UVa posting its doctors’ financial deals online

UVa posting its doctors’ financial deals online

UVa Health System spokesman David Foreman

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The University of Virginia has begun posting its doctors’ financial dealings online for the world to see.

It’s a decision that mirrors a national trend in the health-care industry toward stricter reporting standards and also part of a years-long progression at UVa toward greater transparency.

Roughly a year ago, UVa banned the ubiquitous prescription-themed loot — mugs, clipboards, pens and the like — that once stocked medical faculty’s drawers, desks and pockets.

UVa Health System spokesman David Foreman said officials worried patients might take a doctor or nurse’s use of the freebies as an implied endorsement.

And doctors’ relationships with outside business interests are still permitted, but now must be posted online.

“If these relationships are there, there’s nothing wrong with disclosing them,” Foreman said.

The moves put UVa in line with national trends toward stricter disclosure.

Recently a major medical journal group, the International Committee of Medical Journal Editors, agreed that scientists submitting material will have to disclose a wide array of potential conflicts ofinterest: potentially including their political views and minor children’s’ financial situations.

And a bill has been introduced in Congress that would require medical companies to put a listing of their payments to physicians online. The bill is currently in committee.

One professional organization gave the UVa moves limited praise. “The National Physicians Alliance applauds the University of Virginia School of Medicine for publicly disclosing by name all large industry payments to its faculty members,” wrote Dr. Jean Silver-Isenstadt, the group’s executive director, in an e-mail. “The first step to eliminating conflicts of interest in medicine is to acknowledge the scope of industry relationships with physicians and to examine them. This is a great step in the right direction.”

The American Medical Student Association, which is loosely affiliated with the NPA, rates UVa’s medical conflict-of-interest policies as a “B.” The group lists the university’s reporting policies as good, but not model, policies.

Companies are still allowed to have business relationships with doctors. And they can give donations to the School of Medicine itself, though they can no longer say how the money is to be used.

Free samples of drugs for patients are still accepted, but are strictly tracked.

And the university is cracking down on participation in corporate speakers’ bureaus. In the last year, which is reflected in the data just reported, three faculty members reported working on the bureaus.

But that’s banned now, Foreman said.

A handful of faculty members are on advisory boards for companies, including pharmaceutical companies such as Eli Lilly & Co. and Merck.

Likewise, the site lists other consulting activities doctors engage in. Some of the companies overlap with the firms owned by doctors, and lots of the consulting involves reviewing medical documents and activities related to medical research. But there are also several doctors who consult with law firms about court cases, and even one doctor on the board of directors of Virginia National Bank.

Other, miscellaneous relationships are listed, too. That information includes plenty of entries related to scientific writing, among other things.

All four categories — speaking bureaus, advisory committees, consultancies and other businesses — are only reported if the doctor pulls down more than $10,000 a year from the relationship.

Staff also own significant (more than 3 percent) stakes in separate companies. The firms run the gamut from the expected — Gene Solutions LLC and NanoMedical Systems, for example — to the oddball — such as Camryn Executive Transportation and Limousine and Feather Your Nest Interiors.

The site also lists industry sponsorship of grants and contracts, a long list.

The Institute of Medicine, the independent, nonprofit health arm of the National Academy of Sciences, addressed conflict of interest involving medical companies and industry in an April report.

The report found problems ranging from physicians failing to report income from pharmaceutical companies to their home institutions to corporate and academic scientists delaying or deep-sixing the publication of results from unfavorable clinical trials.

“Disclosure of financial relationships with industry is an essential, though limited, first step in identifying and responding to conflicts of interest,” the report reads, in part.

The report calls for standardized reporting between institutions and a federal intervention to make reporting public.

Faculty members at UVa use a standard questionnaire to report relationships, Foreman said. Nothing was turned up in the reporting process that needed to be addressed, he said.

“[Pharmaceutical companies] do play a very important role in continuing the funding of some of the research, but this just makes sure that there’s no question in anybody’s mind,” Foreman said.

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Reader Reactions

Flag Comment Posted by B.Cates on November 13, 2009 at 3:33 pm

Glad they got all those expensive high dollar made in China ballpoint pens out of the system.Sure to help solve the Health Care problem.What a joke!Most of the technology in todays system didn’t even exist 20 yrs ago.Bottom line if you want the technological advances and cures you have to pay for it.It you quit paying for it will go away.

Flag Comment Posted by poddar on November 13, 2009 at 9:31 am

Why does no one speak of supply and demand as it relates to medical care?  UVA trains a very small number of doctors each year compared to graduates in other disciplines.  Who controls how many are trained?  If we graduated as many doctors as accountants each year, supply and demand would increase competition, lower costs, and increase access, would it not?  And why do I never hear folks like Liberty mention the government control of licensing that I believe is strongly influenced by those in the medical profession when they talk of free markets?  Why don’t we have a strong network of physician’s assistants who perform non-surgical procedures like prescribing prescription drugs for non-life threatening illnesses?  Do I really need a board-certified physician to prescribe amoxicillin for my child?

Flag Comment Posted by Connie on November 12, 2009 at 10:01 pm

When do we get to see this information about our congressmen and office holders?

Flag Comment Posted by Liberty on November 12, 2009 at 5:38 pm

Most doctors do NOT profit from the CYA test they order.

Health insurance cost would come down dramatically almost immediately if it was bought and sold across state lines.
The Domocrats don’t want to do that because it would interfere with their primary goal….iniversal health care with them in control of our lives and 1/6th more of the economy.
NO THANKS.

Flag Comment Posted by Wilbur on November 12, 2009 at 4:24 pm

B. Cates, frivilous lawsuits, undoubtedly, add some cost to medical malpractice insurance rates. But, ultimately, the rates are more associated with actual medical malpractice. Don’t believe for a minute that the doctor profits from every single procedure adn test that is done. Maybe a bit of CYA, but much more of fill the wallet. The enitre healtcare debate, which is supposed to be about controlling the cost of healthcare, has been shifted to controlling the cost of insurance. Insurance rates, which are controlled by the government (state insurance commissioners)are directly related to the cost of medical care. Fix the outrageous cost fo healthcare and the cost of insurance premiums will follow.

Flag Comment Posted by Liberty on November 12, 2009 at 3:31 pm

Where can we find the same information about professors and attorneys?

Flag Comment Posted by Paul on November 12, 2009 at 11:08 am

Here is the link

http://www.healthsystem.virginia.edu/internet/research/data2008.cfm

Flag Comment Posted by B.Cates on November 12, 2009 at 10:40 am

Regarding tests see Tort Reform.The reason Docs run so many tests is easy.CYA(cover your deleted) vs rediculous lawsuits.Hopefully somebody is making a profit on the many tests,MRIs,Xrays etc or else how would you keep the doors open.

Flag Comment Posted by saltydog on November 12, 2009 at 10:00 am

A more noble thing to do would be for UVA to post its profit margins on all of the tests it performs. My guess is that we would see a direct correlation between the frequency and profit margins, and a corresponding correlation on lack of frequency with tests that they either lose money or break even on.

UVA nets a million dollars a day in profits which it uses to subsidize the tuition of the students (annual cost is 55k per student educated)

The doctors getting a little graft is like a dieter worried about the number of sprinkles on her chocolate sundae.

Flag Comment Posted by Wilbur on November 12, 2009 at 7:56 am

Nice article. But, where is the link to the website?

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