When doctors accept a cup of coffee from a drug company representative – or a thousand-dollar speaking fee – they are not violating any laws. But they may be violating a hospital’s policy or raising questions about conflict of interest.
What Percentage of Doctors at Your Hospital Take Drug, Device Payments?
Where a hospital is located makes a big difference in how many of its doctors take payments from drug and medical device companies. See how your state compares below.
Source: Centers for Medicare and Medicaid Services; ProPublica analysis
Credit: Fan Fei and Sisi Wei / ProPublica
The news organization ProPublica has just released national data on the number of doctors who take gifts or payments from pharmaceutical companies.
While Massachusetts has one of the lowest rates overall, two Western Massachusetts hospitals top the list within the state.
The data, from 2014, show three quarters of doctors at Noble Hospital in Westfield took some sort of gift or payment from a drug company — that’s the highest rate in the state. Hospital representatives say employees came to expect free sandwiches and other small perks.
Baystate Health owns Noble — but didn’t at the time — and chief compliance officer Renee Wroth says they wouldn’t stand for that practice now.
“Actually, we’re pretty strict on things like promotional items even, so pens, pads — we try to keep all of that out of our offices and hospitals,” Wroth says. “We certainly don’t allow any type of entertainment, sports tickets, things like that.”
There is some leeway; Wroth says doctors can eat at the buffet at industry-sponsored conferences, for instance. That could explain why Baystate’s main hospital in Springfield ranks around the middle of the state in the percentage of doctors taking drug company gifts or payments.
Source: Centers for Medicare and Medicaid Services; ProPublica analysis
A spokesperson for Mercy Medical Center in Springfield, which ranked second highest in Massachusetts, would not say what their policy is on accepting payments – if there is one.
But in a statement, Mercy president Scott Wolf says the hospital evaluates relationships between doctors and industry and has confidence in its employees to “do the right thing.”
Meanwhile, Cooley Dickinson Hospital in Northampton showed up near the bottom of the state’s gift and payment list. Vice President Kim Saal says no employee can accept anything free from a vendor.
“This extends itself as far as, it’s now Christmas time — and who do we accept cookies from?”
When Saal recently received the children’s game ‘Operation’ in the mail from a vendor, he says, “I opened the box up, saw what was in it, and it was immediately sent back.”
Given the strict policy, Saal says he was surprised ProPublica found a third of Cooley Dickinson’s doctors to have accepted even small gifts, though he says the hospital can’t monitor independent doctors who work there on occasion.
“If this data is true, I’d be concerned,” he says. “There is always an unconscious or conscious reason for that gift being given, and unconscious or conscious change in one’s behavior based on receipt of that gift.”
It’s worth noting that all the Western Mass hospitals had relatively low numbers of doctors accepting larger payments — those of more than a thousand dollars — which is often what drug companies pay for consulting or speaking fees.
Dana Farber Cancer Center in Boston tops that list with almost a quarter of all doctors taking $5000 or more. A spokesperson for Dana Farber says its doctors do often get paid by industry for educational, not promotional, talks.
Baystate’s Renee Wroth says her system also allows doctors to take consulting and speaking fees, as long as they consult on their own time, get paid at fair market value and present their own research.
“We believe that collaboration by physicians and teaching hospitals with industry is necessary to the design and delivery of life saving drugs and devices at times,” she says.
The ProPublica report does not make a direct link between payments from drug companies and medical decision-making. But earlier this month, a study in the journal JAMA Internal Medicine did find that doctors who took even small gifts from pharmaceutical companies tend to prescribe more of those companies’ drugs than doctors who don’t.