BMJ columnist holds doctors to a higher standard over industry payments

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Here in the UK the on-going ‘Leveson inquiry’ has been investigating the practices of the press, as well as its relationship with the police and politicians. It is alleged to have revealed illegal undisclosed payments made by the press to public officials. This is clearly intolerable and wrong but results from a cultural change. In the latest edition of the British Medical Journal, columnist and general practitioner Dr Des Spence draws parallels between this wholly unhealthy situation and a very similar situation that exists in the medical profession [1].

Here’s some excerpts from Dr Spence’s column:

…thousands of pounds and other large payments in kind have been made to doctors in the past few decades. These payments continue and are widespread and undisclosed. This is clearly intolerable and wrong.

The paymasters have been Big Pharma and device manufacturers.

The smell of improper behaviour didn’t come just from Big Pharma but from doctors too. Without the collusion of doctors, Big Pharma would never have been able to operate its corrosive marketing and hospitality culture. We are just as much to blame, for often our behaviour was inappropriate. I believe that doctors should cease to receive all payments from drug companies. Any external witness would find it unacceptable that highly paid public servants accept large undisclosed payments and hospitality (however this might be dressed up as “advisory fees” and “educational support”) from private companies. Some doctors suggest that we are professionals with a higher code of ethics than others, so these payments do not affect our judgment. This is not true.

Dr Spence makes the point that there is talk of disclosure of payments to doctors which, he suggests, is a bare minimum even if these payments are not stopped. He then goes on to take a swipe at the General Medical Council – the organisation whose job it is to regulate doctors and maintain professional standards. Dr Spence continues:

To make this work the industry needs the cooperation of the General Medical Council, a flatfooted institution that has repeatedly failed to acknowledge, deal with, and protect the public from potential conflicts of interests of doctors. In this time of social change we must work with the industry to establish a new working relationship. Medical regulators need to wake up and smell the public mood, for undisclosed payment to NHS public servants stinks.

It’s good to see a doctor stick his head above the parapet and ‘do the right thing’. I think in this column Dr Spence holds us doctors to a higher standard, and many in the profession might do well to take note.


1. Spence D. Medicine’s Leveson BMJ 2012 (Published 7 March 2012)

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