - BUT our insurance only pays for generic - national health care IS NOT THE ANSWER - but regulating the doctor needs to happen. This is after I PAY $12000 annually for health insurance - there needs to be more press on this.

Heardoc

Thu, Dec 23, 2010 : 3:17 p.m.

This is much ado about nothing. What is the point? As stated in the article 'The news organization points out the doctors aren't doing anything illegal by taking money from drug companies'. Now, i realize the conspiracy types out there want to make this a matter of concern when it is not a matter of concern. There must be something evil here....... these docs work with drug companies -- hmmmm we should look into investigate teachers when they work with publishers of classroom books. Maybe we should investigate police who work with gun manufacturers -- better yet - we should investigate news services as they do business with people in the news. This article is a ridiculous waste of time.

Greggy_D

Thu, Dec 23, 2010 : 3:14 p.m.

What a scam.

Lady Audrey

Thu, Dec 23, 2010 : 3:14 p.m.

Our health care system is so broken that doctors who already make a fine living greedily syphon off even more money from the economy by serving as mouth-pieces for the pharmaceutical industry. How about the pharma industry stop pissing money away on marketing and lower drug prices with all the money they save? That way people can afford to buy drugs and also have other discretionary money to spend on something other than medical bills.

Juliana Keeping

Thu, Dec 23, 2010 : 2:52 p.m.

@java, I added the link in the sixth paragraph down. It's to the ProPublica Dollars for Docs home page. I'll be working to pin down the Ann Arbor-area doctors places of work and ask them about the moonlighting. Keep checking in...Juliana

javajolt1

Thu, Dec 23, 2010 : 2:45 p.m.

Never mind....there is a link to a search engine here: http://projects.propublica.org/docdollars/search?term=x&state%5Bid%5D=23

javajolt1

Thu, Dec 23, 2010 : 2:34 p.m.

Is there a link to the complete list?