The big topic at the American Medical Association's annual meeting this summer was not Michael Moore's Sicko but the AMA's sic-ing drug salesmen on doctors by selling its database.
By selling the names, office addresses and practice types of almost every doctor in the US to marketing firms the AMA makes $50 million a year charged the National Physicians Alliance, American Medical Student Association and Prescription Project which protested at the Chicago convention.
The AMA database, called the Physician Masterfile, is used by Health Information Organizations (HIOs) for data mining and detailing which reveals individual doctors' prescribing profiles to help drug salesmen.
Information about more than 900,000 physicians is included in the AMA data selling scheme, two-thirds of whom are not even members of the AMA.
"The pharmaceutical industry's practice of marketing drugs to doctors by creating prescriber profiles intrudes into the private doctor-patient relationship and affects the quality of patient care while driving up the cost of healthcare," said National Physicians Alliance President Lydia Vaias, MD.
"Doctors are not aware that companies are out there that know every prescription a doctor prescribes," added Dr. John Santa an internist at the Portland Veterans Affairs Medical Center working with the Prescription Project, a coalition to curb drug companies' access to doctor prescribing information.
Forty percent of doctors surveyed by the Kaiser Family Foundation were unaware of the data sales and once told, 74 percent disapproved.
Last year, the AMA attempted to stop states from banning such doctor data sales--Vermont just restricted the practice and Maine might be next--by self-policing and creating a Physician Data Restriction Program (PDRP) which lets doctors "opt out" of having their data sold. So far, 8,000 have done so.
But why should the opting out burden be on doctors, some of whom have never heard of the program and/or don't belong to the AMA (which requires those opting out to register on the site) ask Prescription Project physicians who think it should be an "opt-in" program in which doctors consent before their identifying data is sold.
In discussing the doctor data sales on its web site, the AMA sounds like the little boy who didn't hit his brother and even if he did it wasn't hard and even if it was hard, he deserved it.
First it says it doesn't sell the data--or even have it. Then it says it only sells the data to "prevent fraud and abuse," assist accreditation and help the government with national disasters like Sept. 11th and Hurricane Katrina.
Then it says it DOES sell the data "for use by pharmaceutical companies" but that the organizations would get it anyway. (They "have multiple sources of physician data independent of the AMA.")
THEN it says that selling the data lets the AMA "exert regulations on how physician data are used," so it's really Protecting Doctors, albeit from itself.
We're also told that selling doctor data facilitates "efficient drug recalls," and "Food and Drug Administration's ongoing post-approval assessment of drug benefits versus risks"--Big Pharma is really just a humble NGO--and it even helped rebuild patient records after Hurricane Katrina.
Not surprisingly, Verispan, one of the two biggest health information organizations, also hums the National Anthem in defending commercial use of doctor data.
"Improvements in healthcare quality, cost management and patient safety hinge on access to more healthcare information, not less," it says on its web site; "prescriber-level information" significantly "contributes to patient health, safety and quality of life."
But doesn't a physician have the right to health care privacy like patients?
Not necessarily. A New Hampshire court recently ruled that NOT making such data available violated the First Amendment rights of drug marketers.
And two years ago the AMA gave a similar nod to drug marketer provenance when it refused to recommend a ban on prescription drug ads because it "would violate drug makers' free-speech rights" and the "ads have helped increase awareness and reduce stigmas about certain disorders, including mental illness." Months earlier increased awareness of certain disorders necessitated black box warnings on antidepressants for children.
Protesting the data sales, Michael Ehlert, MD, president of the American Medical Student Association, says the AMA should be a leader in "ensuring that doctors are making prescribing choices based on science, not marketing" and that physicians should do all they can to "combat the presence of the pharmaceutical industry that works hard to insert itself into important medical decisions."
But the AMA contends that sales reps perform a valuable service by helping to get "public health and education to the right doctors when new products or devices have come on the market." Funny that's what the Merck ad on the AMA web site says too.
Martha Rosenberg's work has appeared in the Chicago Tribune, L.A. Times, San Francisco Chronicle, Boston Globe, Providence Journal. Arizona Republic, New Orleans Times-Picayune and other newspapers. Now she also shares her views with YubaNet.com's readers.
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